Kimberly Ruth Noyes is on trial facing a charge of second-degree murder in the death of neighbour John Fulton, 12. (CBC)

A woman accused of murdering her 12-year-old autistic neighbour awoke the morning after he was killed and thought it had all been a dream, a forensic psychiatrist testified at her trial Monday.

Kimberly Ruth Noyes, 43, is charged with second-degree murder in the death of John Fulton in Grand Forks, B.C., last summer. The boy's body was found in her home two days after he disappeared on Aug. 13, 2009.

Dr. Roy O'Shaughnessy was the first psychiatrist to interview Noyes, a month after the slaying.

"She was clearly having delusions of thought processes. Her capacity to adequately determine impulse or thought was grossly distorted," O'Shaughnessy told the court in Rossland on Monday.

Noyes told O'Shaughnessy that she woke up and thought Fulton's death had been a dream, "until she went downstairs and saw the body."

O'Shaughnessy said Noyes was still in a depressed, psychotic state at the time of the interview.

"She certainly had ongoing delusions at the time of my interview. She believed the thoughts she had were not her own but implanted by others. She had lost control of her own thought patterns," O'Shaughnessy testified in B.C. Supreme Court.

Isolated and depressed

The court heard previously from Noyes' eldest daughter and other psychiatrists who had treated the woman about her delusion that she had to sacrifice her youngest daughter and then resurrect her.

John Fulton was found dead inside Noyes' home in Grand Forks, B.C., in August 2009. (CBC)

O'Shaughnessy described a dismal existence for Noyes in the month leading up to the boy's death.

"She sat at home in the dark most of the time, no heat, no electricity, no personal hygiene. She had money — the disability [cheque] was put into her account. It wasn't for lack of money. She just was unable to care for herself," he said.

She didn't trust her doctor, felt she couldn't talk to her case worker and wouldn't disclose the nature of her illness, he said.

Defence attorney Deanne Gaffar told court that Noyes believed her actions in the past were evil and "somehow preventing Jesus's return."

O'Shaughnessy agreed with another forensic psychiatrist, Dr. Shabehram Lohrasbe, who testified earlier in the trial that there was "no shadow of a doubt" that Noyes has a "major" mental illness.

"Four previous hospitalizations and documented symptoms by doctors, staff, and psychiatrists — it was well documented that she was bipolar."

When questioned about the medications she was supposed to be taking, O'Shaughnessy said doctors can be caught "between a rock and a hard place" because treating the depression symptoms can cause the manic symptoms and vice versa.

"Three-quarters of patients get a good response [from medications for depression] but with bipolar, it could push a patient over the edge, triggering a [manic] episode," he said.

The trial continues Tuesday, when the defence is expected to call witnesses.