The ruling by Judge Larry A. Burns of Federal District Court suspends the court proceedings against Mr. Loughner while the suspect, who experts said has schizophrenia, undergoes treatment at a federal psychiatric facility in Springfield, Mo.
Before the judge’s decision, Mr. Loughner disrupted the hearing with an outburst that prompted deputy marshals to carry him from the room. He will return to court on Sept. 21, when the judge will review again whether Mr. Loughner understands the 49 charges against him and can assist in his defense.
It remains possible, legal experts said, that Mr. Loughner will never be found competent, and could remain in a psychiatric facility indefinitely, but prosecutors said they hoped the trial would resume. “Our goal has always been and always will be to go to trial,” said Dennis K. Burke, a United States attorney, speaking to reporters outside the courthouse.
Mr. Loughner, 22, looked haggard when he walked into court in shackles. Shaved bald and standing erect during his first court appearance in January, he now has long sideburns and unkempt hair and walks stooped over. He rocked back and forth in his chair during the proceedings, buried his face in his hands midway through and interrupted the judge with an outburst.
“Thank you for the freak show,” he appeared to say. “She died right in front of me. You’re treasonous.”
Other witnesses heard him say, “Thank you for the free shot,” and court officials were reviewing the recording to confirm.
A lawyer close to the case said that Mr. Loughner continued to believe he killed Ms. Giffords and that he has clashed with his lawyer, Judy Clarke, who told him the congresswoman survived a bullet wound to the head.
Expecting that he might act out, security personnel were positioned within two feet of Mr. Loughner and quickly spirited him out of the room. He was escorted back moments later and told the judge he would prefer to watch on a television screen in an adjoining holding cell.
Judge Burns’s ruling that Mr. Loughner was incompetent followed the recommendations of two experts, Christina Pietz, a psychologist who works for the Bureau of Prisons and was appointed by the prosecution, and Dr. Matthew Carroll, a psychiatrist in private practice in San Diego appointed by the judge.
Dr. Pietz conducted 12 interviews with Mr. Loughner over nine hours. She found that his thoughts were random and disorganized and that he suffered delusions and offered nonsensical answers to her questions. She diagnosed schizophrenia.
Similarly, Dr. Carroll found after five interviews over seven hours that Mr. Loughner experienced delusions, bizarre thoughts and hallucinations and appeared to suffer from paranoid schizophrenia, the judge said. Dr. Carroll considered whether Mr. Loughner was faking a mental illness but reported that he showed no signs of that, the judge said.
Judge Burns said he reviewed the hours of videotaped interviews and agreed with the experts’ conclusions. “At the present time, Mr. Loughner does not have a rational understanding of these proceedings,” Judge Burns said, ordering him treated for up to four months.
Paul G. Cassell, a criminal justice expert at the S. J. Quinney College of Law at the University of Utah, said psychiatric evaluations would continue to determine whether Mr. Loughner’s condition has improved. If the experts believe that Mr. Loughner can be rendered competent through psychiatric treatment, then he can be forced to take medications, said Mr. Cassell, a former federal judge.
Forcing medication raises troubling issues for society, said Cynthia Hujar Orr, a lawyer in San Antonio who is a past president of the National Association of Criminal Defense Lawyers. “Is it ethical and proper to help someone regain competence just to go after them for a death penalty offense or a murder offense?” she asked.
John Schwartz contributed reporting from New York.