A doctor who strangled his housekeeper has been sectioned under the Mental Health Act.
Dr Abdalla Eltom, 52, used a necktie to strangle 48-year-old Premawatnie Dolamullage, from Sri Lanka, at his home in Thornton, Merseyside.
He admitted manslaughter on the grounds of diminished responsibility, telling Liverpool Crown Court he carried out the attack while severely depressed.
Eltom had first suffered depression while working at Ormskirk Hospital.
After the killing, Eltom had walked into a police station and confessed.
When asked why he had carried out the killing, he had said: "She was feeding us poo."
Police had investigated whether there were other explanations for the killing, including the possibility that Eltom and Miss Dolamullage had been having an affair, but could find no logical explanation.
The court heard she had been Eltom's housekeeper and nanny to his three children for four years.
She was considered part of the family and called Eltom "Baba" and his wife "Mum".
Psychiatrists agreed he was suffering from severe depression.
He told them he was worried Miss Dolamullage had been using dirty cloths, which may have infected his family, and also claimed she had thrown away his clothes.
The court was told Eltom had suffered depression while working at Ormskirk Hospital, Lancashire, believed to have been triggered by an incident in which he sent home a patient with chest pains who later died.
He had quit his job and continued seeing a psychiatrist but his wife, a neurology specialist, said he had stopped taking his anti-depressant medication.
Ordering Eltom to be detained indefinitely at a secure hospital, Mr Justice Royce said the killing was a tragedy for all concerned.
He said: "This case is a tragedy for the victim and her family, and it is a tragedy for you and your family."