Gabrielle Giffords shooting suspect may soon be mentally fit for trial after judge orders four more months of psychiatric care

The man accused of wounding Congresswoman Gabrielle Giffords could be declared mentally fit for trial after a further four-month stay in a prison hospital.

U.S. District Judge Larry Burns made the decision as Jared Lee Loughner sat nearby, listening intently and quietly. The 23-year-old's demeanor was in stark contrast to his last court appearance in May, when an angry, loud outburst got him kicked out the courtroom.

Burns noted during yesterday's hearing in Tuscon, Arizona, that Loughner wasn't smirking and that, for once, was paying attention to the proceedings.

'There's reason to be optimistic he will recover and be able to assist in his case,' the judge said in ruling there's a substantial probability Loughner's mental health could be restored. 'The court finds that measurable progress has been made.'

Experts have concluded Loughner suffers from schizophrenia, and prosecutors claim he can be made competent with more treatment. But Loughner's attorneys argue prosecutors have failed to prove that his condition will improve enough.

Loughner has pleaded not guilty to 49 charges stemming from the January 8 shooting in Tucson that killed six and injured 13, including Giffords.

During the hearing, a psychologist testified that Loughner has improved to where he understands that he killed people and feels remorse about it, and can be made competent to stand trial within eight months.

Loughner is still delusional but has made strides during the past four months at the Springfield, Missouri, facility, Dr. Christina Pietz said.

When he first arrived, Loughner was convinced Giffords was dead, even though he was shown a video of the shooting.

'He believed it had been edited' by law enforcement, Pietz said.

Now that Loughner is being forcibly medicated with psychotropic drugs, 'he knows that she (Giffords) is alive.'

'He is less obsessed with that,' Pietz testified. 'He understands that he has murdered people. He talks about it. He talks about how remorseful he is.'

As Wednesday's hearing dragged on, Loughner swiveled back and forth in his chair at times, and sighed as the talk turned to video surveillance of the shooting and later his delusions.

But for the most part, he sat still and expressionless. He looked thin and pale and was wearing a white T-shirt and khaki-colored prison pants. He had closely cropped hair and sideburns, and his wrists and ankles were shackled.

According to transcripts of Loughner's May 25 appearance, he interrupted the hearing by blurting out: 'Thank you for the free kill. She died in front of me. Your cheesiness.'

Loughner appeared thin and pale (right) during his courtroom visit yesterday - in a stark contrast to his previous appearance (left)

Federal marshals whisked him from the courtroom, and he watched the rest of the hearing on closed-circuit TV from a separate room.

The judge required Loughner's presence at yesterday's hearing, even though his lawyers objected and argued traveling would be disruptive for their mentally ill client.

Loughner wanted to attend so he could see his parents, who live in Tucson and were at the hearing. They sat in a back corner of the courtroom, holding hands and whispering to each other.

Several survivors of the shooting spree also were at Wednesday's hearing, including Giffords staffer Pam Simon and Daniel Hernandez, the intern who helped Giffords at the scene. Also in the courtroom was Giffords spokesman Mark Kimble, who stood only a few feet from the congresswoman when she was shot.

Pietz testified that Loughner remains on suicide watch but is no longer having auditory hallucinations.

Extending his stay at the Missouri facility by eight months will give him enough time to become mentally fit for trial, she told the judge.

'He has already made improvements, and he has only been on medication for 60 days,' she said.

'Given the progress he has made today, I have no reason to think he wouldn't continue to make progress.'

Burns, in the end, decided to extend the stay for four months, adding that he would have to see more 'measureable progress' before he could add more time.

Burns also ruled that officials can continue medicating Loughner based on the prison's finding that he's a danger to himself.

Prison officials have forcibly medicated Loughner with psychotropic drugs after concluding at an administrative hearing that he posed a danger at the prison.

Loughner's lawyers have been seeking to have the judge, rather than the prison, decide whether Loughner should be medicated.

Loughner's medications include the sedative Lorazepam, the antidepressant Wellbutrin and Risperidone, a drug used for people with schizophrenia, bipolar disorder and severe behavior problems.
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