Shane Todd had major depression, says psychiatrist

SINGAPORE - The psychiatrist who treated American researcher Shane Todd confirmed on Thursday that he had suffered from depression.

But Dr Nelson Lee stopped short of saying whether his 31-year-old patient had harboured suicidal thoughts in the time leading to his death.

The body of Dr Todd was found hanged in his apartment last June, but his parents do not believe he had killed himself.

Forensic evidence, including that from reconstructions of the scene and pathology reports presented by the state at the inquiry earlier, seems to suggest a case of suicide.

Dr Lee, however, could not shed more light on the witness stand on Thursday to support the case for the state or Dr Todd's parents.

This was because Dr Todd visited him only once, and did not return for his follow-up three weeks later. "At the end of the day, patients may not tell you anything, especially if it was a first visit," he said. The psychiatrist from the Psychological Wellness Centre told the court he saw Dr Todd on April 4 last year. This was after a referral from general practitioner Yeo Sze Kin, whom Dr Todd had visited about a fortnight earlier on March 17, complaining of stress.

Dr Lee said that during their session, which lasted about an hour, Dr Todd complained about stress and anxiety due to work and life issues. He concluded that Dr Todd was suffering from "major depression with a significant component of anxiety", and prescribed 26 tablets of the anti- depressant Lexapro for him.

State Counsel Krystle Chiang pointed out to Dr Lee that 19 Lexapro tablets were found at Dr Todd's apartment following his death, which suggested that he took only seven of the daily-dose tablets over two months.

In response, Dr Lee said the seven pills - whether taken sequentially over a week or erratically - would have had "no effect at all", and a patient with moderate to severe depression would still experience a "feedback loop" of negativity if left untreated.

Lawyers engaged by the Todd family, however, asked Dr Lee: "What if it was a situation where I not only removed the stress trigger, I'm taken back to an environment where I would be loved, taken care of, protected. Without medication, would that person's mood improve?"

Dr Lee agreed that the scenario may improve a patient's mood.

Ms Chiang asked if Dr Todd may have masked his suicidal tendency by telling Dr Lee he had no "suicidal ideations" during a suicide risk assessment, even though he started visiting suicide-related websites three weeks before he saw Dr Lee.

But lawyers for the Todd family countered, saying as a "trained clinician", Dr Lee was likely to have been able to pick up suicidal tendencies. Dr Lee agreed that a patient's state was likely to "betray the (true) situation", but said a suicide risk assessment was never 100 per cent predictive.

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