A 42-year-old man has been sentenced to death for killing five people on Awaji Island in Hyogo Prefecture in 2015.

Tatsuhiko Hirano's mental condition was "normal" when he carried out the killings, Presiding Judge Hidenori Nagai said Wednesday in handing down the ruling at the Kobe District Court. Hirano's lawyers immediately appealed.

The focus of the trial was whether Hirano was mentally competent enough to be held responsible for his actions. He had argued during the trial that the case was a "false accusation plotted by 'operatives' who destroyed my brain and forced me to commit the murders."

His lawyers, who had sought acquittal or a lesser punishment, said he was unable to make normal decisions because of a psychotropic drug he had been taking.

Hirano was accused of fatally stabbing five neighbors with a knife in two separate homes in Sumoto, Hyogo Prefecture, on March 9, 2015. The victims were three women and two men between 59 and 84.

He was committed to a mental institution in 2005 and 2010 after being judged by local authorities to be a public danger due to mental illness.

The prosecutors, who demanded capital punishment, highlighted the fact that "he took the lives of five people who did nothing wrong."

Pointing to the brutality of the case and the numerous stab wounds on the victims, they said the influence of the psychotropic drug the defendant had long been using was "limited."