Tap chi THONG TIN YDlfQC So 11 ndm 2012
T A I LIEU T H A M KHAO
1. Nguyen V3n ThSng: Giam dau sau m6 him m$t bSng phuong phap chuan lieu morphine. Lu^n vSn diuy^ khoa cap 2,2003, Tru&ng D^ifigcYHi N0I.
2. Nguyin Hong Thily: Nghlfin ciiXi tic dyng giSm dau du" phong sau mo byng trSn ciia ketamine lieu thap tiem luc khfii me. Lu$n vSn Th^c s9 y iipc, 2005, Tru&ng D^ihgc YHi Ndi.
3. Bodian C.A., Freedman G., Hossain S., Eisenkraft J.B., Berlin Y.; The visual analog scale for pain:
clinical significance In postoperative patients.
Anesthesiology, 2001,95(6), f^. 1356-1361.
1. Chin. M.L: Acute pain management. Annual meeting re/resher course lecture, ASA, 2005, pp.222.
3, Himmelseherb S., Durieux M.E.: Ketamine for perioperative pain management. Anesthesiology, 2005, vol 102, pp.211-220.
o. Kapfer B., Alfbnsi P., Guignard B., Sessler D.I., Chauvin M.: Nefopam and ketamine
comparably enhance postoperative analgesia.
Anesth Analg, 2005,100 (1), pp. 169-174.
7. Nesher N., Serovian I., Marouani N., Chazan S., Weinbroum A.A.: Ketamine spares morphine cosumptlon after transthoracic lung and heart surgery without adverse hemodynamic effect.
Phannacol Res, 2008, Res, Jul, 58(1), pp.38-44.
0. Stawicki. S.P.: Sedation scales: Very useful, very underused. Scientist, King of Prussia, Pa, Usa icu Comer, 2007 Voi.1, No.2, pp.10-12.
1. Subramaniam K., Subramaniam B., Steinbrook RA.: Ketamine as adjuvant analgesic to opiods: a quantitative and qualitative systematic review. Anasth analg, 2004, 99 (2), pp.482-495.
10. Weinbroun A.: A single small dose of postoperative ketamine provides rapid and sustained improvement in morphine-analgesia In the presence of morphrne resistant pain. Anestti Analg, 2003, 96(3), pp.789-795.i5
NGHIBV CUU THUC TRANG CAC ROI LOAN H A N H V I 0 HOC SINH TIEU HOC THANH PHO THAI NGUYBV
Dam Thi Bdo Hoa' TOM TAT
Muc deu: mo ta thut tiang cdc rdi loan hanh vi (RLHV) d hgc sinh tieu hoc tiianh phd Thdi Nguyen.
D& h/0jg vd phudng phdp: md td cat ngang, 1638 hgc sinh ti^ Idp 1 den Idp 5 d 2 trUc^g tieu hqc Nguyen VIA Xuan va Hoang Vdn Thu thdnh pho Thdi Nguyen, tiidlgian tiiang 9/2009-1/2010. Kit qud:
ty li cdcroi toan hdnh vi Id 2,99%. Tnjng do, tang dgng giam diu y chiem 2,26%. Rdi loan utig xd, budng binh chdng d& vd noi ddi diu chiem 0,49%. Cac rdi loan hdnh vl ddn tiiuan chi chUrn ty li 46,94%, con lai la cac bli'u hl&i rdi toan kit hep. Tram cdm ket hdp vdlcacnSI toan hanh vl la pho bien nhit Ngoai ra, gap mot sdroi loan hdnh vi ket hdp vdi lo du, dai chm, cham phdt tri&i tdm than. Mot sd tie CO nhieu na loan f^& h0). Kit luan: cdc RLHV d hgc sinh tiiu hgc thdnh phd Thdi Nguyin khd pho bm va da dang bao gom (3 C3C RLHV ddn thuan vaphdihdp.
SUMMARY
Current s i t u a t i o n o f behavioral disorders in p r i m a r y scliool cliiidren in H i a i Nguyen City Objectives: to desoibe the (xirrent situation of behavioral disorders In pnmary school children In Thai Nguyen City, Vietnam. Methods: The two-stage, cross-sectional study was conducted on a school-sample of 1638 children, aged 6 to 11 of Nguyen Viet Xuan and Hoang Van Thu pnmary schools ffom 9/2009 to 1/2010. Results: The prevalence of behavioral disorders was 2.99%, In which, ADHD was 2.26%; conduct disorder was 0.49% and hostility/lying were 0.49%. 46.94% oftiie behavioral disorders were merely behavioral disorders; The rest was combined behavioral disorders.
Depression cx>mblned with behavioral disorders was the most common. In addition, some behavioral disorders were combined with anxiety, bed wetting, mental retardation. Many children had more than two disorders. Conclusions: Behavioral disorders In primary school children in Thai Nguyen city, Vietnam were quite common and diverse including behavioral disorder alone or combined.
I . DAT VAN OE
Rdi loan tdm than, hanh vi d tre em va thanh thieu nien la van de phd bien d mpi quoc gia tren the gidi cung nhU d Vi§t Nam.
Trong do, cac RLHV d tre em va thanh thieu men Id van de dang rat dUdc quan tam hi§n nay. Dac biet, tre em thUdng chju tdc ddng bdi nhieu yeu to: mdi trUdng sdng, dp lUc hpc hdnh, sang chain tdm ly, sU bien ddi Idn ve
sinh hpc vd cd the nen rat nhay cam va de bj tdn thUdng,... Theo cac sd lieu d i i u tra gan day ciia hau het cac quoc gia tren the gldl, cac RLHV d tre em va thanh thieu nien ngay cdng cd chieu hudng gia tang. Cac nghien ciTu cho thay ty le mac chung ciia cdc RLHV chiem khodng 4-20% tre em lira tudi dl hpc, trong do tang ddng gidm chu y gap d 4-7% tre em va rdi loan hu'dng binh diong ddi, roi loan uhg xu"
Tap chi THONG TIN YDlfQC S311 ndm 2012
gdp d 2-16% tre em. Th§m nUa, cdc RLHV trd em (t khi xuat hl^n ddn d$c md thudng phdl hdp vdi nhi&u rdi lo?n tdm thdn khdc Idm cho benh canh lam sang them phirc tgp vd n§ng n© [11,12]. Theo nghiSn ciru ciia Nguyen Tho (2005) t?i Ddng Nai, ty 1^ hpc sinh ti^u hpc cd bleu hi?n ciia cdc RLHV Id 2,55% [5], Theo Chu Vdn Todn vd cpng si/, ty l§ cac RLHV d trd 11-16 tudi d Thanh Hda Id tir 6,22-8,71 [3], Tuy nhiSn, cdc rdi loan tdm thdn vd hdnh vl trd em thu'dng khdng dUdc phdt hi§n vd can thiep kip thdi, thich ddng. Thdng thudng, cdc trd mdc cdc rdi loan ndy dUpc xem Id cdc trd hU, phdi chju su trirng phat, sU ghdt bd vd si/ xa lanh [1,5]. Da sd trd ndy kdm thfch img vdi trudng hpc, de chuyen tn/dng, quan h^ vdi ban b6 kem, d l mSc te nan xa hpi, khd d i i u chinh dUdc cam xiic, hdnh vi. Cdc rdi loan ndy keo ddi se dnh hudng nhieu den sU phdt tri^n, hinh thanh nhdn cdch ciia dufa tre, anh hUdng 6in nhdn thirc, den hpc tdp, sinh hoat hdng ngay va dac biet Id tre cd the cd nhiJng hdnh VI nguy hiem gay hau qua nghiem trpng dan den viec bi phap ludt truhg phat va tham chi Id nguy cd tU sat,... Thai Nguyen la mdt tinh ndm d khu vUc mien nui phia Bac vdi dan so khoang 1.127.000, la ndi sinh sdng ciia 8 dan tdc Kinh, Tdy, Niing, San Diu, H'mdng, San Chay, Hoa va Dao. Khoang 1/3 dan so Thai Nguyen d do tudi <18. Vdi dac diem Id trung tam ciia khu vi/c mien niii phia Bac, ndi tap trung nhieu khu cdng nghiep va trUdng hoc nen Thdi Nguyen cd nhieu dieu kien thuan ldi nhung cijng la tinh cd nhieu van de xa hpi phiTc tap, trong dd cd van de roi loan tdm than vd hdnh vi d tre em vd thanh thieu nien. Tuy nhien, cho den nay van chuS cd de tai nao nghien ctjftj ve cac RLHV d hpc sinh lite tuoi tieu hpc. De gdp phan tim hieu thUc trang cdc RLHV d tre em tiianh pho Thdi Nguyen, chiing tdi ben hdnh nghien ciru de tai nay vdi muc beu; nghien ciru thi/c trang cac RLHV d hpc sinh tieu hoc thanh pho Thai Nguyen.
I I . DOI T U O N G V A P H l / O N G PHAP
1. Ddi tu'dng nghiin c&u
1638 hpc'Sinh til" Idp 1 den Idp 5 d 2 tru'dng tieu hpc Nguyin Viet Xuan vd tieu hpc Hodng Van Ttiu Thdnh phd Thai Nguyen tir thang 9/2009-1/2010.
* Tieu chuan Ida dign:
+ TU nguyen tham gia nghien culi.
+ Cd ho sd ghi chep day dii cdc sd liSu nghiin ciili.
* Tliu chuan loai tru":
+ Nhuhg tr6 ma cha me tir chdi tham gia nghiin ciru.
2. Phu'dng phdp nghiSn ahi 2.1. Thiit ke nghiin cuU: md td c3t ngang.
2.2. Tiin hdnh:
- Chpn cci mau: thdnh phd Thai Nguyin cd 31 tru'dng tl^u hpc, bdc thdm n g l u nhien toan bO hgc sinh d 2 tru'dng ti^u hpc Hodng Van Thu vd Nguyen V l i t Xuan dUdc cha me dong y cho tham gia nghien ciru sau khi da dUdc thdng bdo ve yeu cau, myc dich nghiin cdXi.
- Chi t i i u nghien cuU: Ddc diem nhdm nghien o i l i : tudi, gidi, ddn tdc; ThUc trang, ddc diem Idm sang cdc RLHV d hpc sinh ti^u hpc; D§c di^m cdc rdi loan phdi hdp b-ong cac RLHV.
- Cac chi sd ddnh gia:
+ T l i u chuan chan dodn tdng ddng gidm chu y (F 90):
Ldm sang: cac trieu chuhg thudng gap: dac biet khd khdn bong viec duy tri sUtap bung chu y so vdi lua tudi (khodng thdi gian tap trung rat ngdn, thay doi thu'dng xuyen cac hoat ddng); Van ddng liin tue mot each bdt thudng so vdi tre khdc ciing tudi (ddc biit bieu hien rd trong Idp hpc va trong buci an); Tinh each xung ddng (benh nhan khdng the chd ddl den luWl minh, hoac hdnh dpng tiileu suy nghi); Ddi khi ludn vi pham ky luat, kit qud hpc tap kem, de bj tai nan. Nhuhg r6\ loan nay thudng xay ra d tat cd mpi ntfl (d nhd, d trudng, khi di chdl).
Thdi gian: cdc rdi loan phdi xuat hien sdm trUdc 6 tuoi vd phdi ton tai trong thdi gian dai (6 thdng trd ten).
+ Tieu chuan chan doan cac RLHV (F 91):
G I ; cd md hlnh hdnh vi lap lai vd dai dang, b^ng do hodc Id cdc quyen cd ban ciia nhuhg ngudl khac hodc nhiihg chuan mut hay luat le diinh ciia xa hpi phii hdp vdi lu^ tudi bi vi pham, keo ddi It nhat 6 thang, trong thdi gian ndy od mot sd trong cdc trieu chirhg (gom cdc the rieng biit ve cdc t i i u chuan hoac sd lutfng cdc trieu chuhg).
G2: rdi loan nay khdng dap utig cdc tieu chuan ciia rdi loan nhan cdch chdng doi xa hpi (F60.2), tam than phdn Hit (F20.-), giai doan huhg cam (F32.-), cac rdi loan lan tda sU phat trien (F84.-), hoac rdi loan tang dpng (F90.-).
[Neu cac tiiu chuan doi vdi roi loan cdm xuc (F93.-) dutfc dap iihg, n i n chan dodn la mot rdi loan h3n hdp cdm xiic va hanh vi (F92.-)].
+ Phdi hdp sir dung tet Vanderbilt de ho trd chan doan xac iSnh vd tet Beck, tet Zung de ho trd cac chan doan benh ly b^m cdm, lo au phcfi hdp.
Tifp ChiTHdNG TIN YDlfQC Sd 11 ndm 2012
- Ky thuat thu thap sd lieu: lay cac chi t l i u theo mau benh an phii hdp vdi yeu cdu vd muc dich nghien ciru. Sdng Ipc tre cd van d i su'c khde tdm than bang thang diem SDQ 25 (Self-Report Strengths and Difficulties Questionnaire) [4], Khdm lam sang tdm than be cd van de su'c khde tam than sau khi da sdng Ipc bang thang SDQ 25 (SDQ25 >14 diem) de xdc dinh chan dodn cdc RLHV theo cac tiiu chl chdn doan ICDIO [7].
2.3. Xdlysdliiu.-i^ng phan mim STATA 10.0.
I I I . KrrQUA X. Ddciffem chung Bdng 1: Ddc dii'm tuoi va gidi
\Gid
rus\
6{16pl) 7 (Idp 2) 8(lc(p3) 9 (Idp 4) lOfljdS) Tonq
Nam SL 199 173 157 174 103 806
71%
24,69 21,46 19,48 21,59 12,78 100
Nit SL 211 173 156 167 125 832
71%
25,36 20,79 18,75 20,07 15,02 100
Tdng Si 410 346 313 341 228 1638
TL%
25,03 21.12 19,11 20,82 13,92 100 Ty l i tre d khdi Idp 6 Id cao nhat (chiem 25,03%). Ty le tre nam chiem 49,21% vd nu' chiem 50,79%.
Bdng 2: Ddc dii'm dan toe Dac di&n dan tdc Dan tdc iQnh Dan toe Tav Dan toe Nfinq Cac dan t6c khac Tonq
SL 1341
187 44 66 1638
7 1 % 81,87 11,42 2,69 4,03 100 Ddn tdc ranh diiem da sd (81,87%). Cdc ddn tpc khdc chiem ty le thap.
2 Ket qua khdm lam sdng cua bdc sy chuyen khoa tam thdn
Bdng 3: Kit qud khdm (n=1638) RLHV
T^nq donq qiam chu v RS loan iJnq xCf, buiSnq binh chonq 6o\
Noi doi Tonq so tre CO roi loan
SL 37 8 8 49
7 1 % 2,26 0,49 0,49 2,99 S o fre c d c a c R L H V c h i e m b^ le 2 , 9 9 % , trong do ty le cdc roi loan tdng dgng gidm chii y diiem ty l i cao nhat (2,26%).
Bang 4: Dac dii'm RLHV fn=49) Cac hinh thii Tanq donq qiam chu y ddn thuan Tanq donq phcS hdp
ROI loan uTig xi!r, bUdng binh chSng doi ddn thuan
Roi loan iimg mii, bi/dng binh chong doi phoi hdp
Na d6i ddn thuan Ni^ Ao\ phdl hdo T6nq
SL 17 20 3 5 3 5 49
7 1 % 34,69 40,82 6,12 10,20 6,12 10,20 100
Cdc hinh thdi RLHV phdi hdp vdi nhau vd phdi hdp vdi cac rdi loan khac chiem ty le cao nhat
Bang 5: Ddc dii'm cdc rdi loan kit hep vdi cdc RLHV
CAc hinh thii TDGCY + CPTTT TDGCY + t r i m cam TDGCY + lo Su TDGCY + trSm cSm + lo au TDGCY + trSm c^m + ^m ^nh TDGCY + RL uTig xif, bLTdng binh chong dfil + trSm cam TDGCY + t r i m cAm + lo au + dai dam
TDGCY + tram cam + n6i doi RLHVUX + d i i d i m RLHVUX + trSm cam RLHVUX + trSm cam + noi doi NOI ddl + trSm cam NOI doi + tram cam + lo au Tonq
SL 2 8 1 4 1 2 1 1 1 1 1 2 1 26
7 1 % 7,69 30,77 3,85 15,38 3,85 7,69 3,85 3,85 3,85 3,85 3,85 7,69 3,85 100 (TDGCY: tSng dong giam chu y; CPTTT: cham phat trien tam than; RLHVUX: RLHV uhg xu)
Cac hinh thdi tang dpng giam chu y kem theo tram cam Id pho bien nhat.
I V . BAN LUAN
1. Ddc dii'm nhom nghien cu'u Nhdm nghien cuU la nhDhg tre em tudi tir 6-10 tuoi, trong dd cao nhat Id nhdm 6 tuoi (hoc sinh khdi 1). Ty l i nay khdng dong deu d cdc khdi Id do cd mdt sd hgc sinh cha me khdng dong y tham gia vao nhdm nghien ciili.
2. Kit qua khdm lam sdng Trong 1638 be dutfc sang Ipc bang tet SDQ25 danh cho thay cd giao va phu huynh hoc sinh da sdng loc ra dutfc nhijhg tre od nghi ngd bieu hien rdi nhieu tam bi. Nhiihg be nay sau dd dutfc cdc bdc sy chuyin Wioa tam than khdm lam sdng va dutfc danh gid bd sung bdng tet Vanderbilt, tet Beck, tet Zung. Kit qud cd 49 be cd bleu hien RLHV, chiem t / le 2,99%. Trong dd, tdng dpng gidm chii y chiem da sd (37 be, chiem t / l i 2,26%). Ty le fre bj mac cac RLHV do 1 so tac gia khac bdo cao nhu^ nghiin cirtJ djch te cac RLHV d be 11-18 tudi d Thanh Hda (Chu Van Toan), t / l i cac RLHV tir 6,22-8,71% [3], nghien cuU d hpc sinh tieu hpc Dong Nai cho thdy t / le be cd van de ve hdnh vi la 2,55%, bong dd chii y a i la tang ddng [5], nghien cirtJ ciia Nguyen HijtJ Ky tai phudng Phudng Diic thanh phd Hue ty le rS loan hdnh vi d lua bJol 10-17 tuoi chiem ty le 2,96% [2]. NhU vay, ket qua nghien cuU ciia chung tdi tutfng b/ nhU nghiCTi ciiU ciia cdc tac gid Nguyen Thp d Ddng Nai; Nguyen HQli Ky CTTidnh pho Hue) va thap hdn so vdi nghien culi Chu Van Toan [3] cd le do nhdm
Tqp chi THONG TIN YDUQC S311 nam 2012
trd nghien ciib ciia chung tdi Id nhOtig bd nhd, tudi bj- 6-10. Vdi lite bidl ndy, thudng b^ it bj tdc d$ng bdi cdc yeu te mdi budng, hdn nOa s\f thay ddi vg tam sinh ly chua cd bien doi nhleu.
3. D$c dii'm Idm sdng cdc RLHV Trong 49 b i cd bi^u hl$n RLHV thi tdng dOng gidm chii y Id chii ygu (37 trd) trang dd, tdng d$ng gidm chii y ddn thuBn Id 17 b6, chiim ty l§
34,69%. Tdng d^ng gidm d i i i y kgt hdP roi loan khdc gdp d 20 b i , chiim ty 1$ 40,82%. Rdi lo^n uhg xir, budng binh chdng doi vd ndi ddl It g$p hdn vd chii y i u Id cdc rdi loan phdl hdp. K i t qud ndy Id phii \^<p vdi Nurcomb B. va cdc tdc gid khac, vi d bid em lu^ hjol 6-11 tudi, cdc RLHV thuifrig gdp Id tdng ddng gidm chu y, cdn cdc RLHV uhg y.\S gdp d bi& Ida tudi Idn hdn, ddng thdi RLHV thudng dl k^m vdi m^t sd rdi lo^n khdc [11,9,12]. Nghien culi ciia chung tdi cung phii hdp vdi mpt sd tdc gid khdc ciia Viet Nam nhu Nguyen Thp, Chu Vdn Toan [3,5].
4.D^ai^t6ito^k€thdptrongc^RLHV Trong 49 tre cd RLHV thi chi cd 23 tre cd RLHV ddn thuan, cdn lai chii yeu Id cac RLHV ket hdp (bdng 5). Trong dd, tram cam ket hdp vdi cac RLHV la thUdng gdp nhat nhu tram cdm ket hdp vdi tdng ddng, gidm chii y (30,77%). Ngoai ra cdn gdp cac rdi loan pha hdp giOa lo du vdi rdi loan ijYig xxS, tang dpng giam chu y vdi rdi loan irtig xir,... vd nhieu tre cd tren 2 rdi loan. Cdc roi loan ket hdp ndy thu'dng lam cho benh ndng hdn va qua trinh can thiep gdp nhieu khd khdn hdn [8,10]. Tren thUc te trong qua trlnh nghien culi chiing tdi da gdp nhuhg tre cd RLHV ndng k i t hdp vdi tram cam va lo au qua muC d i n den cd y tu'dng chdn sdng vd hdnh vi b/ sdt.
V. KET LUAN
Qua nghiin CUXJ thuc trang cdc RLHV d hpc sinh tieu hpc thdnh pho Thai Nguyen, chung tdi nhan thay:
- Trang 1638 tr^ tham gia vao nghien ciiU ty l i cdc RLHV Id 2,99%. Trong do, tdng ddng giam chu y chiem 2,26%. Rdi loan uhg xir, du'dng binh chdng ddl va ndi doi deu chiem 0,49%.
- Cdc RLHV ddn thuan chl chiem ty l i 46,94%, cdn lai Id cac bi^u hien rdi loan ket hdp.
Trong dd, tram cdm ket hdp vd^ cdc RLHV la phd
biSn nhdt. Ngodi ra, cd the gdp RLHV k i t hdp vdi lo du, ddl dam, ch§m phdt trl^n t^m than.
- Cd th^ g$p cdc bid cd nhiiu rSt loan phdl hdp.
* Khuyin nghj: CSn tuyin fruyen cho cdng dbng, d$c bl$t Id cha m? vd gido vien ve cac rdi lo^n tdm thdn vd hdnh vl d t r i em de kip tiidi nh§n biit vd can tiil§p, giiip dd. Cdn cd tiiim cdc nghiin cuU sdu r§ng hdn v i cdc roi loan tdm tiiSn vd hdnh vi d lira tu6l hpc sinh tieu hpc T A I L I | U T H A M KHAO
1. Nguyfin Thj Klm Hfnh v i cs: Ngtiign a>U ty l#
mSc vd m$t 50 y^u t6 llSn quan d€n 10 nhom binh tSm thSn thudng g^p t^i Thanh Hoa. Bio do nghidm thu dS tii nghlSn cuU Hioa hgc cap nganh, 2005, tr. 12-45.
2. Nguyfin Hfhi KV: Nghien ciru ty 1$ mSc v i m ^ sd ySu t5 li§n quan 6Sn 10 nh6m benh tdm than 0}\liJng g$p t^l phudng Due, thdnh pho Hui. £1? Hi nghiSn aiv khoa hgccSpb$, 2004, 0:20-42.
3. Chu V3n Join: I4ghl&i cuU cac roi ban tarn ttian va h^nh vt d tr6 em d Thanh Hda. Bio do n^^ thu di lii nghiSn aJU Idioa hgc c^M, 2008.
4 TrSn TuSn: Ddnh gid do nh^y vd do ddc hieu cua bi^ cdu hdi SDQ25 sir dgng trong chan dodn sang Igc r6l nhilu tdm tri tren doi tudng tre em 4-16 tuoi tai Vi^ Nam. Bio do nghl0m thu (^ tii nghien aiv d^
Bg so 779/(^LHH ngay 15/2/2005, Uen h^ dc Hgi Khoa hgc vi Kythu$t Vi$tNam, Oting 3/2006.
5 Nguyin Th^: Khao sdt \^ vein de rfR kian phdt trien tdm ly, hdnh vi vd cdm xuc 6 hgc sinh pho thong. /Cy yeu cong trinh nghiin aiti Ichoa hgc B^h
vi4n TSm thSn Tmng uOhg h, 2005, fr. 48-54.
6. Nguyin VJIn Thg: Nghien cuu thanh lap mo hinh chdm s6c sut kti6e ^ m than cho hpc sinh pho thSng a Dong Nai. Ky yeu ha thio idioa hgc "diim sde Slit Ichde tinh than" H^ Khoa hoc Tim ly - Giaodijc ViitNam, 2007, tr.245'265.
7 76 chtirc Y t e The g M : Phan to^i benh QuSc te Idn thiJr 10 vg cdc roi toan tam than va hanh vi (ICD - 10), CSeneva, 1992, tr.258-269.
8. Benjamin J.S., Virginia A.S.: Kaplan & Sadock's Synopsis of Psychiatry: Behavioral Sdences^Qinicat Psychiatry. 10"" Edltkm. Uf^incott Williams &
Wiikins, 2007, pp. 1259-1282.
9 Dorothy S.: Child and Adolescent Psychiatry: A Practical Guide. 1" Edition. UppinaM Wiiiams &
Wiikins, 2007, pp. 60-77.
10. Klykylo W.M., Kay J.L: Oin'ical Oiikl Psydiiativ.
Second Edition. John W9ey & Sons, 2005, pp.153'203.
11. Nurcombe B.: Disorders usually pres^ting in middle childhood (6-11 years) or adolescence (12- 18 years). Current diagnosis and treatment in psychiatry. 1* Edition. New York: McGraw-Hill, 2000, pp.562-586.
12. Linda W.: Essentials of Child Psychopathology.
John iWleySi Sons, 2005, [^.61-154.s
Gia: 6.000 d&ng
