Oscar Pistorius's mental health in focus

Forensic psychiatrist Merryl Vorster is being cross-examined by state prosecutor Gerrie Nel.

Oscar Pistorius arriving at the High Court in Pretoria ahead of his murder trial on 13 May 2014. Picture: Christa Eybers/EWN.

PRETORIA - The Oscar Pistorius murder trial resumed this morning with the defence's forensic psychiatrist Merryl Vorster being cross-examined by state prosecutor Gerrie Nel.

It was confirmed that the defence team will re-examine Vorster before Nel launches his application to have the athlete referred for a psychiatric evaluation.

Pistorius's mental health is under the spotlight after the diagnosis of Generalised Anxiety Disorder (GAD) by Vorster.

Pistorius is facing a charge of premeditated murder after shooting and killing his girlfriend Reeva Steenkamp on Valentine's Day last year.

Picture: Carte Blanche.

He claims she was an intruder and shot her by mistake.

The Paralympian is also facing two separate firearm-related charges and one for the illegal possession of ammunition.

On day one of his trial, he pleaded not guilty to all of the above charges.

CROSS-EXAMINATION

This morning, Vorster agreed that the diagnosis of GAD spanned the athlete's functioning in general.

She said, "It's a disorder which would affect his social, family and professional life. For anxiety to be a disorder, you have to have anxiety more often than not for an extended period of time."

Vorster also told Nel that with any disorder, there were levels of severity.

Nel asked, "If it is severe enough and impacts the person, can it be seen as a mental illness?"

The psychiatrist responded "Not necessarily. You'd have to look at the impact on the individual's ability to live and socialise and Pistorius was still able to function as a professional athlete and socialise. He had distress because of it."

She admitted that the disorder may be relevant to his version of events, but that was for the court to decide.

Nel, who seemed very careful with his questions, asked "Girlfriends have testified and not mentioned him being an anxious person. The accused is anxious about crime. Did you take that into account in your report?"

A very confident Vorster responded, "Yes. After his home was burgled, he increased security at his home. He had dogs, an alarm system and locked himself in bedroom. He said he wanted to move to Johannesburg to a house with a gatehouse and a double gate access."

Nel noted the various security measures Pistorius failed to take, saying one wouldn't expect someone with GAD and excessive security concerns to leave ladders lying around, for example.

Picture: Pool.

Vorster was forced to agree with this point.

Roux objected and said that Nel was getting some of his claims wrong.

Judge Thokozile Masipa asked Nel to be more specific.

Essentially, Nel is trying to make the point that if Pistorius really does have GAD, he must be referred for observation.

If not, then Vorster's evidence can't be accepted.

VORSTER'S REPORT QUESTIONED

Nel moved on to Vorster's report.

Vorster admitted that when she drafted the report she believed it could also be used for sentencing.

"The GAD diagnosis and his vulnerability could be considered in sentencing. A previous clinical psychologist confirmed my findings of the accused."

This admission by Vorster is very important as it suggested that the defence was planning to use GAD as a mitigating circumstance if Pistorius was found guilty.

Nel asked, "You based your report solely on the version of the accused? Isn't that biased?"

The doctor responded, "Yes" to Nel's first question and for the second answered, "It is not for me to decide on the merits of the version. It is up to the court to decide. It would be an advantage to have all the versions. But it's still up to the court to decide."

Nel argued, "Would the different version not have affected your diagnosis of GAD and the role it played?"

Vorster replied in the negative.

She said, "If there was an argument about a relationship, the person with GAD would have increased anxiety. All people get anxious in arguments. That is the nature of an argument."

The psychiatrist also admitted that, "People with GAD aren't dangerous as such, but they probably shouldn't have firearms."

Picture: Sky News.

'GAD NOT PICKED UP IN CHILDHOOD'

Nel then questioned Vorster's findings that Pistorius had suffered from GAD from the age of 11 months.

He argued that any child losing their mother would cause anxiety and that its not uncommon.

Picture: Pool.

Vorster said these were contributing factors.

"His family constantly encouraged him to be as normal as possible. That would be stressful, to conceal his disability. He would have known he was anxious, but not that he had a treatable condition."

She eventually agreed with Nel's point.

"It appears Pistorius's mother was his primary attachment figure. She died when he was a teenager."

'GAD DIAGNOSIS ELEVATED'

Nel also accused the witness of elevating the anxiety of the accused to a disorder and asked why she did this.

Vorster replied, "Clinically, he presents as having a disorder. If you look at the history, there is evidence of the disorder. His newer friends that he had were merely to avoid being lonely. They were not people he could confide in. His sexual relationships were also generally short."

The doctor claimed her findings would be relevant if the court found that Pistorius shot at what he presumed was an intruder.

"If the court finds he deliberately shot Steenkamp, my report would not play a role. He said he was scared and that he fired at the noise."

Nel almost immediately jumped at this statement.

He said, "In court the accused denied that he fired at the noise. Surely red lights must be going on for you now?"

Vorster, who seemed on the back foot with Nel's discovery said, "I would not expect him to remember with exact clarity what happened at the time."

Nel then asked for more time to consult and an early tea adjournment was granted.

Get all the latest on the EWN Pistorius trial.

Video: Nel questions Pistorius's mental state.