Executive function in parents of patients with familial versus sporadic bipolar disorder.

OBJECTIVE: Studies investigating the cognitive function of healthy relatives of patients with bipolar disorder are conflicting, and the neurocognitive profile of relatives of bipolar disorder probands is still unclear. We aimed to evaluate executive function in unaffected parents of familial and sporadic patients with bipolar disorder. METHODS: The study included 24 unaffected familial parents (FP) of patients with bipolar disorder, 26 unaffected sporadic parents (SP) of patients with bipolar disorder and 26 controls matched with the parents for gender, age and duration of education (76 subjects in total). All of the subjects were interviewed with the Structured Clinical Interview for DSM-IV-Axis I. Executive function was assessed using the California Verbal Learning Test (CVLT), the Trail Making Test (TMT), the Wisconsin Card Sorting Test (WCST) and the Stroop test. RESULTS: In comparison to their respective matched controls, FP performed significantly worse on the CVLT, TMT, WCST and Stroop test, whereas SP performed significantly worse only on WCST perseverative errors and Stroop color test. FP performed significantly worse than SP on the CVLT, TMT, and WCST. CONCLUSION: The present study investigated relatives with and without a family history of bipolar disorder separately and found that executive function was impaired in parents with a positive family history of bipolar disorder. These findings bring more evidence suggesting that deficits in prefrontal executive function and verbal memory are associated with familial vulnerability to bipolar disorder and that executive function and verbal memory impairments may represent a potential endophenotype of bipolar disorder.

Evaluation of health anxiety in adults admitting to primary healthcare institutions.

OBJECTIVE: Health anxiety is defined as the negative over-interpretation of the usual physical sensations, although the person does not have any physical illness. The study aims to evaluate the health anxiety levels of individuals over the age of 18 who admit to primary healthcare institutions in Eskisehir and the factors that may be associated with it. METHODS: This is a cross-sectional study. The study was conducted in adults who admitted to primary healthcare institutions in Eskisehir. The study group consists of 1200 individuals. For the purpose of collecting data, a questionnaire including the questions regarding the factors related to health anxiety and the Health Anxiety Scale were used. In the analysis of the data, a logarithm of The Short Health Anxiety Inventory (SHAI) scores was performed to determine the factors affecting the inventory score and hierarchical multiple linear regression analysis was used. RESULTS: The total scores from The SHAI ranged from 1 to 47, with an mean of 16.4±8.7 and a median score of 15. Of 41.9% of study group scored above mean score. Female gender, deterioration of family income, presence of chronic disease, worsening of general health status, symptoms of mental and behavioral disorders, high number of admissions to health institutions, and hospitalization history were found to be factors affecting the level of health anxiety. CONCLUSION: Health anxiety was found to be an important problem among those who admitted to primary healthcare institutions in Eskisehir. Providing education to individuals in risky groups in terms of health anxiety, and these groups should be closely monitoring in terms of health anxiety and providing psychosocial support when necessary will prevent excessive use of health services in the long-term.

Relationship between Mental Disorders and Optimism in a Community-Based Sample of Adults.

Optimism should be included in efforts to protect mental health, as it can provide cognitive resources. Optimism also reduces the negative effects of stressful life events associated with the occurrence and recurrence of mental disorders. This study aimed to evaluate the relationship between mental disorders and optimism in a community-based sample of adults. The study was conducted in three semi-rural clusters determined via random sampling. After adjustment in accordance with the independent variables, the relationship between each psychiatric disorder and Life Orientation Test (LOT) was calculated using logistic models. Overall, 24.5% of participants were categorized into at least one mental disorder group, with 20.8%, 3.5%, and 0.3% having one, two, or three mental disorders, respectively. The median LOT score was lower in patients diagnosed from the Primary Care Evaluation of Mental Disorders modules, except for the somatoform disorder module. Maintaining an optimistic view reduced the risk of mood disorders by 0.86 (OR; 95% CI, 0.81-0.91), anxiety disorders by 0.89 (0.83-0.97), and probable alcohol abuse by 0.83 (0.74-0.93) times after adjustment. The role of an optimistic view in coping with mental problems should be investigated in detail.

Dopamine D2 receptor gene -141C Insertion/Deletion polymorphism in Turkish schizophrenic patients.

Schizophrenia is a chronic and neuropsychiatric disease that affects about 0.5-1% of the world's population. An increase in dopamine and dopamine D2 receptor (DRD2) gene products has been well described in schizophrenic patients. Several groups have studied the relationship between dopaminergic hyperactivity and cellular communications have obtained discordant results. Studies searching for the relationship between the schizophrenia and DRD2 gene have gained more interest. Our objective was to determine the relationships among schizophrenic symptoms in schizophrenia subtypes and severity of symptoms in terms of DRD2 gene -141C Insertion/Deletion [Ins/Del; I/D] polymorphism by PCR-RFLP (polymerase chain reaction-restriction fragment length polymorphism) assay method. Genomic DNA was prepared from peripheral blood by using salt extraction method. After amplification of genomic DNA, PCR products were digested with BstNI restriction enzyme for the detection of DRD2 gene -141C Ins/Del polymorphism in 73 schizophrenic patients and 60 healthy control subjects. The allelic frequencies of the DRD2 gene -141C Ins/Del polymorphism in case and control groups were 79.5 and 77.5% for I allele; 20.5 and 22.5% for D allele respectively. There was no significant difference in frequencies of genotypes and alleles between the two groups. In schizophrenic and control subjects, there were no significant relationship in severity of the disease and schizophrenia types among the -141C Ins/Del genotypes and alleles.

Turkish Version of the Test Your Memory (TYM-TR) as a Screening Tool in Memory Clinics.

INTRODUCTION: This study compared the Turkish version of Test Your Memory (TYM) MMSE (Mini-Mental State Examination) and CDT (Clock Drawing Test) in patients with neurocognitive disorder. METHODS: After a thorough medical workup, patients with a diagnosis of neurocognitive disorder were enrolled. A cross-sectional design was used to compare the TYM results with those of MMSE and CDT. RESULTS: This study was conducted on 100 patients, including 46 males and 54 females, aged 52 to 86. The majority of patients were diagnosed with vascular neurocognitive disorder. The z-score of TYM-TR was significantly lower in the domains of registration, recall, visuospatial, and total score. The same results were achieved when CDT was added to MMSE. The same pattern was observed separately for those who were diagnosed with a mild or major neurocognitive disorder. CONCLUSION: Patients' cognitive deficits might be more evident when measured by the TYM-TR compared to the MMSE.

Completed suicide rates of older adults in 5-year age bands in Turkey between 2002 and 2013: A retrospective study.

AIM: Studies have shown that the causes and methods of suicides differ among young and old individuals; consequently, it is important to identify the subgroups that are at high risk for suicide to aid in suicide prevention. The present study compared the causes and methods of suicides between 2002 and 2013 among older adults aged 65-69 years, 70-74 years and ≥75 years by completed crude suicide rate and sex. METHODS: Data detailing sex, the causes and methods of completed suicides in older adults aged 65-69 years, 70-74 years and ≥75 years that occurred between 2002 and 2013 were drawn from the Turkish Statistical Institute. RESULTS: In all age groups, crude suicide rates were threefold more frequent among men than among women. In both sexes, the most frequent suicide cause was mental illness. In the group aged 65-69 years, the most common cause of suicide was financial difficulty for men and marital conflict for women. The most frequent suicide method among older adults of both sexes was hanging. In all age groups, firearms use was more common among men and jumping from a high place was more common among women. CONCLUSION: The present findings suggest that the most common suicide cause in both sexes and in all age groups was mental illness in Turkey. To prevent suicidal behavior in older adults,; it is important to diagnose mental disorders, such as mood disorders and substance abuse, and to treat them quickly. Geriatr Gerontol Int 2019; 19: 66-69.

The association between repeat number in C9orf72 and phenotypic variability in Turkish patients with frontotemporal lobar degeneration.

Frontotemporal lobar degeneration (FTLD) describes a group of progressive brain disorders. The expansion of a noncoding GGGGCC (G4C2) hexanucleotide repeat in the C9orf72 gene is a major cause of both familial FTLD and amyotrophic lateral sclerosis. The aim of this study was to determine the prevalence of C9orf72 G4C2-repeat expansion in a Turkish population with FTLD and to determine its effects on the phenotype. The G4C2 expansion in the C9orf72 gene was analyzed in 100 cases of FTLD without mutations of the MAPT, PGRN, CHMP2B, VCP, TARDBP, and FUS genes and 100 age-matched healthy controls by using repeat-primed polymerase chain reaction and fragment length analysis techniques. A possible pathogenic repeat (≥30) was found in one of the familial cases (1/33), but none of the sporadic cases. The difference in the allele length between the cases and controls was statistically significant (p < 0.01). Intermediate (20-30) repeats were detected in 4% of our cases. Patients with psychotic symptoms appear to be enriched for intermediate and possibly pathogenic repeats. To determine whether the intermediate and ≥30-repeat allele carriers shared the C9orf72 risk haplotype, we examined rs4879515 and rs3849942 in all samples and family members of patients with possibly pathogenic alleles. We identified at least one risk allele for each single-nucleotide polymorphism in all intermediate and possibly pathogenic repeat carriers. We observed that ≥8 unit repeats were strongly correlated with the tagging risk alleles for both single-nucleotide polymorphisms (p < 0.001). To our knowledge, this is the first study to evaluate C9orf72 G4C2 repeats in Turkish patients with FTLD. The present findings suggest that pathogenic expansions of the C9orf72 repeat are uncommon in Turkish patients with FTLD, but intermediate repeats may be a risk factor for FTLD and act as a genetic modifying factor for psychotic symptoms.

[Comparison of patients with schizophrenia, obsessive-compulsive disorder, and schizophrenia with accompanying obsessive-compulsive symptoms]. / Obsesif kompulsif belirtileri olan sizofreni hastalarinin sizofreni ve obsesif kompulsif bozukluk hastalari ile karsilastirilmasi.

OBJECTIVE: The present study aimed to determine if schizophrenic patients with OC-symptoms represent a subtype of schizophrenia and to evaluate the differences between schizophrenic patients with OC symptoms and OCD patients. METHODS: The study included 20 patients diagnosed with OCD, 40 schizophrenic patients, and 20 schizophrenic patients with OC symptoms. While the distribution and the severity of psychotic symptoms in the OC-schizophrenia group were compared to those of the schizophrenic patients, and while the distribution and severity of obsessive-compulsive symptoms of the OC-schizophrenia group were compared to OCD patients, all 3 groups were compared to each other in terms of demographic data and other clinical characteristics. RESULTS: There were no differences in the distribution and severity of psychotic symptoms between the OC-schizophrenia group and the schizophrenia group. Moreover, the distribution and severity of OC symptoms in the OC-schizophrenia group were no different than those in the OCD group. Brief Disability Questionnaire scores were significantly higher in the OC-schizophrenia group than in the other 2 groups. Hamilton Depression Scale and Hamilton Anxiety Scale mean scores were significantly higher in the OCD and OC-schizophrenia groups than in the schizophrenia group. Moreover, Yale-Brown Obsessive-Compulsive Scale total scores were not correlated to the Scale for the Assessment of Negative Symptoms or the Scale for the Assessment of Positive Symptoms scores in the OC-schizophrenia group. CONCLUSION: According to our results OC-schizophrenia might be a sub-type of schizophrenia, which doesn't have more severe psychotic symptoms, but more severe depression and anxiety, which are related to greater disability.

Violence and related factors among high school students in semirural areas of Eskisehir.

OBJECTIVE: The aim of the study was to determine the frequency of violence-related behaviors and related factors at school or school environment among high school students educated in the semirural areas of Eskisehir. METHODS: This was a cross-sectional study. The sample comprised 1465 high school students. Data were collected using a questionnaire that included questions regarding sociodemographic characteristics and the 2013 survey questions of the "Youth Risk Behavior Surveillance System" of the Centers for Disease Control and Prevention. RESULTS: It was found that 8.5% of students exhibited violent behaviors at school or school environment. According to multiple logistic regression analysis, sex, father's employment status, smoking, alcohol use, and feeling unsafe were effective independent variables on violence. CONCLUSION: Students had a high rate of violence-related behaviors at school or school environment. Community-based public health interventions are required to solve this problem.

Sexual differences in the completed suicides in Turkey.

The aim of this study was to determine whether there is a difference between men and women in terms of suicide age, suicide method and suicide reason in Turkey. This study recruited 17,327 cases that had committed suicide between 1990 and 2000. Of all the cases who committed suicide during a period of 11 years, 61.1% were men, 38.9% women. The highest suicide score fell into the age group 15-24 (P<0.001). The most frequently used methods for suicide were self-hanging (48.2%) and use of firearms (19.2%) (P<0.001). The proportion of those committing suicide taking chemicals (drugs, etc.) was higher in women than in men (P<0.001). The most frequently seen reasons for suicide were illness and (33.8%) unsatisfactory relationships (33.0%) (P<0.001, each one). Women committed suicide much more because of unsatisfactory relationships, whereas for men it was due to illness (20.8% and 14.6%, respectively). There were significant differences between men and women in terms of suicide age, suicide method and suicide reason in Turkey. When evaluating suicide cases it is essential that the differences between sexes be taken into consideration.

[Development of a questionnaire to assess inter-episode functioning in bipolar disorder: Bipolar Disorder Functioning Questionnaire]. / Bipolar Bozuklukta Islevsellik Olçeginin Gelistirilmesi, Güvenilirlik ve Geçerliligi.

OBJECTIVE: Even though quality of life and functioning are topics that are point of interest, they are not assessed adequately in mood disorders. In this study, it is aimed to develop a functioning assessment scale in bipolar disorder. METHOD: Bipolar Disorder Functioning Questionnaire (BDFQ) is developed by the Scientific Section for Mood Disorders of the Psychiatric Association of Turkey. The questionnaire contains 58 items, and consists of eleven subscales: emotional functioning, intellectual functioning, sexual functioning, feelings of stigmatization, social withdrawal, household relations, relations with friends, participation to social activities, daily activities and hobbies, taking initiative and self sufficiency, and occupation. RESULTS: In this study, 252 remitted bipolar patients from 15 centers were included. In addition, thirty subjects without any lifetime psychiatric, neurological or physical disease were recruited. The mean age of the patients was 38.6+/-12.1 and 56% (n=141) were female. The mean duration of the bipolar disorder was 11.9+/-9.2 years, and 91.3% of the patients were diagnosed to have bipolar I disorder. In the reliability analyses, after the exclusion of six items with low reliability coefficients, The Cronbach alpha coefficient was calculated to be 0.91. The item-total scale correlations were between 0.22-0.86. In test-retest reliability, the correlation between the two ratings was high (r=0.82, p<0.0001). In validity analyses, 13 factors were obtained representing 65.1% of the total variance in exploratory factor analysis. In confirmatory factor analysis, 11 domains fit the model with a RMSEA of 0.061. BDFQ significantly correlated with GAF (r=0.428, p<.0001). BDFQ also showed significantly negative correlation with HAM-D (r=-0.541, p<0.0001) and YMRS (r=-0.365, p<0.0001). It discriminated the patients (mean score=111.8+/-15.2) from the healthy subjects (mean score=121.4+/-10.4) well (t=-2.300, p=0.038). CONCLUSION: With the six items excluded, it is suggested that the 52-item BDFQ is a reliable and valid instrument in the assessment of functioning in bipolar disorder.

Identification of violence in Turkish health care settings.

This study sought to investigate the contributing factors to and frequency of violence against health care workers (HCWs) working in western Turkey. The population is composed of a random sample of 1,209 HCWs from 34 health care workplaces. Written questionnaires were given to HCWs at all sites, where staff were instructed to register all types of violence they had experienced. In all, 49.5% of HCWs reported having experienced verbal, physical, or verbal and physical violence, with this total being made up of 39.6% men and 60.4% women. A larger percentage (69.6%) of general practitioners reported experiencing verbal abuse and physical violence by patients and patients' family members or friends. Younger workers, inexperienced staff, and those in emergency services were more likely to report violence. Violence directed toward HCWs is a common occupational hazard. Public health authorities should plan preventive interventions based on the findings of this study.

Sex-related differences in methods of and reasons for suicide in Turkey between 1990 and 2010.

OBJECTIVE: To analyse suicides occurring in Turkey between 1990 and 2010 according to sex, age, reason and method. METHODS: Data concerning suicides occurring in Turkey between 1990 and 2010 were obtained from annual records published by the Turkish Statistical Institute. Data were analysed according to sex, age, reason for suicide and suicide method. RESULTS: The crude suicide rate was 2.42 per 100 000 population in 1990 and 4.02 per 100 000 population in 2010. The highest number of suicides was seen in those aged 15-24 years. In this age group, the number of suicides in females was significantly higher than in males. The most common suicide method in Turkey was hanging. Men used firearms more frequently than women. All the reasons for suicide occurred in a higher number of males than females; however, the difference between males and females was more significant for economic problems, relationship problems and educational failure. The leading reason for suicide in females was relationship problems. CONCLUSION: Detecting population subgroups with a high suicide risk and obtaining regional demographic data are of great importance for future studies on suicide prevention.

Test your memory-Turkish version (TYM-TR): reliability and validity study of a cognitive screening test.

BACKGROUND/AIM: The test your memory (TYM) is reported to be a sensitive cognitive function assessment scale for people with dementia. The aim of the present study was to investigate the reliability and validity of an adapted Turkish version of the TYM (TYM-TR) among Turkish dementia patients. MATERIALS AND METHODS: The TYM-TR was given to 59 patients with dementia aged 60+ and 336 normal controls aged 23-75+. The diagnostic utility of the TYM-TR was compared with that of the mini-mental state examination (MMSE) to validate it. RESULTS: The internal consistency of the TYM-TR was a = 0.85. The test-retest reliability was 0.97 (P < 0.001). The TYM-TR showed a statistically significant correlation with MMSE; r (57) = 0.628 P < 0.001. The TYM-TR distinguished dementia patients from controls (AUC = 0.994). A cut-off point of 34 was optimal for detecting dementia with a sensitivity of 96.61% and a specificity of 96.13% [95% CI (0.981-0.999)]. CONCLUSION: The Turkish version of the TYM was found to have good reliability and validity to distinguish dementia in the Turkish population.

[Evaluation of mental health services in primary health care settings in the city centre of Eskisehir]. / Eskisehir ilinde birinci basamak saglik kurumlarinda verilen ruh sagligi hizmetlerinin degerlendirilmesi.

OBJECTIVE: The purpose of this study was to determine the proportion of cases thought to have a mental disorder, and/or proposed treatment. Additionally, we assessed the relationship between age and sex regarding mental disorders, and the treatments recommended to patients diagnosed as mentally ill by their physicians. METHOD: During a one year period the out-patient polyclinic registration lists of 313,139 patients attending primary health care clinics in the centre of Eskisehir were scanned by the researchers. RESULTS: The proportion of mental disorders in patients attending primary care centres at least once owing to a mental disorder was 2.34%. However, this proportion in patients attending once was 1.04%. Compared with men, women attended primary care clinics more frequently. The most common diagnoses were depression and anxiety disorders; these were more frequent in women than in men. The most frequently prescribed medicines for mental disorders were anxiolytics and antidepressants. CONCLUSION: The low levels of diagnoses and treatments of psychiatric disorders in primary care settings are thought to be associated with the following: physicians under-recognising mental disorders despite being educated about this subject, mental screening scales not being used, patients being unaware of their diseases and giving insufficient information to physicians about mental symptoms, co-occurrence of medical diseases and psychiatric problems, the physicians' negative approach to patients, and the physicians' tendency not to give importance to drug or medical records.

[Tobacco, alcohol and substance use prevalence among elementary and secondary school students in nine cities of Turkey]. / Dokuz Ilde Ilk ve Ortaögretim Ogrencilerinde Tütün, Alkol ve Madde Kullanim Yayginligi.

OBJECTIVE: Previous studies in Turkey regarding substance use have failed to take into consideration the elementary school students. The purpose of the present study is to determine prevalence of tobacco, alcohol, and substance use among elementary and secondary school students in Turkey. METHOD: The study was conducted in 9 big cities that were selected from different geographic regions of Turkey. According to the student population size of the cities, a sample of 1250 or 2500 students were selected from each city. The questionnaire was administered to 11.989 elementary school students, and 12.270 secondary school students. In elementary school students' questionnaire, for the substances other than tobacco, alcohol, inhalants and cannabis a general term "drug" was used. RESULTS: Overall, Izmir had the highest rate of substance use. The prevalence of tobacco use at least once in life time was found to be 16.1% in the elementary school. The lifetime prevalence was found to be 15.4% for alcohol use and 1.7% for inhalants and for general term "drug". The prevalence of tobacco use at least once in life time was 55.9%, for alcohol use it was 45.0%, for cannabis use 4.0%, for inhalant use 5.1%, and for heroin and ecstasy use 2.5% among secondary school students. A significant difference was found between males and females in terms of tobacco, alcohol and other drug use both in the elementary and the secondary school. The risk for substance use was found to be greater in private schools than public schools. CONCLUSION: Although the prevalence of substance use among elementary and secondary school students is low when compared to the findings from other countries. It was observed that especially the prevalence of tobacco use was quite high.

The Prevalence of Psychiatric Disorders Distribution of Subjects Gender and its Relationship with Psychiatric Help-Seeking.

INTRODUCTION: The aim of this study was to investigate the prevalance of psychiatric disorders and psychiatric help-seeking behaviours in central Eskisehir according to sociodemographic variables. METHOD: In this study, for the purpose of revealing the psychiatric disorder profile of Eskisehir city and evaluating the prevalance of psychiatric disorders according to gender differences and psychiatric help-seeking behaviours; The Primary Care Evaluation of Mental Disorders (PRIME-MD) scale and psychiatric help questionnaire were administered to 1475 subjects who were randomly selected from 24 primary health care centers in Eskisehir. RESULTS: The prevalence of psychiatric disorders was as follows: at least one mood disorder 37%, anxiety disorders 29%, somatoform disorders - 8.6% and, possible alcohol abuse 7.7%. All diagnoses except possible alcohol abuse were found to be more frequent in women than men. Also It was found that in subjects who were thougth to have a psychiatric disorder, 64% of mood disorder patients, 67% of anxiety disorder patients, 70% of somatoform disorder patients and, 61% of possible alcohol abuse patients can receive appropriate treatment. DISCUSSION: Since psychiatric disorders are common, it is important to direct such patients to appropriate treatment. Therefore, new studies are necessary to find out the prevalance of psychiatric disorders and risky groups as well as to identify the reasons that why such people do not seek for help in different regions of our country.

The effects of infertility on sexual functions and dyadic adjustment in couples that present for infertility treatment.

OBJECTIVE: The aim of this study was to determine the effects of infertility on sexual functions and dyadic adjustment in infertile couples that seek infertility treatment. MATERIALS AND METHODS: The Beck Depression Inventory (BDI), Golombok-Rust Inventory of Sexual Satisfaction (GRISS), and Dyadic Adjustment Scale (DAS) were administered to the infertility group (n = 220) and control group (n = 110). None of the study participants had an Axis I psychiatric disorder. RESULTS: There wasn't a significant difference in BDI score between the 2 groups. None of the study participants had clinical depression. Men in both groups reported more problems according to GRISS total scale and subscale scores (except the avoidance subscale) than the women. Women in both groups reported more problems according to GRISS avoidance subscale score than did the men. Men in the control group reported more problems on the GRISS frequency subscale, as compared men in the infertile group. Women in the control group reported more problems based on GRISS total score, and GRISS frequency, satisfaction, touch, and avoidance subscale scores, as compared to the women in the infertile group. The men in the infertile group were more satisfied with dyadic adjustment than the women in the infertile group. The men and women in the control group had higher DAS total score, and DAS consensus and emotional expression subscale scores. CONCLUSION: The differences in sexual functions between the infertile and control groups were not significant. Both women and men in the infertility group reported more dyadic adjustment problems than those in the control group.

The first report of a patient with probable variant creutzfeldt-jakob disease in Turkey.

Variant Creutzfeldt-Jakob disease (vCJD) was first reported in the UK in 1996. Here, we report the first Turkish case of vCJD. A 47-year-old man, who has never lived outside of Turkey and had had no transfusion, was admitted to the University Hospital with speech disorder, cognitive decline and ataxia following depression, irritability, and personality change. The immunoassay of the 14-3-3 protein in the cerebrospinal fluid was negative. Brain magnetic resonance imaging revealed high-signal lesions involving the bilateral caudate and lentiform nucleus on T(2)- and diffusion-weighted imaging. The patient developed akinetic mutism 10 months after disease onset. The clinical presentation and neuroimaging findings were compatible with the vCJD cases reported since 1996 and met the World Health Organization's case definition for probable vCJD.

An analysis of changes in cerebral blood flood velocities in depressive pseudo-dementia and Alzheimer disease patients.

BACKGROUND: Patients with pseudo-dementia are at particular risk of being labeled as Alzheimer dementia. We thus need better diagnostic methods. In this study, we evaluated the cerebral reactivity of the posterior cerebral arteries (PCAs) during visual stimulation by transcranial Doppler ultrasonography. METHODS: The study group consisted of 13 and 11 patients suffering from pseudo-dementia and Alzheimer disease (AD), respectively, and 10 healthy controls. Visual reactivity was defined as the differences of cerebral blood flow velocity (CBFv) against the visual stimulus. Mini Mental State Examination and Montgomery-Asberg Depression Rating Scales were used as psychometric tests. The transcranial Doppler ultrasonography device was applied for simultaneous recording of both PCAs. Obtained data were evaluated by Student t test, and 1-way analysis of variance tests, with a priori as P<0.05. RESULTS: Subjects with AD had a lower CBFv following visual stimuli (P<0.001). Mean CBFv throughout the procedure [P<0.001; right and left sides, in AD and depressive pseudo-dementia (DPD), respectively], velocity at rest (P<0.001 in each side for both groups), and velocity at stimulation (P<0.001; each side for both groups) on both PCAs were significantly lower in patients with AD and DPD than those of the controls. Compared with the controls, the relative (r) CBFvs (%) were found to be significantly lower in AD (P<0.05, P<0.01, for the right and left side, respectively). CONCLUSIONS: We have shown that CBFv decreased in patients with AD and DPD, but vasoneuronal activity was only impaired in patients with AD. On the other hand, although the results do not show significant differences between depressive and demented groups by TCD, further studies will be needed for differentiating these diseases.