Judges at the International War Crimes Tribunal in The Hague have ordered a psychiatric examination to be carried out on the former Yugoslav president, Slobodan Milosevic.

A spokesman for the court said the examination will assess the mental strain that his trial - now in its ninth month - is having upon him.

The judges have also ordered a new medical report by a Dutch cardiologist to look into Mr Milosevic's complaints of exhaustion.

There are mounting concerns that his refusal to appoint a defence lawyer is taking its toll on his health and disrupting his trial.

His trial was adjourned on Tuesday for the fifth time after Mr Milosevic said he was unwell.

Last week there were also no hearings in the case as Mr Milosevic, aged 61, complained of exhaustion and fatigue.

The latest adjournment comes after Mr Milosevic on Monday rejected prosecutors' demands for him to be obliged to take a defence lawyer, in order to speed up proceedings.

He accused the prosecution of trying to stop him speaking and vowed to continue with his own defence.

New concerns

Judges had ordered a medical report that is to focus on "the current state of health of the accused, when he is likely to be able to resume the trial and the prognosis as to his future fitness".

This should be filed within seven days, while the psychiatric report is expected within 14 days.

After extensive health checks earlier this year, doctors found Mr Milosevic was facing "severe cardio-vascular risks" and recommended shorter trial days, but it is the first time there has been any concern about his mental health.

The new system, designed to ease the workload the former Yugoslav president, began with the second part of the case, focusing on Bosnia and Croatia, started on 25 September.

The former Yugoslav leader has suffered several times from influenza, causing long adjournments in the trial, which began in February.