The new classification systems in psychiatry have dressed both patients and psychiatrists in completely new attire. One (DSM -5) is widely used and critics are hardly at peace with the psychiatry of normal living conditions and phenomena and a missed opportunity to 'save the normal'. The second attire is still standing on the mold in tailoring salon in Geneva (ICD-11) and is being ornamented by the online testing through a global network of clinical practice, now around 15,000 clinicians and mental health professionals, before it is distributed to psychiatrists worldwide. The objective is to (be) treated better and to keep quiet. We remain silent for fear, shame and insecurity in the face of devastating tendencies in the modern world. Unprocessed traumas and mourning from the past in current global setting support various mental disorders. Trauma leaves strong emotions, so if it has not been processed and the loss has not been mourned, these charged emotions get the characteristics of emotional volcanoes or timed bombs that are easily activated. Unprocessed group trauma among political or ideological leaders can become a means of strong manipulation of the masses. And the 'masses' are immersed, globally, in the mentalization of cognitive achievement at the expense of the emotional principle. By forcing competitiveness, perfectionism and narcissism, people try to 'be successful' at all costs. Perfectionism is a phenomenon that, under the influence of scientific and technological progress, computerization and globalization, increasingly affects the psychosocial development, functioning of the individual and society as a whole. Perfectionism is increasingly associated with anxiety and affective disorders, obsessive-compulsive disorders, eating disorders, and suicidality. Virtual reality, virtual sexuality, pornography, pervasive alienation and loneliness create a position of shame and cultural discomfort, which is so far the price of conformism. But in the Manichean prism, we might also call the new age an era of shamelessness and perversion in the broader sociocultural context leaving open the key question: "Can modern civilization avoid self-destruction?"

In psychiatry, stigma means negative marking of the person only because s(he) has a diagnosis of mental disease, and usually this refers to schizophrenia. Stigmatization is related to prejudice, i.e. negative attitudes that are deeply rooted on false beliefs that schizophrenia cannot be treated. In principle, stigma is caused by combination of ignorance and fear which represents the basis of the creation of entrenched myths and prejudice. From a historical point of view, schizophrenia as a disease remains for public, one of the medical areas that are related to fear, a sense of discomfort, prejudice and avoidance. A combination of difficult mental disease, discrimination and stigmatization can be devastating for mentally disabled patients. Throughout history, stigma played significant role in patient's emotional and social isolation from other people deepening their suffering. A common consequence of stigma is discrimination which represents violation of basic human rights. Mentally disabled patients are often unjustifiably seen as dangerous, incapable, irresponsible which causes their isolation, homelessness and economic collapse. Thereby, possibilities for normal life, work, treatment, rehabilitation and social integration are decreased.

BACKGROUND To establish the prevalence of metabolic syndrome and its parameters in group of patients with schizophrenia in polypharmacy - receiving first generation antipsychotics versus clozapine alone treated group. SUBJECTS AND METHODS 48 outpatients with schizophrenia divided into two groups: the first group of 21 patients in polypharmacy with first generation antipsychotics, and the second group of 27 patients treated with clozapine alone were assessed for the presence of metabolic syndrome. We used logistic regression models to assess the relationship between metabolic syndrome and antipsychotic therapy, gender and age. RESULTS Metabolic syndrome was found in 52.1% of all subjects. Compared to first generation antipsychotics polypharmacy, the monopharmacy with clozapine was associated with elevated rates of metabolic syndrome (28.6% vs. 70.4%, p=0.004). With regard to particular parameters of metabolic syndrome, the elevated plasma triglycerides were significantly more present in subjects within Clozapine group (p=0.03). Logistic regression analysis showed that female gender (p=0.004), and clozapine treatment (p=0.005) were significantly associated with metabolic syndrome. CONCLUSION Compared to polypharmacy with first generation antipsychotics, the higher prevalence of metabolic syndrome is found in patients treated with Clozapine alone. The most prevalent metabolic disorder is dyslipidemia.

Aim: To describe the treatment of opiate addicts who had to spend certain period in prison, after introduced in outpatient administering of substitution medicament Buprenorphine/Naloxon in Bosnia-Herzegovina. Methodology: We assessed 10 male opiate addicts aged 24.8±4.7 years. With presentation of clinical vignettes, authors described how opiate dependants with criminal past imprisoned in jail because of aging penalties avoided discontinuation of treatment after they were included in the Buprenorphine/Naloxon maintenance treatment program. This practice has been implemented in cooperation of Department of Psychiatry in Tuzla and Tuzla prison from 27 July 2009. Results: All opiate dependants described with clinical vignettes showed surprised with positive effects on overall outcomes of Buprenorphine/Naloxon after implementation of continual treatment in prison in cooperation with jail officers (nurse and guards). Also they were very satisfied with life quality during treatment in prison. Also jail officers, family members of dependant person showed satisfaction with achieved efficacy of Buprenorphine/Naloxon eider during aging penalties. Conclusion: Medically assisted treatment of opiate dependence with Buprenorphine/Naloxon for imprisoned addicts implemented as outpatient treatment with involvement of jail officers who were instructed in Buprenorphine/Naloxon daily administration, improved quality of life of treated opiate dependants, and quality of their relations in prison with others.