He's no longer hearing voices, and he has no difficulty in understanding, Pietz said.
She was the first doctor to diagnose him with a psychotic disease, Pietz said.
He saw a psychiatrist again after he was caught drunk at school, Pietz said.
In discussion with prison officials, Loughner has said, "I'll never get out, " Pietz testified.
Loughner likes his prison jobs and he gets paid for them, which is important for him, Pietz said.
Pietz met Loughner in March 2011 and determined he had schizophrenia and wasn't competent to participate in court proceedings.
The work makes him feel proud to do well in something, Pietz said.
Loughner said if this is true, "Jared is a failure, " according to Pietz.
Pietz recounted Loughner's teenage years, saying that he appeared normal until age 16.
He wrote nonsensical things on the chalkboard, showed a disorganized thought process, and became obsessed with the Constitution, Pietz said.
Loughner became ostracized in high school, but at that point, there were no signs he would hurt anyone, Pietz said.
Then he showed symptoms of depression in 2006, and his girlfriend broke up with him and a friend died, Pietz said.
In high school, he began hearing voices and yelling out things in the classroom -- behaviors that are symptoms of schizophrenia, Pietz said.
Dr. Christina Pietz, a forensic psychologist, told the judge Tuesday that Loughner is "one of the worst" mentally ill patients she's ever seen.
He started taking medication for the first time on June 21, 2011, and over time, he expressed remorse about what he did, Pietz testified.
Loughner was disappointed and upset upon hearing the diagnosis, Pietz said.
According to records, he didn't take his anti-depression medication, Pietz said.
Loughner is worried that he will be harmed by other inmates, but Pietz said she thinks Loughner would be all right in the general prison population.
Loughner sought treatment and was diagnosed with depression, Pietz said.
Loughner told Pietz that he was especially sad about the child killed in the shooting -- Christina Taylor Green, age 9, who was remembered nationally because she was born on September 11, 2001.
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