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Anand K Pandurangi

Publications and source records attributed to Anand K Pandurangi.

12 recordsLinked to original sources
PubMed2006

Posttraumatic stress disorder and body mass index in military veterans. Preliminary findings.

INTRODUCTION: Current management of posttraumatic stress disorder (PTSD) focuses on the psychiatric parameters of this condition. Little has been written about co-morbid overweight and obesity in PTSD. METHODS: We used the database of the recently constituted PTSD program at the Hunter Holmes McGuire Veterans Affairs Medical Center in Richmond, Virginia to assess and better understand the prevalence and severity of overweight and obesity among military veterans with PTSD. Variables assessed included age, decade of life, height, weight, sex, race, and severity and chronicity of PTSD. We used PTSD CheckList-Military Version (PCL-M) to assess current complaints and service-connected disability (SCD) to estimate the long-term severity of PTSD. RESULTS: Of the 221 male veterans extracted from our PTSD database for purposes of this study, 144 (65.2%) were in the age range of 50 to 59 years consistent with Vietnam veterans dominating our study population. Their mean body mass index (BMI) was 30.2+/-5.8 kg/m(2) placing the typical veteran in the obese range. Far exceeding the current US population rate of 64.5%, 82.8% of our study population was either overweight or obese. Our sample had BMI measurements greater than those reported for non-PTSD veterans and also BMI measurements reported in the literature for veterans with PTSD. Current (PCL-M) and long-term (SCD) markers of PTSD did not relate to obesity. CONCLUSIONS: The prevalence of overweight and obesity among our veterans with PTSD far exceeded current US population findings and those of other veteran groups with and without PTSD. PTSD symptoms, whether assessed acutely or chronically, did not explain our findings. Prospective studies of PTSD and comorbidity are needed using larger study populations to better understand the relationships among PTSD, stress, and obesity.

Aged↗
PubMed2006

Posttraumatic stress disorder: clinical features, pathophysiology, and treatment.

Posttraumatic stress disorder (PSTD), classified as an anxiety disorder, has become increasingly important because of wars overseas, natural disasters, and domestic violence. After trauma exposes the victim to actual or threatened death or serious injury, 3 dimensions of PTSD unfold: (1) reexperiencing the event with distressing recollections, dreams, flashbacks, and/or psychologic and physical distress; (2) persistent avoidance of stimuli that might invite memories or experiences of the trauma; and (3) increased arousal. Traumatic events sufficient to produce PTSD in susceptible subjects may reach a lifetime prevalence of 50% to 90%. The actual lifetime prevalence of PTSD among US citizens is approximately 8%, with the clinical course driven by pathophysiologic changes in the amygdala and hippocampus. Comorbid depression and other anxiety disorders are common. General principles of treatment include the immediate management of PTSD symptoms and signs; management of any trauma-related comorbid conditions; nonpharmacologic interventions including cognitive behavioral treatment; and psychopharmacologic agents including antidepressants (selective serotonin reuptake inhibitors most commonly), antianxiety medications, mood stabilizing drugs, and antipsychotics. This review of PTSD will provide the reader with a clearer understanding of this condition, an increased capacity to recognize and treat this syndrome, and a greater appreciation for the role of the internist in PTSD.

Cognitive Behavioral Therapy↗
PubMed2006

Treatment of depression in patients with coronary heart disease.

Depression and coronary heart disease are common conditions that often occur together. Evidence shows that the co-occurrence of these illnesses is not random but driven by depression as a risk factor for the occurrence and progression of coronary heart disease. This link is due, in part, to the impact that depression has on neuroendocrine pathways leading to increased platelet activation, cortisol and catecholamine excess, and altered autonomic nervous system function that influence the pathogenesis and progression of coronary atherosclerosis and subsequent heart disease. We know that treating depression in patients with coronary heart disease improves the symptoms and signs of depression. Evidence is less compelling that treating depression improves the morbidity and mortality of coronary heart disease. However, early findings suggest that some antidepressants may improve the course of coronary heart disease and improve patient compliance with various cardiac interventions. We outline a practical approach to the treatment of depression in patients with coronary heart disease. This approach includes education, counseling, antidepressant drugs, and referral when appropriate.

Antidepressive Agents↗
PubMed2006

Posttraumatic stress disorder in male military veterans with comorbid overweight and obesity: psychotropic, antihypertensive, and metabolic medications.

UNLABELLED: Posttraumatic stress disorder (PTSD) is an important syndrome among military veterans. Little has been written about comorbid medical conditions of PTSD, particularly overweight and obesity. We focus on psychotropic and non-psychotropic drugs, their interactions, and metabolic issues most relevant to primary care physicians. METHOD: Data from the recently constituted PTSD program at the Department of Veterans Affairs Medical Center in Richmond, Va., were retrospectively reviewed to assess the prevalence and severity of comorbid overweight and obesity in male veterans with PTSD. Also, our database allowed us to correlate various drugs used to treat hypertension, diabetes mellitus, and dyslipidemia with body mass index (BMI). RESULTS: The mean BMI of 157 veterans with PTSD (DSM-IV criteria) in this sample was in the obese range (30.3 ± 5.6 kg/m²). The number of drugs a given patient was taking for treatment of hypertension, diabetes mellitus, and dyslipidemia correlated with BMI. Psychotropic drugs associated with weight gain did not explain our findings. CONCLUSIONS: Overweight and obesity among our male veterans with PTSD strikingly exceeded national findings. The administration of psychotropic drugs associated with weight gain did not explain these findings. The number of medications used to treat hypertension, diabetes mellitus, and dyslipidemia correlated significantly with BMI. Rather than these medications explaining the high prevalence of overweight and obesity in our study population, obesity probably worsened these components of the metabolic syndrome, necessitating more aggressive treatment reflected in the high number of drugs prescribed.

Journal Article↗
PubMed2006

Toxicology findings in child and adolescent suicides in virginia: 1987-2003.

OBJECTIVE: In a follow-up report of child and adolescent suicides in Virginia, we describe postmortem toxicology findings in a subset of these youths. METHOD: We analyzed "unnatural" deaths from Virginia's Office of the Chief Medical Examiner for 1987 to 2003. There were 2818 unnatural deaths in children and adolescents. We grouped unnatural deaths as accidents, homicides, and suicides. Toxicology records were available for 753 cases, of which 732 were black or white youths. RESULTS: There were no age differences among suicide victims and accident or homicide victims. Whites were more likely than blacks to die by accident and suicide. White females were more likely than black females to commit suicide. Black males were more likely than white males to suffer homicide. For all unexpected deaths, antidepressants were more commonly found among whites than blacks. Suicide by poisoning occurred more commonly among whites. Recreational drugs were more commonly found among blacks than whites. Suicide by gun occurred more commonly among blacks. Antidepressants were found in 39 black and white suicide victims. Anti-depressants (all tricyclic antidepressants) were causally related in 17 cases of suicide by poisoning. No other antidepressants were found in lethal levels in suicide by poisoning. Selective serotonin reuptake inhibitors (SSRIs)/venlafaxine appeared more commonly in the suicides (p < .0001) than in accidents or homicides. For suicides, SSRIs appeared no more commonly in poisoning than in gun or hanging deaths (p = .695). CONCLUSIONS: Antidepressants appeared more commonly among youths committing suicide than those dying by accident or homicide. SSRIs did not appear more commonly among youths committing suicide by poisoning than those committing suicide by gun or hanging. Because our data are descriptive, they are subject to over-interpretation. Cause-effect inferences should not be drawn.

Journal Article↗
PubMed2006

Body mass index relates to males with posttraumatic stress disorder.

INTRODUCTION: We looked at the relationships among posttraumatic stress disorder (PTSD), body mass index (BMI) and socioeconomic status (SES) in a newly formed PTSD program at the Hunter Holmes McGuire Veterans Affairs Medical Center in Richmond, VA. METHODS: We reviewed 265 records and then selected only black and white male veterans (n=252) for study. Variables were: 1) age, 2) decade of life, 3) height, 4) weight, 5) sex, 6) race, and 7) SES (estimated using priority group status). Low income is an important variable determining priority group status. RESULTS: About two-thirds of the veterans were in the age range of 50-59 years (Vietnam veterans). Their mean BMI was 30.2 +/- 5.6 kg/m2, and this value did not separate by race. Far exceeding national numbers, 84.1% of our veterans were either overweight or obese. Veterans in the lower priority groups had greater (p=0.029) BMIs than their counterparts in higher priority groups. CONCLUSIONS: The pervasiveness of overweight and obesity in our PTSD population was profound. Our observations suggest that low SES is a likely contributor to veterans in lower priority groups having greater BMIs than veterans in higher priority groups.

Adult↗
PubMed2005

Child and adolescent suicides in Virginia: 1987 to 2003.

OBJECTIVES: The aim of this study was to better understand suicides in children and adolescents using records from the Office of the Medical Examiner of Virginia from 1987 to 2003. MAIN FINDINGS, KEY DATA, AND STATISTICS: Suicide accounted for 16.8% of unnatural deaths. Suicide rates were highest for Caucasians. Guns were the most common method of death for suicides, followed by hanging and poisoning. Poisoning other than carbon monoxide accounted for 7.8% of suicides, with tricyclic antidepressants (TCAs) the most identifiable poison. Female youths were 10 times more likely to die from TCAs than male youths, after adjusting for race and age. CONCLUSIONS: Guns and hanging were the principal methods of suicide. Among the antidepressants, TCAs have been the most common poisons used in suicide. Increasing age was a powerful determinant of suicide. Some patients may have stockpiled their TCAs for a while before their TCA overdose. Other suicide victims may have used TCA supplies from family members. Hence, some of the suicide victims may not have taken TCAs on a regular basis before committing suicide. Further exploration of TCA-induced suicidal thoughts is needed. Conclusions cannot be made at the time about the precise role that TCAs played in TCA-induced suicide reported in our study.

Adolescent↗
PubMed2005

Invited comment.

Explore the source record for details and available documents.

Antipsychotic Agents↗
PubMed2005

Body image and attitude toward obesity in an historically black university.

INTRODUCTION: The obesity epidemic is a major problem in the United States, particularly among black women. Body image and attitudes toward obesity are important areas to understand and address in any comprehensive approach to this epidemic. METHODS: From an initial evaluation of 200 college students (25 male and 25 female freshmen, sophomores, juniors and seniors each) attending an historically black university, we selected those students who identified themselves as black for data analysis (n = 191). All students underwent height and weight measurement from which body mass index (BMI) was calculated. Each student answered two questions related to nine silhouettes for each sex that progressively moved from extreme thinness to extreme obesity. Also, each student answered 20 questions describing attitudes about obesity. RESULTS: Black college students placed between the 62nd and 72nd percentiles of national BMI data for adolescents. Black female students were more likely than their black male counterparts to be obese. BMI did not vary by sex or grade level. Students of both sexes generally preferred "trim" silhouettes with the caveat that students with BMIs <25 kg/m2 preferred smaller silhouettes than did students with BMIs > or =25 kg/m2. BMI and sex did not favor any particular set of attitudes toward obesity. CONCLUSION: Black male and female college students from an historically black university were largely in the "normal" range of BMI percentiles for sex and age. Our black female students were more likely to be obese than our black male students. Our findings suggest that young black women are tolerant of a variety of body sizes. Based on findings from our Attitudes Toward Obese Persons scale, body size sense of self and sex do not influence attitudes toward obese persons. Further studies are needed.

Adolescent↗
PubMed2003

Effects of animal-assisted therapy on patients' anxiety, fear, and depression before ECT.

OBJECTIVE: To determine whether animal-assisted therapy (AAT) is associated with reductions in fear, anxiety, and depression in psychiatric patients before electroconvulsive therapy (ECT). MATERIALS AND METHODS: Before their scheduled ECT treatment, 35 patients were assigned on alternate days to the treatment condition, consisting of a 15-minute AAT session, and the standard (comparison) condition, consisting of 15 minutes with magazines. Visual analogue scales were used to measure anxiety, fear, and depression before and after treatment and standard conditions. RESULTS: The effect of AAT on fear was significant in both the mixed-model, repeated-measures analysis of covariance (ANCOVA) (p = 0.0006) and the secondary analysis (p = 0.0050), which covaried out all of the demographic conditions (gender, race, marital status, pet ownership, age), condition order, and the pretest rating. The effect of AAT on anxiety approached significance in the ANCOVA (p = 0.0982), but in the secondary analysis, the effect was not significant (p = 0.6498). The AAT effect on depression was not significant in ANCOVA (p = 0.7665) or in the secondary analysis (p = 0.9394). A least squares mean analysis showed that AAT reduced fear by 37% and anxiety by 18%. There was no demonstrated effect of AAT on depression. CONCLUSIONS: Animal-assisted therapy may have a useful role in psychiatric and medical therapies in which the therapeutic procedure is inherently fear-inducing or has a negative societal perception.

Adult↗