A man who police say confessed to strangling Etan Patz was charged with second-degree murder on Friday, 33 years after the 6-year-old boy vanished from his New York neighborhood and soon changed the way the nation responds to missing children.

Pedro Hernandez, 51, who worked as a stock boy in a small food store on the Manhattan SoHo street where Patz was last seen on May 25, 1979, was charged with a single count of second-degree murder, according to court records.

According to a one-sentence charging document, Hernandez told police that he "strangled Etan Patz and placed him inside a plastic bag, thereby causing the death of Etan Patz ... in the basement of 448 West Broadway."

"The defendant had made statements that he in fact killed Etan Patz. In addition, a number of years ago, he made admissions to civilian witnesses that he had been involved in the killing of a young boy in Manhattan at that time," said Assistant Manhattan District Attorney Armand Durastanti.

"It has been 33 years and justice has not yet been done," Durastanti said at a brief arraignment hearing.

Hernandez's lawyer, Harvey Fishbein, sought to cast doubt on the confession, saying his client has a "history of hallucinations, both visual and auditory."

Hernandez, who is being held without bail, did not appear in court for his arraignment and was shown remotely by video link from New York's Bellevue Hospital, where he was moved on Friday. He was shown sitting with his hands cuffed, flanked by his lawyer and a police officer, and wearing an orange jump suit.

Fishbein, a court-appointed attorney with lengthy experience using psychiatric defense tactics, requested a psychiatric exam to determine Hernandez's "fitness to proceed." He said Hernandez has been diagnosed with schizophrenia and bipolar disorder and is on medication.

Hernandez, who was taken into custody for questioning on Wednesday and formally arrested on Thursday, will make his next court appearance on June 25.

Changed view of missing kids

Patz's highly publicized disappearance prompted President Ronald Reagan to sign into law the Missing Children's Assistance Act in 1984, sparking the start of a non-profit missing children's center and triggering enormous changes in the way police and the public respond to reports of missing children. As a result, Patz was one of the first missing children whose face appeared on a milk carton appealing to the public for information on his whereabouts.

On Thursday, New York Police Commissioner Raymond Kelly said Hernandez had confessed during in a videotaped interview that he strangled the boy in the store's basement, placed his body in a bag and dumped it in the trash. Apart from the confession, however, Kelly said police have no physical evidence.

Hernandez had been living in Maple Shade, New Jersey, where he lived with his wife and daughter.

The break in the case came a month after the FBI and New York City Police conducted an excavation of a basement in another neighborhood building, which failed to yield clues. It did, however, prompt a tip about Hernandez, who had told family members as far back as 1981 that "he had done a bad thing and killed a child in New York," Kelly said.

His confession continued to draw skepticism from those who have closely followed the case, including author Lisa Cohen, whose book "After Etan" detailed what happened after his parents agreed to let him take his first walk alone to the school bus stop. He never returned.

"There have been hundreds and hundreds of false leads and moments when they know the case was solved - and it wasn't," Cohen said in an interview on CNN early Friday.

Patz told his parents he planned to stop at the store to buy a soda before boarding the bus, and Hernandez now says he lured the boy to the basement with the promise of a free soft drink.

Perhaps nodding to the notion that authorities themselves are not satisfied with Hernandez's confession alone, Manhattan District Attorney Cyrus Vance Jr. called Friday's proceedings "the beginning of the legal process, not the end."

"There is much investigative and other work ahead, and it will be conducted in a measured and careful manner," Vance said in a statement.