The Hiroshima High Court upheld the death penalty Tuesday for a 41-year-old man who killed five people and injured 10 others when he plowed a car into a train station in 1999 and stabbed commuters.

Presiding Judge Toshikazu Obuchi determined Yasuaki Uwabe was mentally competent at the time of the crime, supporting a 2002 district court ruling, saying he perpetrated the carnage "quite calmly."

Uwabe took 120 sleeping pills on the evening of Sept. 29, 1999, and drove a rental car into JR Shimonoseki Station in Yamaguchi Prefecture, running over seven people. He then attacked eight others in the station with a kitchen knife. Four people died that day and another victim died that December.

Uwabe pleaded not guilty, with his lawyers saying he was mentally incompetent because he had delusions he might be attacked by other people. The judge ruled there was no reliable evidence to back up this claim.

Prosecutors have said Uwabe's actions were committed out of anxiety because of business and family troubles.

Uwabe told the Shimonoseki branch of the Yamaguchi District Court that he committed the crime at the instruction of God. But in the appeals trial, he said he had lied about that.