The law of mental health service in modern Russia as during N.M. Karamzin's period (XVII-XVIII centuries) “works” at paper. Anybody doesn't protect the social and economic rights of patients. For full citizens of schizophrenics don't consider. Them were deprived of a basal human right - on work, on active social life.

Human has always required making a healthy and ethical relationship with the environment and this has been one of the basic human needs. According to Islamic view, Islamic morality seems as like as another accepted religions such as christianity fundamental to doctor and patients relationship to govern relations with God who is very confident . Moral virtues and its knowledge are required for the effective and suitable confidentiality whose study affects the pattern to introduce the Islamic ethics.

Therefore, the study has been carried out to evaluate physician/patient relations with emphasis on the confidentiality principle. The study aims to present an appropriate step in the pattern of ethics of physician/patient relationships.in comparision of Islamic view and world accepted principalistic medical ethics rules.

This research was carried out by library method and using books (including holy Quran),facts and declrations and articles from

confidentiality. In this study, necessity to new legislation for ethical rules and need for more researches is explained . Also, in order to more explanation this talk few application examples of confidentiality in doctor and patient relationship is mentioned. Ethical decision making in cases of such as psychiatric patients as like as Tarrasof low I-II cases or in cases of AIDS anger patient who will contaminate another by needle stick needed to clear support,. Our final result and home massage is 'Both two views medical & specialized psychiatry ethics and Islamic ethics are very closely similar for saving human basic rights of course each of them has exceptions’.

Articles and studies were identified throughPubMed, Web of Science and Scopus databases as well as existing reviews. Thesearch terms included “transference”, “cognitivebehavioral therapy”, “acceptance and commitment therapy”,“schema therapy,” “dialectic behavioral therapy” Compassiontherapy“, ”ethics “in different combinations. Other relevanttexts were searched by references found articles.

Transference relationship can work inconjunction with therapy and helps to achieve its objectives, or restricts thetherapy, distorts it or blocks. For uncomplicated psychiatric disorders and tosolve simple problems CBT doesn´t address the therapeutic relationship. Conversely, therapeutic relationship becomes the focus of the therapy in clientswith personality disorders. It can be used to identifying automatic thoughts, dysfunctional assumptions and core beliefs well as to their changing. Transferencemay also be misconduct in favor the therapist at the expense of the client. Thecrossing of the borders can be done unconsciously or consciously. Ethicalreflection of the therapeutic relationship is possible only when the therapistconceptualizes recognized transference of the client and also owncounter-transference reactions. Self-reflection, however, must be supplementedby asking the relevant ethical questions.

The practice of psychiatry throws multitude of ethical challenges and dilemmas for a clinician in making decisions. Historically, doctors follow the well-established principles of medical ethics – namely justice, autonomy, beneficience and non-maleficience in medical practice. Along with these, clinical practice in psychiatry in England and Wales is governed by the principles outlined in the Mental Health Act 1983.

Whilst general ethical guidances are available as principles mentioned above, there are no clear directives in a complex clinical presentation when the various principles are in conflict themselves. Example, it is difficult to assess whether autonomy takes precedence over beneficience or vice versa when they are in conflict. In such cases, clinicians are left to exercise their own judgment.

We undertook a literature search to look for instances of published cases about hierarchy in different principles of medical ethics in the context of complex clinical presentations in psychiatry that pose conflict in the aforementioned principles. The results are outlined. We illustrate this in relation to a complex clinical presentation we came across in our practice that deals with detention, capacity and consent. The case exemplifies conflict is different ethical principles.

Psychiatric practice is complex without set rule. No clear consensus exists in the application of ethical principles specifically when they appear to be conflict. It is imperative there is a debate to agree on a hierarchy of ethical principles such that practitioners bias and prejudices are not brought in to practice in times of ethical conflicts.

Evaluation of knowledge on Section 136 of mental health act in Police officers in Cheshire

Section 136 allows a Constable to remove a mentally disordered person from a public place to a place of safety for up to 72 hours. There has been an increasing rise in the use of section 136 of mental health act with recent reviews showing that in 2005-2006 there were 11000 detentions under section 136 in police stations and about 5500 detentions in hospitals. More recent data has shown a significant increase in the number of those detained under Section 136 in hospital. The data for England found 7035 such assessments in 2007 rising in successive years to 8495 and 12038 (Care Quality Commission, 2010). In this context it would be imperative to evaluate the knowledge on Section 136 of mental health act amongst the police personnel. Only one relevant study was found after an extensive literature search in this domain and this showed that the knowledge among the police on this area was poor (Lynch et al 2001)

A structured questionnaire based on code of practice of mental health law on section 136 was outlined. Mental health law experts and legislators have been consulted in formulation of this questionnaire. This questionnaire has been distributed within the police force of Warrington city, Cheshire.

The results are still awaited but would be obtained in few weeks time and this could be sent over to the submission Panel as addendum.

Apotemnophilia or body integrity identity disorder (BIID) denotes a syndrome in which a person is preoccupied with the desire to amputate a healthy limb. The desire to amputate one’s healthy limb seems to be related to a disturbance in the person’s perception of one’s own identity. Patients suffering from BIID have a mismatch between their actual and perceived body schema, and they feel that being an amputee is a necessary and important aspect of their identity.

More investigations are needed in order to develop noninvasive treatment strategies in this domain in order to reduce the subjective symptoms and the physical discomfort of patients.

BIID is not listed in the current DSM-V as an official disorder. Transability spectrum exists, but there is no diagnosis, it has no legal status. In order to recognize and reduce significant psychological suffering of people with BIID (anxiety, depressive symptoms, suicidal behavior etc.) the authors of this paper recommend the following:

• • the need for establishing clear diagnostic criteria and

• • therapeutic protocols in dealing with BIID

Respectively the disorder should be better described so as to develop further and more specialized treatment strategies.

Considering the fact that there is a relative increase in the number of people with BIID, there is a need for setting precise diagnostic criteria. Also, a comparison with the transgender spectrum could be a good example- in terms of setting clear guidelines, such as there are in dealing with persons with GID.

The relationship of tattoos to the diagnosis of personality disorders was explored in a forensic psychiatric inpaitent hospital setting. It was hypothesized that a greater proportion of forensic inpaitents possessing tattoos had higher criminality and had personality disorders in compairison to the people with tattoos without criminal history. In this study we compared also the important sociodemographic caharctersitics of criminals with tattoos and the normal population with tattoos without criminality.

Forensic male and female psychiatric paitents (N=42) were administered a semi-structured interview to determine the presence of tattoo. Personality disorder was determined after clinical psychiatric examination by 5 different spychiatrists and aditionally personality disorders criteria acording to DSM-5 were cehcked out. The same semi-structured interview was appilied on th control group withou personality disorder evaluation.

Paitents with tattoos had a significantly less number of tattoos but tattoos on different areas of their body, and were more likely to have histories of substance abuse, sexual-abuse, unhappy childhood, enduring violence, taruamtic life-experiences, and suicidal attempts than non-criminals.

This is the first study of which compares the forensic psychiatric paitents with normal controls in means of tattoos, personality disorders and other demographic charactersitics performed in Turkey. We concluded that there is an interaction between criminality and tattoos but the reverse is not always true at least in our control sample.

Neonaticide denotesmurder of a child during the first 24 hours oflife; infanticide is the murder of achild under the twelve months of age. Neonaticide is statistical rare delictand is defined as a „privileged murder' according to the Croatian Criminal LawAct.

To describe thecases of six women who faced criminal charges for neonaticide and infanticide. Aftera forensic psychiatric assessment of their level of criminal responsibility, thesepatients were considered guilty byreason of reduced sanity and some committed to penale institution and others toambulantory forensic treatment at the Forensic Unit of University Psychiatry ClinicVrapce, Zagreb.

To report some riskfactors for neonaticide and infanticide based on psychiatric diagnosis, age ofperpertrator and socio-cultural background.

These reports wereanalysed based on content of medical histories and court reports.

Borderlinepersonality disorder, acute stress reaction, low intelectual capacity, level of education, poverty, younger age and disturbed family relationswere most common among presented neonaticide and infanticide perpetrators atthe Forensic Unit of the University Psychiatry Clinic Vrapce.

The investigationinto cases of neonaticide and infanticide may offer an insight into the factorsthat may be of relevance in understanding how a mother may come to commitdescribed delicts and enhance the odds for effective prevention. Identifyingrisk factors for neonaticide requires better psychiatric care for the parturient women in maternal wards and further nationwide research andcoordination.

Croatia is introducing the new Law on Protection of Persons with mental disorders on January 1, 2015. Major changes are related to the terms of involuntary admissions, thus aiming to improve protection of persons with mental disorders within psychiatric care.

Aim of this paper is to compare mental health legislation and position of mentally ill people in five EU countries, namely Croatia, Germany, Spain, Sweden and UK.

Methods of descriptive analysis are employed to explore similarities and differences among countries in relation to the four following indicators - involuntary admission procedure, forms of involuntary treatment, maximum duration of involuntary treatment and patients' legal right to complain.

Despite all being in the EU, countries included in the study vary substantially in their legislation for the practice of involuntary hospital admission which will be presented in details.

How involuntary treatments should be legislated and regulated is highly controversial. We believe that EU countries should join forces to create a common understanding of this issue because legal differences could lead to substantial discrepancies in human right protection practices regarding persons with mental disorders.

Treatment resistant schizophrenia (TRS) represents patients suffering with the severe end of the disorder spectrum. Forensic patients with TRS present an additional consideration with regards to their risk of violence. This study aims to establish the prevalence and corresponding disability levels of such patients within all three security levels in typical forensic hospitals in the UK.

This is a retrospective cross sectional study of case notes to identify patients who fulfill the criteria for TRS. To identify the disability caused by TRS, the patients length of inpatient stay and incident record will be used. All data will be anonymised and kept confidential, only known to the named researchers.

Forensic patients with TRS form a significnant cohort in secure forensic hospitals. These patients often are the most unwell and present with significant risk of violence, despite being on conventional treatment. In addition, this group of patients are unlikely to be able to meaningfully participate in psycho-social therapy such as offending behaviour work or occupational therapy. Hence perpetuating their duration of detention within secure hospitals. This leads to a spiralling effect where these patients become institutionalised following protracted periods of detention, resulting in further disability than caused by the effect of the disorder on its own. This study aims to identify this cohort within a representative sample of secure hospitals in the UK.

Schizophrenia and bipolar disorder seem to be completely distinct. However, years of intensive investigation on the genetic bases of these disorders suggest that they share common genetic risks.

In order to support this hypothesis, we report the cases of two heterozygous twins. One has been diagnosed with SA and the other with bipolar disorder type II (BPII).

Sirs Z R and T R are 31 years old. They are from a non-consanguineous marriage. Their parents divorced when they were 13 years old. Their mother would be followed for schizophrenia and she is currently stabilized.

Mr. Z R was in school up the third year upper. He is followed in psychiatry for SA since the age of 15 years. He had been hospitalized in the psychiatric department 13 times. The patient is currently well stabilized with risperidone and valproate.

Mr. T R is a teacher of mathematics. He is followed from the age of 18 years for BPII. He presented previously 4 major depressive episodes that would have been of medium intensity and 5 hypomanic episodes.

He was treated with valproate (500mg/day) with a good treatment adherence.

He had been hospitalized once in the psychiatric department for physical and verbal hetero aggressiveness. The final diagnosis over this hospitalization was hypomanic episode with an hysterical personality.

Schizophrenia and bipolar disorder share common genetic risks, therefore early detection of endophenotypes in unaffected relatives of patients with these disorders should allow the development of strategies to prevent them.