Orion Krause appeared before a judge today and was ordered to undergo a psychological examination.
Authorities believe he used a baseball bat Friday to murder his mother, his grandparents and a home health care worker who was caring for his grandparents.
Officials said they all died from blunt force trauma.
A shock to people back in the Rockport area where Krause attended the local high school and was known as a gentle person.
The victims were identified as Frank Darby Lackey III, 89; Elizabeth Lackey, 85; Elizabeth Buffy Krause, 60; and Bertha Mae Parker, 68.
A neighbor told reporters Krause was nude and bloody Friday when he showed up at the persons door to say he had murdered four people and needed help.
A motive for the alleged crime is still unclear.
Krause will be held without bail pending a competency hearing.