Psychiatry_part 2 / Измененные состояния сознания - Психологическая и философская проблема в психиатрии. Дрёмов С.В / ISS

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51

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53

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

54

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55

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57

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

8-16/, 1988).

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58

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excitement) + "268H95-. 656 B+C+/8/=+9-46/- 2/C7@ID-1+- (excitation), .56 + 1-D+BB-*-1F+*/2511G- E,/F++. HD5 I- ,/I1/ /.1-4.+ B*-0D/246/- 3*-D4.528-1+- / 65.-64+- 4-, 7-*=4/1/246+0 "I+C1-11G0 3/*G2", 34+:/8/=+9-46+- 3*/;28-1+; ,-.57/8+C,5" ( -*8C, -B- B-*8+1, @D,E1, 1993).

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3-*2@H /9-*-DA 154 7@D@. +1.-*-4/25.A 152;C9+2/4.+ (1-2/C,/I1/4.A /.28-9A4; /. /3*-D-8-1- 1G: 3*-D,-./2 + 4/7G.+0) - B-1/,-1, :/*/</ C156/,G0 +C 68+1+9-46/0 34+:/35./8/=++ + 3*-D- 4.528;H?+0 4/7/0 954.1/- 2G*5I-1+- @1+2-*458A1/0 C52+4+,/4.+ /. 4/D-*I51+; ./=/ +8+ +1/=/ @*/21; + 4.*5:5 *5C/./ID-4.28-1+; 4 1+,. G *544,5.*+25-, 152;C9+2/4.+ 656 48-D4.2+- @=*/CG *5C/./ID-4.28-1+; 4 4/D-*I51+-, 656/=/-8+7/ @*/21; 45,/4/C151+; + 656 7/8-C1-11@H 56F-1-

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59

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60