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rafft-Ebing R., 1909; <5;8=A:89 ., 1986; (>AB0:>28G .., ":0G5=:> .., 1992). !@548 A5:AC0;L=KE ?@02>=0@CH8B5;59, G0AB8G=> 8;8 ?>;=>ABLN 0<=578-@>202H8E ?5@8>4 45O=8O, 1>;LH>9 ?@>F5=B 70=8<0NB ;8F0 A >@30=8G5A:8<8 8 ?A8E>35==K<8 48AA>F80B82=K<8 @0AAB@>9AB20<8 (Bourget D., Bradford J.V.W., 1995). 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izenberg, Z. Zemishlany, 1995; G. Kockott, W. Pfeiffer, 1996). ><8<> MB>3> CAB0=>2;5=>, GB> >4=8< 87 G0ABKE ?>1>G=KE O2;5=89 ?A8E>D0@<B5@0?88 O2;ONBAO A5:AC0;L=K5 48ADC=:F88. > 40==K< Segraves (1989) @0A?@>AB@0=5==>ABL M@5:B8;L=KE 48ADC=:F89 C 1>;L=KE ?@8=8<0NI8E =59@>;5?B8:8 :>;51;5BAO <564C 23 8 45%.  ?>1>G=>< 459AB288 0=B845?@5A- A0=B>2 =0 A5:AC0;L=CN DC=:F8N 2 2845 @0AAB@>9AB20 MO:C;OF88 8 >@307<0 C:07K20NB Rabkin et al. (1 984), Hekimian et al. (1978), Vaisberg (1 974) 8 4@. 0 2>7<>6=>ABL @0728B8O 8<?>B5=F88 =0 D>=5 ?@85<0 ?@>872>4=KE 15=7>48075?8=0 C:070=0 2 @01>B0E Bitran et al. 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'5@57 2-3 <5AOF0 87>;OF88 27@>A;K5 6C:8 >1=0@C6820NB O2=K9 ?>;>2>9 48<>@D87< 2 ?@>872>4AB25 :0=B0@848=0: A0<FK A>45@60B 17 <3, B.5. 10% 682>3> 25A0, 0 A0<:8 ?>AB5?5==> B5@ONB 2A5 70?0AK :0=B0@848=0 8 ?5@8>48G5A:8 ?@8>1@5B0NB 53> B>;L:> :0: :>?C;OB82=K9 ?>40@>: >B A2>8E ?0@B=5@>2 (Carrel et al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onkanen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elly,1998; Masters, 1992) =5 @5:><5=4CNB 2=CB@5==55 ?@8<5=5=85 :0=B0@848=0 4;O MB>9 F5;8, B.:. 53> B5@0?52B8G5A:85 8 B>:A8G5A:85 4>7K 1;87:8 <564C A>1>9. ">:A8G5A:85 MDD5:BK :0=B0@848=0 =5>4=>:@0B=> >?8A0=K 2 25B5@8=0@=>9 ?@0:B8:5 8 A2O70=K A ?>540=85< ;>H04L<8 ;NF5@=K, 70@06Q==>9 ?>?C;OF859 "?C7K@=>3>" 6C:0. Shawley et al.(1984) =01;N40;8 2 M:A?5@8<5=B5 =04 :>?KB=K<8 1>;8, =5MDD5:B82=K5 ?>?KB:8 <>G58A?CA:0=8O, B@5?5B0=85 480D@03<K. >-B>3=><>=8G=K< ;01>@0B>@=K< B5AB>< O2;O5BAO 2KO2;5=85 38?>:0;LF85<88, 38?>-<03=575<88, 38?>?@>B58=5<88, <8:@>35<0BC@88 8 C<5@5==>9 07>B5<88. <5NBAO 548=8G=K5 :;8=8G5A:85 =01;N45=8O >B@02;5=89 :0=B0@848=><, 2 B>< G8A;5 A> A<5@B5;L=K< 8AE>4><, 2 <548F8=A:>9 ?@0:B8:5.Fisch et al.(1978) A>>1I8; > 5 A;CG0OE 8=B>:A8:0F88 :0=B0@848=>< 157 ;5B0;L=>3> 8AE>40. '5BK@5 ?0F85=B0 8A?>;L7>20;8 2KA>:85 :0=B0@848= :0: 0D@>48780: 8 >48= 4;O :@8 <8=0;L=>3> 01>@B0. > 2A5E A;CG0OE =01;N40;0AL <0:@>35<0BC@8O, 2 >4=><, ?>G5G=0O =54>AB0B>G=>ABL A C25;8G5=85< :@50B8=8=0 ?;07<K 4> 5,6 <3 =0 100 <;. Hundt et al.(1990) >?8AK20NB ;5B0;L=K9 A;CG09 >B@02;5=8O :0=B0@848=>< ?@8 53> :>=F5=B@0F88 2 AK2>@>B:5 72,3 =3/<;. Zouvanis et al.j 1 994) ?@82>48B @5B@>A?5:B82=K9 0=0;87 10 A;CG052 A C;80=->@M-?>4>1=K< A8=4@><>< 2 @57C;LB0B5 >B@02;5=8O :0=B0@848=><. Karras et al.(1 996) ?@54AB028;8 4 A;CG0O >B@02;5=8O :0=B0@848=><, E0@0:B5@87CNI8EAO 876>3>9, 48AD03859, B>H=>B>9, 35<0BC-@859 8 487C@859. B<5G0;8AL B0:65 M@>788 8 :@>2>87;8O=8O A;878AB>9 ", ?>G5G=0O 18>?A8O 2KO28;0 BC1C;O@=K9 =5:@>7 8 @07@CH5=8O 3;><5@C;. 01;N40;8AL 2038=0;L=K5 8 @5:B0;L=K5 :@>2>B5G5=8O. 2B>@K >B<5G0NB 1;03>?@8OB=>5, 2 F5;><, B5G5=85 ?>4>1=KE >B@02;5=89. >:0;L=>5 B>:A8G5A:>5 459AB285 0;;>?0B8G5A:8E 4>7 :>=B0@848=0 >B@065=> 2 8AA;54>20=88 Dubertret et al.(1984), 345 CAB0=>2;5=> 2>7<>6=>ABL @0728B8O ?A>@80B8G5A:8E ?>2@5645=89 :>68 ?>A;5 0??;8:0F88 :0=B0@848=0. 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