Stoloff has treated Rohde since September 2016 - shortly after Rohde was arrested, the court heard on Wednesday.

"When I saw Jason in November 2017, he was in a sad and lonely place and there has been a dramatic deterioration since then," said Stoloff.

Judge Gayaat Salie-Hlophe asked Stoloff to provide an explanation for Rohde's failure to appear in court on Monday.

The witness testified that Rohde displayed symptoms of severe manic-depressive episodes, which include negative effects on his ability to solve problems and to concentrate.

In Stoloff's expert opinion, Rohde should be hospitalised for two to three weeks under intensive medication, he told the court.

"I am concerned about Jason's level of despair and the risk to self."

A dishevelled-looking Rohde appeared in court in handcuffs, after spending Tuesday night in the cells of Stellenbosch police station.

Stoloff testified that Rohde was wheeled to the police vehicle that transported him from his medical institution to Stellenbosch.

'Degrading and demeaning experience'

"Because I was there, I can tell you that it was a degrading and demeaning experience for Jason," said Stoloff.

The State pointed out that Stoloff had only treated Rohde since 2016 and questioned whether there was an "element of deception".

Stoloff admitted that there is a possibility that Rohde could be deceiving the court, but he defended his patient.

"I know he wants proceedings to be concluded as quickly as possible," he said.

On Monday, Rohde failed to appear in court. His lawyer Pete Mihalik applied for a postponement, saying his client had been hospitalised. He also presented the court with three confidential medical reports excusing Rohde from attending the trial for six weeks.

Salie-Hlophe rejected the application, arguing that the reasons for Rohde's absence were insufficient.

She then ordered an inquiry into Rohde's mental state.

Rohde is on trial for the alleged murder of his wife Susan at Spier Wine Estate in Stellenbosch, where she had accompanied him to the annual Sotheby's conference. She was found dead in their bathroom on July 24, 2016. At first, it was thought that she had committed suicide, but Rohde has since been charged with murder and he is also accused of tampering with the murder scene. He has pleaded not guilty.

Salie-Hlophe postponed the matter to February 21 and ordered that Rhode be released on bail on condition that he remains hospitalised.

He was warned to inform the investigating officer is he was discharged from his medical facility sooner.

News24