SALT LAKE CITY -- A street preacher charged with kidnapping teenager Elizabeth Smart was removed from court Tuesday after shouting Biblical admonitions, the fifth time he has been removed from hearings.

Brian David Mitchell was in his defense chair only seconds before the outburst: "Awaken, arise Israel. Come forth, Babylon. Repent, repent for the kingdom."

Mitchell's loud voice could be heard from down the hall after he was taken away from the hearing to gauge his mental fitness for trial. The hearing resumed Tuesday after a two-month break.

Psychiatrist Noel Gardner, who testified in March that Mitchell was competent to stand trial, said Mitchell's conduct Tuesday was "outrageous and bizarre" but not evident of a mental disease.

"I think his [religious] ideas are extraordinarily irrational, but just because you're irrational doesn't mean you have a mental disease. All of us hold irrational ideas," Gardner testified.

Gardner, who interviewed Mitchell's parents and siblings but not him, said Mitchell grew up in a dysfunctional family headed by a father who spent years writing a "metaphysical" book of religion.

Mitchell was not close to his father but admired him and was disrespectful of his mother. He experienced a troubled childhood and dropped out of school, Gardner said.

Mitchell was cleared by mental health experts when he gave up two children from his first failed marriage, though he pointedly refused to let his mother adopt the children.

Gardner described Mitchell as no different from millions of people with firm religious beliefs but said he veered into narcissism and a delusion of prophecy.

"Several of his siblings said they never heard him apologize or admit he was wrong -- that's classic narcissism," Gardner said.

The competency hearing was to resume Wednesday.

In spite of Mitchell's repeated interruptions, Judge Judith Atherton has allowed the hearings to continue without him.

Prosecutor Kent Morgan described the drawn-out competency proceedings as the "last shot" by a team of public defenders trying to avoid trial.

Defense lawyers would not comment and did not immediately respond to an Associated Press request to speak with Mitchell.

Mitchell, 51, a self-proclaimed messenger of God, is accused of kidnapping then 14-year-old Elizabeth in 2002, sexually assaulting her and keeping her as his second wife.

Mitchell and his wife, Wanda Barzee, 59, are charged with kidnapping, aggravated sexual assault, aggravated burglary and attempted aggravated kidnapping. He is also charged in the attempted abduction of Elizabeth's cousin.

Barzee, who has filed for divorce, has been ruled incompetent to stand trial and is being treated at a state facility.