Psychiatrists offer differing views at teen's double murder trial
From Jim Polk
CNN
CHARLESTON, South Carolina (CNN) -- A state psychiatrist who began seeing 12-year-old Christopher Pittman two weeks after he shot and killed his grandparents testified Thursday that the now-15 year old knew what he was doing was wrong.
Pamela Crawford said once Pittman decided to kill them, he waited until they were asleep before entering their bedroom with a shotgun.
"That's significant," she testified. "It shows planning. It shows at least some clear thought."
Prosecution testimony will continue Friday and closing arguments are scheduled for Monday.
Pittman is being tried as an adult on two counts of murder in the November 2001 slayings of Joe and Joy Pittman.
Authorities said he admitted the killings when they captured him the next day.
Defense attorneys contend that Zoloft drove Pittman to kill.
The prosecution argues Pittman shot his sleeping grandparents to death because he was furious over being told he might be sent back to his home in Florida following a scuffle on the school bus.
Crawford testified Thursday that Pittman told her he burned down his grandparents' home outside rural Chester, South Carolina, to ensure he had time to get away.
"It shows not only that he knew it was wrong, that he knew it was legally wrong, that he knew there would be some consequence," she testified.
The forensic psychiatrist said, "It is my opinion, based on all the information, that he would have been criminally responsible" for the crimes. She said he had the mental capacity to understand and control what he was doing.
Crawford, who is employed by South Carolina's Department of Mental Health, began seeing Pittman on December 12, 2001, two weeks after his grandparents' deaths. She met with him half a dozen times over the next two months.
Defense witness says teen was psychotic
Earlier Thursday, a retired Food and Drug Administration psychiatrist testified for the defense that Pittman was manic and psychotic when he shot and killed his grandparents.
Richard Kapit was an FDA safety officer who signed off on the approval of Prozac in 1989. In the early '90s, he reviewed the protocols for the first clinical testing of Zoloft and Paxil but did not have a role in their final FDA approval for treatment of depression in adults.
Kapit said Zoloft clouded Pittman's mind.
He testified, "I do believe he did not have the ability to form criminal intent on that date due to intoxication with Zoloft."
Kapit said the child was under the influence of Zoloft the rest of the night after the slayings and the following day.
"Chris Pittman was behaving in a way that was frantic, impulsive, reckless and extremely angry," he testified. "Those are characteristic behaviors of mania."
The psychiatrist interviewed Pittman last fall, three years after the slayings. He based his opinions on two days with the boy, plus the reports of a state-employed psychiatrist who had spent a longer time with Pittman.
Pittman had been sent to live with his grandparents in South Carolina after running away from an unhappy home in Florida, threatening to kill himself and spending six days at a psychiatric center.
That clinic put Pittman on the antidepressant Paxil, and Kapit said nurses' records revealed the boy started showing almost immediate signs of anger.
On his second day on the drug, Kapit said that a nurse wrote, "He needs help managing his anger." On the third day, the notes said, "Defiant, throwing things, angry."
When his grandmother took Pittman to a physician in Chester to renew the prescription, the doctor had no Paxil on hand, so he gave the boy a sample pack of Zoloft.
Neither Paxil nor Zoloft is approved for treating children with depression, but both are widely prescribed for younger patients anyway.
The FDA has backed off an earlier warning that antidepressants such as Zoloft can cause suicidal actions among children and teens taking those medications.
In a revised warning posted last week on its Web site, the agency said the drugs "increased the risk of suicidal thinking and behavior in short-term studies of adolescents and children" with depression and other psychiatric disorders. (Full story)
News of the warning change surfaced this week in testimony at the Pittman trial.
Limiting the warning language to a risk seen in studies, rather than saying the drugs could cause suicidal behavior in younger patients, was a significant retreat for the FDA -- and came after months of pharmaceutical industry lobbying.
