This is maybe old hat by now, but here's part of an interview from 2004 with Justin A Frank, Director of Psychiatry at George Washington University:
"If one of my patients frequently said one thing and did another, I would want to know why. If I found that he often used words that hid their true meaning and affected a persona that obscured the nature of his actions, I would grow more concerned. If he presented an inflexible worldview characterized by an oversimplified distinction between right and wrong, good and evil, allies and enemies, I would question his ability to grasp reality. And if his actions revealed an unacknowledged - even sadistic - indifference to human suffering, wrapped in pious claims of compassion, I would worry about the safety of the people whose lives he touched.
For the past three years, I have observed with increasing alarm the inconsistencies and denials of such an individual. But he is not one of my patients. He is our president. George W. Bush is a case study in contradiction. The gulf between his personality and those policies - and the style with which they are executed - grows ever wider, raising serious questions about his behavior."
Elsewhere we read that: "The head of the world’s unchallenged hyperpower, Dr. Frank further diagnosed, "fits the profile of a former drinker whose alcoholism has been arrested but not treated." The result: a "paranoid megalomaniac", as well as “a sadist”.
Dr. Frank found Bush’s "lifelong streak of sadism” has ranged from blowing up frogs with firecrackers “to insulting journalists, gloating over state executions, and pumping his fist gleefully before the bombing of Baghdad."
Not unlike the Americans who continue to cheer him on. [This was 2004].
But at least GW has an excuse. The psychiatrist concluded that Bush’s binges "may have affected his brain function.” What is really important, Dr. Frank declared, is that because the issues around death and personal failure that led to Bush’s years of heavy boozing were never treated, “he has no capacity to take responsibility for his behavior. Black and white thinking results most often from untreated alcoholism.”