CENTENNIAL, Colorado (CNN) -- Colorado movie shooting suspect James Holmes was charged Monday with 24 counts of first-degree murder -- two counts for each of the 12 people killed in the shooting.
Twelve of the murder counts cite "deliberation," and 12 cite "extreme indifference" to the value of human life.
The 24-year-old former doctoral student also was charged with 116 counts of attempted murder -- two for each of the 58 moviegoers wounded in the attack. Finally, he was charged with one count of felony possession of explosive devices and one count related to the use of an assault weapon, a shotgun and a handgun during the incident.
The 142 counts are all in connection with the July 20 massacre in the Century Aurora 16 multiplex.
Shackled around his wrists and ankles, Holmes was escorted into Arapahoe County Courthouse by two sheriffs deputies. Five other sheriffs deputies were standing in the courtroom.
During the hearing, Holmes appeared calm and frail. He sat at the right edge of the defense table, his dyed-orange hair matted on top, its roots dark.
For a while, he stared blankly at the judge's bench but appeared to be aware of what was going on. When the judge asked him whether he understood why his attorneys were asking for more time before a hearing, he said softly, "Yes."
About half of the approximately 120 seats in the courtroom were filled with victims or their family members; more watched on video in an overflow room.
One young man in the front row of the courtroom leaned forward and stared at Holmes without averting his gaze throughout the 45-minute proceeding.
One observer, her left arm and leg in bandages, sat slumped in her seat. Around her wrist was a hospital wristband.
"It was very important to come today to see him as who he was," MaryEllen Hansen told reporters outside the courthouse. She said her niece, Ashley Moser, miscarried and was left paralyzed in her legs by the shooting; Moser's 6-year-old daughter, Veronica Moser-Sullivan, was killed.
"I got a sense that he was very aware of what was going on," Hansen said. "He had an expression and kind of a persona of evilness to him. But he looked very sane to me, he really did."
Asked if she favors the death penalty, the retired school principal said, "I'm a Christian and I do believe that he should probably be locked away and live with what he did every day of his life."
In his initial court appearance last Monday, Holmes appeared dazed and did not speak.
Arapahoe County District Attorney Carol Chambers said last Monday that deciding whether to pursue the death penalty would take time, since it would involve input from victims and their relatives.
Authorities have remained silent about a possible motive in the case.
A court document filed Friday revealed that Holmes was a patient of a University of Colorado psychiatrist before the attack.
The disclosure was made in a filing by Holmes' public defenders requesting that authorities to hand over a package he sent to Dr. Lynne Fenton at the university's Anschutz Medical Campus, where he had been studying neuroscience before announcing earlier this month that he was withdrawing from the program.
The package seized by authorities under a July 23 search warrant should remain confidential, protected by the doctor-patient relationship, the request said.
"The materials contained in that package include communications from Mr. Holmes to Dr. Fenton that Mr. Holmes asserts are privileged," said the document. "Mr. Holmes was a psychiatric patient of Dr. Fenton, and his communications with her are protected."
In response, prosecutors asked for Arapahoe County District Judge William Sylvester to deny Holmes' request, saying it contained inaccuracies including claims of media leaks by government officials that in reality may have been fabricated by news organizations.
The package is expected to be the focus of a status hearing set for August 9.
Prosecutors say they will begin turning over thousands of pages of discovery in the next couple of days. The defense says they need this information to prepare for the hearing.
During the week of November 12, attorneys expect a preliminary hearing and an evidence hearing that will include several days of testimony.
Monday's court appearance comes after a weekend of funerals and memorial services for the victims. On Saturday, family and friends gathered outside Dayton, Ohio, to honor Matt McQuinn, who died while shielding his girlfriend from gunfire.
"Greater love has no one than this, that he lay down his life for his friends," said Herb Shaffer, McQuinn's uncle. "In a moment of crisis, you don't have time to think about what you're going to do, all you have time is to react."
Jessica Ghawi was remembered in San Antonio, Texas, by her brother, Jordan, who encouraged mourners to turn the tragedy into something positive. "If this coward could have done this with this much hate, imagine what we can do with this much love," he said.
Ghawi, a 24-year-old aspiring sports broadcaster, had narrowly avoided a shooting incident at a Toronto mall less than two months before the killings in Colorado.
"If you're putting your dreams on hold, you stop that right now," her brother said. "You don't know how long you have here."
A private service was held in Crystal Lake, Illinois, for John Larimer, a 27-year-old Navy petty officer, who received full military honors.
Ten survivors remained hospitalized on Monday, three of them in critical condition.