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Jared Loughner's "major mental illness" makes him incompetent to stand trial, a federal judge ruled Wednesday. Earlier, the accused Jan. 8 shooter interrupted the proceedings with an outburst and was escorted from the courtroom.

A psychologist and psychiatrist both determined that Loughner, 22, is schizophrenic and unable to either understand the 49 charges against him or participate in his own defense in a case that carries the possibility of the death penalty.

Loughner suffers from hallucinations, paranoid delusions and irrational thoughts, the doctors said.

He will undergo four months of treatment in an attempt to restore him to competency.

Neither prosecutors or Loughner's defense attorneys disputed the reports.

U.S. District Judge Larry Burns agreed with the doctors' findings, and ordered Loughner to be taken into custody by the U.S. Attorney General and put into treatment.

"The defendant was generally unable to provide rational and coherent thoughts," Burns said, summarizing the doctors' reports.

The competency exams were done to determine Loughner's current mental state; neither the doctors' reports nor the hearing addressed his sanity at the time of the shooting.

Outburst

Earlier, Loughner was removed from the courtroom after an outburst.

"Thank you for the freak show. She died in front of me," he yelled, his voice thick and high pitched.

He continued with either "You're treasonous!" or "You're cheating us!"—his froggy voice and a wrestling match with two federal marshals made him difficult to understand.

Some in the room heard Loughner's first words as "Thank you for the free pill" or "Thank you for the free kill."

He was immediately pulled from his chair and pushed through a side door of the courtroom, where several loud slamming noises were heard.

Prior to his disturbance, Loughner was more subdued than in his previous court appearances. He didn't wear the eerie smirk he's shown before.

He wore a khaki jumpsuit, with chains attaching his handcuffs to his waist and between his ankles. He was disheveled, with his jumpsuit open. Loughner was bearded and his hair has grown longer and shaggy.

Loughner spent much of the early part of the hearing sitting quietly next to his lawyers, sometimes looking about the room. At one point he bounced in his chair for a few moments, moving his feet.

Right before he began to yell, he held his head in his hands on the defense table.

The incident came 40 minutes into the hearing, while the court was addressing the issue of public records requested by media organizations.

After a ten-minute recess, the judge questioned whether Loughner wanted to remain in the courtroom.

Burns asked if he had "calmed down a little bit in the back" and asked his attorneys if he could "comport himself as a gentleman."

During a brief reappearance, Loughner was asked by the judge if he wished to remain present at the hearing, or watch the proceedings from another room.

"I'd like to watch on the TV screen," Loughner said in a thin voice.

Incompetency finding

Loughner's inability to stand trial at this time comes as no surprise. We reported last week that the move was likely, because neither prosecution nor defense wanted to question the doctors who examined him.

The judge reviewed 40-plus page reports from both Dr. Christina Pietz and Dr. Matthew Carroll, along with 18 hours of videotaped mental examinations of Loughner.

The accused suffers from a "major mental illness," the judge said Pietz reported. He has "prominent delusions" and has "no rational understanding of the proceedings" against him.

Pietz, a staff psychologist at the Bureau of Prisons' Medical Center for Federal Prisoners in Missouri, said that Loughner was "definitely unable to provide rational or coherent answers" to questions about the legal system, the judge said.

"At times he answered simple questions with answers that were lengthy and nonsensical," Pietz said.

Loughner has schizophrenia of undifferentiated type, Pietz's report said.

Carroll's report said that Loughner has paranoid schizophrenia, Burns said as he summarized the doctors' findings from the bench.

Loughner's mental state is characterized by delusions, bizarre thinking and hallucinations, Carroll said.

Loughner was "fixated on incomplete or unrelated issues" when examined, Carroll said, and showed "illogical or confused" thinking and "psychotic beliefs."

Loughner's "irrationality is manifest" in his suspicions about his defense lawyers, Carroll reported, which "prevents him from working with them or any lawyer."

Judy Clarke, the lead defense attorney, had expressed concerns in earlier hearings about the state of Loughner's relationship with his lawyers.

Burns said that Loughner sent the court two letters about his attorneys, and hinted that Loughner had asked for a change in his lawyers.

Both Pietz and Carroll said that Loughner is not "malingering," or faking mental illness.

"The defendant’s behavior has become increasingly odd over the last two years," Burns said, citing the reports.

"Most people who fake mental illness want to be described as mentally ill, but Mr. Loughner does not. He scoffs at it," Burns said, citing Carroll's report.

About 30 victims and family members watched the hearing, which was covered by about 50 reporters.

Loughner's parents sobbed quietly as Burns read the laundry list of adjectives describing their son's mental illness. His mother, sitting near a wall, hid her tears with sunglasses.

Dozens of U.S. marshals scanned the room throughout the hearing.

Treatment

Loughner will receive treatment while in custody to bring him to a state where he is able to stand trial.

He will be returned to the Springfield, Mo., facility where he spent five weeks being examined, said prosecutor Wallace Kleindienst.

Loughner can receive medication, counseling and other treatments as doctors try to restore his competency.

"We believe he can be restored to competency with proper medication," said Robbie Sherwood, a spokesman for the U.S. Attorney's Office.

If Loughner does not cooperate with treatment, the court could order that he be given medication by force.

A hearing was scheduled for Sept. 10 to review progress in restoring him to competency, with a report to be filed with the court Aug. 31. There is a chance the hearing may not be held if Loughner is found to still be incompetent.

The incompetency finding doesn't mean that Loughner won't face trial. If he is still unable to be tried after four months, he could be held, undergoing treatment, for as long as the potential jail terms he faces: life.

Most defendants are restored to competency after receiving treatment.

Public records

Before finding Loughner incompetent to stand trial, Burns denied a move by the Arizona Republic, KPNX and the Washington Post to modify an earlier order barring the release of information on the shooting investigation by the Pima County Sheriff's Department.

Such information is generally public record in Arizona, available to inspection by anyone.

Federal rules differ, and Burns held that because the case was moved into federal court, he does not need order the documents' release under a state law.

Burns said he was mindful of "local traditions" and asked prosecutors to review the material to determine if any can be released.

Bill Badger, a retired Army colonel who was grazed by a bullet as he helped tackle Loughner on Jan. 8, filed a memorandum with the court Tuesday asking that any information regarding him be redacted before PCSD documents are released, and that his privacy rights under the Federal Crime Victim Act be upheld.

49 federal charges

Loughner is accused of killing six and shooting U.S. Rep. Gabrielle Giffords in the head in what authorities charge was an assassination attempt.

Among those killed were a nine-year-old girl and Arizona's presiding federal judge.

He also is charged with wounding 12 others at the "Congress On Your Corner" meet and greet with constituents at a Northwest Side grocery store on the morning of Jan. 8.

In March, Loughner was charged with 49 federal counts in the attack. Not guilty pleas were entered on his behalf by the court.

Fourteen of the charges Loughner faces could result in the death penalty, if the prosecution seeks it. No decision of whether to ask for capital punishment has been made, authorities have said.

Loughner likely will face local charges in the shooting incident, authorities have said, but only after the federal case is resolved.

Giffords recovering

Giffords is back in a Houston rehab facility following an operation to replace part of her skull last week.

Giffords was moved Tuesday from Memorial Hermann-Texas Medical Center to the nearby rehabilitation hospital where she has been recovering after being shot in the head Jan. 8.

Doctors replaced part of the congresswoman's skull with a synthetic plate in a 3.5 hour operation last Wednesday. A portion of Giffords' skull was removed to allow her brain to swell without causing damage after she was shot through the left side of her brain at a constituent event.

"She's doing fine, great," said Giffords' spokesman, C.J. Karamargin on Tuesday.

Giffords had remained in the hospital where the surgery was performed until doctors were sure there were no signs of infection, Karamargin said.

Giffords was also given a permanent internal shunt, to drain excess cerebrospinal fluid, during the operation.

The surgery came as Giffords' husband, Capt. Mark Kelly, was in space commanding the shuttle Endeavour.

Giffords, who watched Kelly blast off at the Kennedy Space Center, made two trips to Florida to see the shuttle lift off after the original launch was scrubbed by NASA.

Giffords will continue her rehab in Houston once she is released from The Institute for Research and Rehabilitation (TIRR) Memorial Hermann, her husband said last week in an interview from Endeavour.

Kelly is due to return to Earth on June 1.

Giffords will turn 41 on June 8, five months after she was shot.

Doctors don't know when Giffords can be released from the hospital, or when she might be able to return to Congress, they said.

"Your guess is as good as mine," said Dr. Dong Kim, a neurosurgeon who has been treating the congresswoman, at a press conference after the operation.

"We can't predict how much progress she'll make. We can't predict when she'll return to work," Kim said.

Giffords is "recovering very nicely," said Dr. Gerard Francisco, who has been managing her rehab.

Her cognition has "improved very significantly," he said, noting that "we're having meaningful, fun conversation—she's cracked me up."

"It's difficult at this juncture to make any guesses about when she'll go back to work," he said.

While doctors said they have a tentative schedule for Giffords' rehab and release, they declined to give specifics about dates.

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