Jerusalem: Accused child sex offender Malka Leifer is not fit to be extradited to Australia to face charges, a defence psychiatrist has told a Jerusalem court.

Dr Gregory Katz, who works in Jerusalem's Kfar Shaul Mental Health Centre, was cross-examined on Wednesday.

Accused child sex abuser Malka Leifer (right) pictured in February last year. Credit:AP

Melbourne sisters Dassi Erlich and Nicole Meyer, who have been at the forefront of a campaign to have Leifer sent back to Australia to face 74 charges of child sexual abuse and rape, travelled to Israel for the closed hearing in the Jerusalem District Court.

The charges stem from Leifer's time as principal of the ultra-orthodox Adass Israel School in Elsternwick in Melbourne's south-east.