A woman who attacked two strangers with a knife had killed her mother six years before, the Old Bailey has heard.
Nicola Edgington stabbed her mother in November 2005 and disappeared for three weeks.
She pleaded guilty to manslaughter on the grounds of diminished responsibility and was made the subject of a hospital order without limit of time.
But by October 2011, while being treated in the community, she attacked the two women, who were going to work in Bexleyheath, south east London.
Kerry Clark (22) managed to fight Edgington off but Sally Hodkin (58) died when her neck was cut with a large butcher's knife.
Just hours earlier, Edgington had gone to a hospital — but walked out before she could be admitted as a voluntary inpatient.
Edgington (32), of Greenwich, south east London, denies murdering law firm accounts manager Mrs Hodkin and the attempted murder of Miss Clark, who is now 24.
Edgington claims her responsibility was diminished because of her mental state.