A judge has ordered a psychiatric examination to determine whether a former mental patient accused of hacking a Manhattan psychotherapist to death with a meat cleaver is fit to stand trial.

State Supreme Court Justice Charles Solomon directed the exam for David Tarloff on Tuesday. The judge denied a defense request for the exam in May because he wanted see whether Tarloff's psychoactive medications were working.

Defense lawyer Bryan Konoski says his 40-year-old client lacks criminal responsibility for killing 56-year-old Kathryn Faughey in her office on Feb. 12 because he is psychotic.

Konoski says Tarloff has told him to "go to hell" and refuses to speak to him. He says Tarloff also refers to himself as "the messiah."