[Symptomatology and treatment of persistent genital arousal disorder. Case report]. / Az állandó genitális izgalom szindróma tünettana és kezelési lehetoségei.

Persistent genital arousal disorder is a rare condition among women characterized by unwanted and intrusive sexual arousal that can persist for an extended period of time and unrelated to sexual desire or sexual stimuli. Since its first documentation in 2001, numerous studies have been dedicated to investigate its specifics. The persistent genital arousal occurs in the absence of sexual interest and fantasies and it causes excessive psychological suffering. Masturbation, spontaneous orgasm or sexual intercourse can offer only a temporary relief. Researches provide a limited insight into the characteristics of persistent genital arousal disorder. This paper presents a case and summarizes the scientific findings on prevalence, etiology and treatment perspectives.

[Current practice of positive family planning service in the National Institute of Child Health in the last six years]. / A pozitív családtervezés gyakorlata az Országos Gyermekegészségügyi Intézetben - az elmúlt hat év tükrében.

The aim of positive family planning is to prevent preterm delivery and congenital abnormalities. Using primer prevention models at this time helps to prevent the common disorders which are the leading causes of death. The mission of the National Institute of Child Health is to promote preconceptional health and thus, mother and baby's health. This article introduces the practice of our institute's family planning department and the last six years' experiences.

[Prevention of perinatal depression and anxiety with periconceptional care]. / A perinatalis depresszió és szorongás megelozése perikoncepcionális gondozással.

In the public mind, pregnancy, childbirth and newborn care is one of the most wonderful living experiences. However, epidemiological studies have shown that the risks of psychiatric disorders in the perinatal period are multiplying. Pregnancy entails with dramatic physical, mental and social role changing. The birth is a big, irreversible life event, and it should also be nominated as "rite of passage". This process represents a normative crisis during life, which needs new coping mechanisms to be developed. The stress and anxiety during the development of the fetus causes negative consequences in the short and long-term and it causes dangerous complications for the mother, too. During postpartum period, the incidence of major depression is approximately 15-20% that most frequently occurs within 6 months after birth but until the child is 2 years old it can develop any time. Serious risks of the postpartum depression are suicide and infanticide. In addition, it also represents serious teratogenic effects of cognitive and psychomotor development of children. It makes harder to recognize that the symptoms are largely the same as in any other stage of depression occurring during lifetime, but some of the symptoms compliant of normal pregnancy and the postpartum period. In addition, the majorities of women recognize heavily the problem and visit a doctor, because based of social expectations they should feel happiness. After the disclosure of risk factors and securing preventive conditions, preparing to be a mother is effective in prevention of development of perinatal depression. The effective therapy is primarily based on the coaching approach, and requires multi-directional approach.

[Family planning in Hungary: past and present]. / A családtervezés Magyarországon: múlt és jelen.

Periconceptional Care Service begins 3 month before the planned pregnancy and continues until 12th week of pregnancy. Its goal is to prevent congenital abnormalities (CAs) and preterm birth. Nowadays, 20-25% of infant mortality is caused by CAs in industrialized countries and CAs are among the leading causes of death. An important feature of CAs is that they represent a defect condition; therefore it's difficult to achieve a complete recovery. Thus, prevention is considered the only optimal solution in the medical care of cases affected with CA. In the last 25 years, several studies confirmed the possible prevention of CAs mainly neural-tube defects (NTDs) by folic acid supplementation during periconceptional period. Family Planning Service exists in Hungary since 1984. This model is optimal for the introduction of periconceptional folic acid/multivitamin supplementation, thus provide an effective method for primary prevention of birth defects.

[The treatment of depression during pregnancy]. / A depresszió kezelése terhesség alatt.

The treatment of depression during pregnancy--the medical treatment or it's interruption should be considered based both on its inherent dangers and on its potential benefits--requires complex thinking of the psychiatrist, because the mother's and the fetus' health should be also considered. The area of reproductive psychiatry is evolving rapidly, which is highly necessary, in order to enhance the competence of psychiatrists. It is estimated that 20-25% of women in the stage of reproductive age require psychiatric care, so this type of maternal disease needs specific care for family planning. The methodology of the treatment depression during pregnancy is highly important, because present studies suggest that this is one of the most serious teratogenic risk to the fetus and to the new-born's development.

Short-Term Oral Diazepam Treatment during Pregnancy : A Population-Based Teratological Case-Control Study.

OBJECTIVE: To study the possible human teratogenicity of short-term (generally 3 weeks) oral diazepam treatment during pregnancy. DESIGN AND SETTING: A matched case-population control pair analysis based on the total (maternal self-reported and medically recorded) or medically recorded diazepam treatments, in addition to a comparison between cases and patient controls in the population-based large data set of the Hungarian Case-Control Surveillance of Congenital Abnormalities from 1980 to 1996. STUDY PARTICIPANTS: 38 151 population-control neonates without any congenital abnormalities, 22 865 neonates or fetuses with congenital abnormalities (cases) and 812 neonates or fetuses with Down's syndrome (patient controls). MAIN OUTCOME MEASURES: 24 congenital abnormality groups. RESULTS: 2746 (12.0%) cases, 4130 (10.8%) population controls and 97 (11.9%) patient controls were born to mothers treated with diazepam during pregnancy. The matched case-population control pair analysis showed a higher rate of limb deficiencies, rectal-anal atresia/stenosis, cardiovascular malformations and multiple congenital abnormalities after diazepam use during the second and third months of gestation, i.e. in the critical period for most major congenital abnormalities, based on maternal self-reported and medically recorded information. However, the evaluation of only medically recorded diazepam use did not indicate a higher use of diazepam in any congenital abnormality group. Thus, the higher occurrence of diazepam treatment among cases in the primary analysis may be due to the lower proportion of maternal self-reported diazepam intake in the population control group, i.e. recall bias. The comparison of diazepam use between 24 congenital abnormality groups and patient controls as the referent group showed a difference only in the group of intestinal atresia/stenosis, probably due to chance error caused by multiple comparison. CONCLUSIONS: Short-term diazepam treatment in usual therapeutic doses during pregnancy did not present any detectable teratogenic risk to the fetus.

A population-based case-control teratologic study of nitrazepam, medazepam, tofisopam, alprazolum and clonazepam treatment during pregnancy.

OBJECTIVE: To study the association between nitrazepam, medazepam, tofisopam, alprazolum and clonazepam treatments during pregnancy and prevalence of different congenital abnormalities (CAs). MATERIALS AND METHODS: A matched case-control study using cases with CAs and population controls from the dataset of the nationwide Hungarian Case-Control Surveillance of Congenital Abnormalities (HCCSCA), 1980-1996. RESULTS: Of 38,151 pregnant women who had babies without any defects (population control group), 75 (0.20%) were treated with these five benzodiazepines during pregnancy. Of 22,865 pregnant women who delivered offspring with CAs, 57 (0.25%) had benzodiazepine treatment. The occurrence of five benzodiazepine treatments during the second and third months of gestation, i.e. in the critical period for most major CAs did not show significant differences in matched case-control pairs. CONCLUSION: Treatment with five benzodiazepines studied during pregnancy did not present detectable teratogenic risk to the fetus in humans but the amount of information was limited for different CAs.