By Natasja Sheriff

NEW YORK (Reuters) - Jurors weighing murder and kidnapping charges against a man who confessed to strangling 6-year-old Etan Patz in 1979 ended a fifth day of deliberations on Tuesday without reaching a verdict.

Pedro Hernandez, 54, is on trial in the killing of Patz, whose disappearance from his New York City neighborhood nearly 36 years ago changed the way U.S. authorities respond to reports of missing or abducted children.

Patz was among the first children whose picture appeared on milk cartons in an effort to find them.

Jurors during deliberations in state Supreme Court in Manhattan asked to rehear testimony from Dr. Michael First, a witness for the defense, which maintains Hernandez is mentally ill and that the confession he gave police in May 2012 was coerced.

The psychiatrist, who met Hernandez in June 2012, diagnosed him with Schizotypal Personality Disorder and said he had difficulty distinguishing fantasy from reality.

The panel also asked to rehear the testimony of Dr. Flavia Robotti, a witness for the prosecution, which maintains Hernandez is not mentally ill and that his confession was voluntary.

Robotti, a psychiatrist who examined Hernandez at Rikers Island jail in June 2012, said he told her without prompting that he hurt a child.

"He felt terrible because in his own words, 'I hurt a child.' Never even said any other words, never said 'kill.' He said, 'I hurt a child,'" Robotti said in her testimony.

The jury also asked Judge Maxwell Wiley to clarify his instructions on whether a person can be convicted on a confession alone. In a case that hinges on the former deli worker's confession, the judge told jurors they must find additional evidence that those crimes took place.

The panel retired without reaching a verdict and was due to resume on Wednesday morning.

Patz disappeared on May 25, 1979 as he walked to his school bus stop alone in his Soho neighborhood for the first time. He has never been found, and he was declared dead in 2001.

Hernandez in 2012 confessed to choking the boy in a neighborhood deli basement and leaving a box with Patz's still-moving body in an alley.

Defense attorneys say the real killer is a longtime prime suspect, Jose Ramos, whose girlfriend once walked Patz and his friends home from school. Ramos is a convicted child molester in prison in Pennsylvania.

If convicted, Hernandez faces a maximum penalty of life in prison.

(Editing by Barbara Goldberg, Ellen Wulfhorst and Jonathan Oatis)