A man who knifed three generations of the same family to death had been taking MDMA in the days before the savage killings, a court heard on Tuesday.
Joshua Jacques, 29, is accused of murdering girlfriend Samantha Drummonds, 27, her mother Tanysha Ofori-Afuffo, 45, her grandmother Dolet Hill, 64 and Ms Hill’s husband, chef Denton Burke, 58.
The ‘bloodbath’ took place at Mr Burke’s and Ms Hill’s home on Delaford Road, Bermondsey, southeast London, in the early hours of 25 April last year.
Hours before the killings Ms Drummond had phoned her best friend several times to raise concerns about Jacques’ mental state, the Old Bailey has heard.
In a voice note she said: ‘Josh is basically getting to the point where he could basically have an episode, like I don’t know what’s triggered him.’
Giving evidence pychiatrist Dr Raman Deo was asked about Jacques’ mental state at the time of the stabbings.
He said: ‘There is sufficient evidence to suggest that Mr Jacques was suffering from abnormality of mental function.
‘(He had) bipolar disorder that substantially impaired his ability to make a judgement.
‘He was also unable to exercise self-control, which resulted in the eventual stabbings of the victims.
‘It is highly unlikely but for his mental state that the killings would have occurred.
Jacques had been diagnosed with Bipolar type one disorder, which produced manic, psychotic symptoms.
The episodic mood disorder, which led to hypo-manic episodes or symptoms was likely to have been at least somewhat affected by Jacques’ cannabis intake.
Jacques had also been taking MDMA, a form of ecstasy, in the days prior to the deaths.
‘I am satisfied that this man would have matched the criteria for bipolar affected disorder with psychotic symptoms.
‘It was noted he appeared somewhat sedated by prescribed medication.’
Dr Deo said on the balance of probabilities Jacques was suffering from mental health issues ‘and it did significantly impair his judgement on the night in question.
‘It is my view, he was manic and paranoid on a number of issues.
‘My opinion is that on balance the abnormality of mental function arising from bipolar disorder would have been a significant factor in the killings.
‘In the days and weeks prior to the killings, he was experiencing reduced sleep, paranoia and other symptoms indicating a possible relapse of his bipolar disorder.
‘Bipolar disorder is a recognised medical condition, I do not believe at the current time, there is evidence to suggest there is any other medical condition in this case.’
Ms Ofori-Akuffo was a qualified nurse while her mother Ms Hill had worked as a housekeeping assistant at Guy’s and St Thomas’s hospital in Westminster for 21 years before retiring in 2018.
Jacques, of Minard Road, Lewisham, has admitted four counts of manslaughter but denies four counts of murder on the grounds of diminished responsibility.
The trial continues.