J. Richard Ciccone

Effects of lithium on evoked potentials and performance during sustained attention

Two versions of the continuous performance test (CPT) differing in complexity were administered to 15 patients with bipolar affective disorder, manic type before and after treatment with lithium. Reaction time, performance accuracy, and the late positive component (LPC) of the event related potential evoked by the task were measured concurrently. Lithium treatment decreased errors of commission on both CPT tasks, although the difference was significant only for the simpler task. Reaction time was significantly increased by lithium treatment on the more difficult CPT task, LPC amplitude to the target stimulus on the difficult CPT was significantly increased by lithium. The data are interpreted as consistent with an attention-enhancing effect of lithium, coupled with a general reduction in the tendency to respond to stimuli.

Factors predictive of changes in the legal status of psychiatric inpatients

The objective of this study was to identify factors predictive of duration of involuntary hospitalization, i.e., factors that would predict early versus late conversion to voluntary status. Charts of 209 patients admitted involuntarily to an acute psychiatric inpatient unit were studied using a naturalistic, prospective design. Multivariate regression analysis was used to determine the effect of a number of variables in predicting duration of involuntary hospitalization. Of all variables studied, only smoking preference was found to be a statistically significant predictor of duration of involuntary hospitalization. Smokers were converted to voluntary status earlier than non-smokers. The authors concluded that clinicians may not be using commitment statutes as per recommended legal guidelines. Patients who smoke may be applying overt and covert pressure on clinicians with regard to conversion to voluntary status to gain smoking privileges.

Judicial Telepresence in Involuntary Commitment Hearings

In Doe v. State , 217 So.3d 1020 (Fla. 2017), the Supreme Court of Florida quashed the decision of the Second District Court of Appeal that permitted judicial telepresence at involuntary commitment hearings. The court held that individuals subject to commitment hearings have a right to have a

The Journey to Find My Grandfather

I met my paternal grandfather, but he was a mystery to me. He had a large, locked trunk that I knew nothing about. From my point of view, he was quiet, detached, even distant. When I was a boy of five or six, he was the Nonno (Grandfather in Italian) I knew existed, but rarely saw. I was told that

Competence to Stand Trial

One of the most important and most frequent requests that courts make of psychiatrists is to give an opinion on a defendant’s competence to stand trial. It is difficult to determine the number of psychiatric evaluations for competence to stand trial in a given year in the United States. One study found that 12% of the individuals referred to a court clinic setting were referred for evaluation of their competence to stand trial. In fact, a larger number of referrals had been sent with a request for an evaluation of competence but, on further discussion with the referring person, it was clear that what was being requested in many cases was a psychiatric evaluation regarding need for treatment.