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Bowe Maddigan may have been faking his psychotic state in hospital after allegedly raping and murdering Wangaratta girl Zoe Buttigieg.
The 11-year-old’s body was discovered in her Inchbold Street home on the morning of October 25.
Psychiatrist Jennifer Ellix assessed Maddigan, now 30, for three days at Wangaratta Hospital after he was caught by police before deciding he was fit to be interviewed.
She found he “may have been feigning some symptoms” and did not have a psychotic illness.
“It's an opinion because his presentation wasn't consistent … there is no test,” Dr Ellix told Wangaratta Magistrates’ Court on Thursday.
“When I spoke to him he would be hearing things.”
But when Maddigan spoke to nurses, he was clear and attentive.
Maddigan faced court for a three-day committal hearing, charged with murder and two counts of sexual assault.
Legal aid defence counsel Stephen Payne argued a defence of mental impairment.
The court heard he was drinking and smoking cannabis with Zoe’s mother on October 24 and was happy as the centre of attention.
Paramedic Martin O’Sullivan assessed Maddigan early the next morning and discovered the man had become paranoid and was hallucinating.
“He was acting very abnormally,” he said.
“His mood was changeable … from quite tense and distressed and excitable, to relaxed and happy.”
The hospital’s locum psychiatrist admitted Maddigan as an involuntary patient based on concerns over “paranoid delusion” and noted blood splattered on his foot.
The accused was kept in seclusion without a television or clocks.
“He was unable to give a description of recent events, except I followed the white line,” Dr Ellix said.
The court heard Maddigan had walked more than 10 kilometres south of Wangaratta before police found him on the side of the Hume Freeway at Glenrowan.
He had been prescribed seroquel, which can be used as antipsychotic medication, but Dr Ellix said his dose of 25mg would only have been used to help him sleep.
“It's the lowest dose you can get, it's not an antipsychotic dose,” she said.
“It's used for people feeling a bit anxious, a bit edgy.”
Senior Constable Sarah Edwards gave evidence Maddigan appeared sad, scared and startled when police found him on the freeway.
“When we made sudden movements, he would jump,” she said.
Forensic pathologist Victoria Francis said she examined Zoe’s body and discovered “an area of purple discolouration” on her vagina, which was a “possible overlying injury”.