D Pathak

University of New Mexico Hospitals, Albuquerque, New Mexico, United States

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Publications (61)326.35 Total impact

  • [Show abstract] [Hide abstract]
    ABSTRACT: The purpose of this study was to assess the validity and reproducibility of an interviewer-administered, semi-quantitative food frequency questionnaire (FFQ) among 132 volunteer New Mexico Hispanic (H) and non-Hispanic white (NHW) women, aged 35-74 years, with (n = 47) and without (n = 85) a breast cancer history, and to add to the limited data presently available on the performance of FFQs among different ethnic groups. Validity was measured at one month and six months from baseline against four-day food records, and reproducibility was tested by comparing FFQs. Unadjusted validity correlation coefficients were highest at one month, ranging from 0.38 (polyunsaturated and monounsaturated fat) to 0.57 (calcium); energy-adjusted correlation coefficients were highest at six months, ranging from 0.15 (polyunsaturated fat) to 0.68 (calcium). Energy-adjusted correlation coefficients were statistically significant by ethnicity for vitamins A and C, protein, carotene and calcium, and by case status for saturated fat, folate, fiber, and vitamins A and E. Reproducibility correlation coefficients (unadjusted) ranged from 0.40 (polyunsaturated fat) to 0.71 (carbohydrate, retinol); energy-adjusted correlation coefficients ranged from 0.42 (vitamin E) to 0.78 (fiber), and differed significantly by ethnicity for saturated fat and retinol, and by case status for carbohydrate. Overall, our FFQ has comparable characteristics to other FFQs and is suitable for use with New Mexico's H and NHW women.
    Ethnicity & disease 02/1998; 8(1):81-92. · 1.12 Impact Factor
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    ABSTRACT: To make a dimensional assessment of personality in individuals with pathological anxiety, the Tridimensional Personality Questionnaire (TPQ) was administered to 32 patients with panic disorder (PD) and 49 patients with generalized anxiety disorder (GAD). The most striking findings were a substantially increased score on the harm avoidance dimension in both groups of patients, and a lack of significant differences between the TPQ scores in patients with PD and GAD. The former finding suggests that higher levels of harm avoidance may be common to (although not necessarily specific for) various types of anxiety disorders. The latter finding is in agreement with the findings that PD and GAD do not differ significantly with respect to the associated personality disorder diagnoses, which may further cast a doubt on the validity of the distinction between PD and GAD.
    Journal of Affective Disorders 05/1996; 37(2-3):75-9. · 3.30 Impact Factor
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    ABSTRACT: Fifty-eight chronic nightmare sufferers were randomly assigned to two groups: treatment (n = 39) and wait-list control (n = 19). Treated Ss were taught a cognitive-behavioral technique called imagery rehearsal in which they learned in a waking state to change a nightmare and then to visualize the new set of images. Subjects were assessed pre-treatment and 3 months followup for nightmare frequency, self-rated distress and subjective sleep quality. Compared to controls, the treatment group showed significant and clinically meaningful decreases in nightmares. Treated Ss decreased nightmares as measured in nights/week (mean = -2.0, SD = 1.7, P = 0.0001) and actual number of nightmares (mean = -4.2, SD = 4.5, P = 0.0001). Significant improvement in self-rated sleep quality occurred in those treated compared with controls (P = 0.004); and, reduction in nightmares was a significant predictor of improvement in sleep (r = 0.55, P = 0.0001). These preliminary results lend support to the theory that, for some chronic sufferers, nightmares may be conceptualized as a primary sleep disorder which can be effectively and inexpensively treated with cognitive-behavioral therapy.
    Behaviour Research and Therapy 10/1995; 33(7):837-43. · 3.85 Impact Factor
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    ABSTRACT: A mammographic pattern of > 25% radiodensity is associated with increased risk for breast cancer. Mammographic pattern is influenced by age, body weight, reproductive factors, and race/ethnicity. The interaction among these factors in predicting breast radiographic pattern, and their association with the presence of histologic markers of increased risk of breast cancer, is poorly defined. To elucidate the relations among epidemiologic, radiographic, and histologic markers of breast cancer risk, the authors studied these factors in an unselected forensic autopsy series, accumulated between 1978 and 1983, of 486 women aged 15-98 years at death. Older age and/or postmenopausal status was the strongest predictor of radiolucent breast pattern. Obesity, defined as a Quetelet index (weight(kg)/height(m)2) of > 25, and large breast size were also highly significant predictors of breast radiolucency. Factors related to parity were not significant predictors of breast parenchymal pattern. Native American race was an independent predictor of breast radiolucency in this population. A dense parenchymal pattern was associated with increased prevalence of marked cystic change and the presence of duct epithelial hyperplasia in women under age 35. The results support the association of breast radiodensity with ethnic/racial, reproductive, and histologic factors predictive of cancer risk. However, this association is overshadowed by the effects of obesity and aging or menopause.
    American Journal of Epidemiology 10/1995; 142(8):813-9. · 4.78 Impact Factor
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    ABSTRACT: All unexpected deaths in New Mexico from 1977 to 1988 were reviewed. By statute each such death must be reported to the Office of the Medical Examiner (OMI) and according to institutional policy autopsied even when death is presumed to be from natural causes. From this group the 650 index cases that form the basis of this report were obtained. The crude rate of sudden, unexpected death among New Mexico residents 5 to 39 years old during the study period was 6.6/100,000 persons at risk. As documented by autopsy, the underlying cause of death in a majority of these cases (53.4%) was related to cardiovascular disease and alcoholism. Male persons in general are at increased risk for sudden, unexpected death, and American Indian and black male persons are at greater risk than their Anglo and Hispanic counterparts. American Indians account for a disproportionate share of the unexpected deaths resulting from alcoholism, and black male persons are at particular risk for unexpected death resulting from cardiovascular diseases. This report emphasizes the importance of life style and diet in the well-being of persons 5 to 39 years old.
    Human Pathlogy 01/1995; 25(12):1332-40. · 2.84 Impact Factor
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    ABSTRACT: The presence of radiographic silicosis as a risk factor for lung cancer was assessed in a case-control study conducted within a study cohort of New Mexico underground uranium miners. Chest radiographs were interpreted for the presence of silicosis for 65 lung cancer cases and 216 controls. The presence of silicosis on the chest radiograph taken closest to the start of employment or on the latest radiograph available was not associated with lung cancer risk after adjustment for cumulative exposure to radon progeny. The odds ratio associated with the presence of any type of opacity indicative of pneumoconiosis on the chest x ray closest to the start of employment was 1.33 (95% confidence interval, 0.31-5.72). For the most recent available chest x ray, the corresponding odds ratio was 1.16 (95% confidence interval, 0.35-3.84). Although the findings are limited by the relatively small number of subjects, the lack of association of silicosis with lung cancer suggests that silica exposure should not be regarded as a major uncertainty in extrapolating radon risk estimates from miners to the general population.
    Health Physics 05/1994; 66(4):450-3. · 1.02 Impact Factor
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    ABSTRACT: Groups of patients with principal diagnosis of panic disorder (n = 54) and generalized anxiety disorder (n = 49) were compared on the basis of their comorbidity with other mental disorders. The rates and patterns of comorbidity were similar, except for comorbid simple phobia and past drug abuse. This finding was interpreted as failing to support a notion that there is essential distinction between panic disorder and generalized anxiety disorder.
    Psychopathology 02/1994; 27(6):269-72. · 1.62 Impact Factor
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    ABSTRACT: In order to compare hypochondriacal phenomena in patients with generalized anxiety disorder (GAD) and panic disorder (PD), and in order to examine the relationship between worries about illness on one hand, and disease fears/phobias and hypochondriacal beliefs on the other, the authors administered the Illness Attitudes Scales to patients with both GAD and PD, and determined the spheres of worry in patients with GAD. Patients with GAD were significantly less hypochondriacal than PD patients. A specific relationship between GAD and hypochondriasis was not found because worries about illness, which characterize some GAD patients, were largely independent from disease fears/phobias and hypochondriacal beliefs, which are a hallmark of hypochondriasis.
    Psychotherapy and Psychosomatics 02/1994; 61(1-2):93-9. · 9.38 Impact Factor
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    ABSTRACT: Nightmare frequency and self-rated distress were assessed retrospectively in two groups of chronic nightmare sufferers 30 months after treatment. In the initial phase, the image group (N = 9) learned a cognitive-behavioral technique (imagery rehearsal) for the treatment of nightmares. They were taught in one group session to: (1) record a nightmare; (2) change it (usually to something positive); and (3) rehearse the new images daily. The record group (N = 10) recorded nightmares during the first month only and learned imagery rehearsal subsequent to 3-month follow-up measurements. At 3 months and at 30 months, both groups had significantly fewer nightmares, but only the rehearsal group had less total distress. The results support the theory that nightmares are a primary sleep disorder rather than a symptom of an underlying psychiatric problem.
    Journal of Behavior Therapy and Experimental Psychiatry 01/1994; 24(4):325-30. · 2.23 Impact Factor
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    ABSTRACT: Ages of onset and the sequence of appearance of panic disorder (PD) and comorbid conditions were determined in a sample of 54 patients with the principal DSM-III-R diagnosis of PD. The onset of PD was earlier in patients with moderate to severe agoraphobia (AG) than in panic patients without AG. Patients with alcohol abuse and drug abuse before the onset of PD also had a tendency to develop PD earlier, which suggests that these conditions might have specifically predisposed to PD. All comorbid disorders, except for major depression, were more likely to precede the onset of PD so that, more often than not, PD appeared as a chronologically secondary condition. However, it was found that only for primary substance abuse such a temporal relationship might denote etiologic relatedness to PD, because of the reduced temporal distance between the onset of primary substance abuse and secondary PD.
    Psychiatry Research 04/1993; 46(3):285-93. · 2.68 Impact Factor
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    ABSTRACT: We examined the onsets of comorbid psychiatric disorders in patients with panic disorder (PD) (N = 54). In 42 patients (77.8%), PD was preceded by another psychiatric condition (secondary PD group), while in 12 patients (22.2%), PD occurred first or was the only diagnosed mental disorder (primary PD group). Patients with primary and secondary PD did not differ with respect to demographic variables, mean ages of onset of PD, mean duration of PD, number of patients with a personality disorder, and number of patients with different DSM-III-R subtypes of PD. Except for the anger and sleep scales of the Hopkins Symptom Checklist 90, patients with primary PD had significantly less self-rated psychopathology; they also displayed less extensive phobic avoidance, and had a lower rate of current psychiatric comorbidity. These findings are discussed in light of the value of the concepts of comorbidity and primary/secondary dichotomy.
    Journal of Affective Disorders 03/1993; 27(2):81-6. · 3.30 Impact Factor
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    ABSTRACT: Twenty subjects with chronic nightmares for 17.2 years mean duration were randomly divided into two groups: Rehearsal and Recording. At inception, subjects in both groups were instructed to write down their nightmares for one month. The Recording group received no other intervention. Rehearsal subjects received a single treatment group session teaching an imagery rehearsal technique to reduce nightmare frequency. At inception and three months follow-up, both groups were compared for nightmare frequency and for self-rated distress with scales (Symptom Checklist and Symptom Questionnaire) measuring anxiety, depression, hostility, somatization and total distress. Nightmare frequency decreased significantly in both groups: Rehearsal group-7.2 per month to 2.0 per month (72% reduction) (p < 0.006); Recording group-9.4 per month to 5.0 per month (47% reduction) (p < 0.02). There were no statistically significant differences in the nightmare frequency reductions between groups. All anxiety, depression, somatization, hostility and total distress scores decreased substantially in the Rehearsal group. Most changes were significant. Changes in the Recording group were inconsistent and not significant. Two brief case histories are presented.
    Sleep 10/1992; 15(5):470-3. · 5.10 Impact Factor
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    ABSTRACT: Diagnoses of comorbid disorders were determined in a sample of 54 patients with panic disorder as defined in DSM-III-R. The sample was divided into the following three groups: (1) uncomplicated panic disorder (PDU); (2) panic disorder with mild agoraphobia (PDM); and (3) panic disorder with moderate to severe agoraphobia (PDA). In comparison with patients with PDU, patients with PDA had higher comorbidity rates in general, received multiple comorbid diagnoses more frequently, had a higher prevalence of major depression, dysthymia, social phobia, generalized anxiety disorder, and obsessive-compulsive disorder, and scored higher on most measures of self-rated psychopathology. These findings support the notion that PDA may be a disorder essentially different from PDU.
    Psychiatry Research 06/1992; 42(2):171-83. · 2.68 Impact Factor
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    ABSTRACT: The purpose of this study was to examine the effects of one session of instructions on the frequency of chronic nightmares and on self-rated distress. Twenty-eight volunteers with chronic nightmares (mean duration = 19 years) were treated with either one session of desensitization with instructions on how to practice this treatment or with one session of instructions to change the nightmare and how to rehearse the new version. The authors administered four scales of the SCL-90 and the corresponding scales of the Symptom Questionnaire. At 7-month follow-up of 23 patients, there was a significant reduction in the frequency of nightmares and significant decreases in self-rated depression, anxiety, and hostility. There were no significant differences between the effects of the two types of treatment. In four patients, whose mean duration of nightmares was 23 years, the nightmares ceased. The results of this preliminary study suggests that the instructions given to the patients reduced the frequency of their chronic nightmares and decreased their self-rated distress.
    American Journal of Psychiatry 06/1992; 149(5):659-63. · 14.72 Impact Factor
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    R Kellner, J Hernandez, D Pathak
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    ABSTRACT: Four self-rating scales of hypochondriasis and the Symptom Checklist-90 were administered to 100 general practice (GP) patients and matched non-psychotic psychiatric out-patients. In a stepwise linear regression, self-rated somatic symptoms and anxiety predicted hypochondriacal fears and beliefs; self-rated depression did not appear as a predictor. There were differences between males and females and between psychiatric patients and GP patients in the associations of these constructs. These results varied in part with the scale of hypochondriasis used. Various scales of hypochondriasis appear to measure different features of the hypochondriasis syndrome. Fear of disease (disease phobia) was associated with anxiety, whereas a false belief of having a disease (disease conviction) was associated more with somatic symptoms.
    The British Journal of Psychiatry 05/1992; 160:525-32. · 6.61 Impact Factor
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    ABSTRACT: The purpose of this study was to examine correlates of hypochondriacal fears and beliefs in patients with panic disorder (PD) (n = 54). They were evaluated using the structured diagnostic interviews for axis I and axis II disorders (SCID-UP-R and SCID-II). They were administered the Illness Attitudes Scales (IAS) as a measure of hypochondriacal fears and beliefs, the Hopkins Symptom Checklist 90 (HSCL), and the Fear Questionnaire (FQ). One half of the patients rated themselves as having substantial hypochondriacal fears and beliefs. The sample was divided into groups of patients seeking predominantly treatment or relief from symptoms (treatment-oriented), and those who were searching for a cause of their illness (explanation-seeking): the latter had significantly more hypochondriacal concerns. Avoidant, histrionic, and borderline personalities were more common in the hypochondriacal group. The results of several analyses suggest that patients with PD who are also agoraphobic, fear physical disease more and have more false beliefs of having a disease than PD patients without agoraphobia.
    Journal of Affective Disorders 03/1992; 24(2):73-85. · 3.30 Impact Factor
  • R Kellner, J Hernandez, D Pathak
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    ABSTRACT: In order to examine the relationship of self-rated inhibited anger to somatization, the authors administered several self-rating scales, including the SCL-90 and a Likert scale pertaining to inhibited anger, to psychiatric patients and family practice patients of both sexes. In a linear stepwise regression, depression predicted inhibited anger in all four groups. Previous studies have reported an association of inhibited anger and somatization; the present study suggests that depression is the link between the two in the majority of patients. The relationship of inhibited anger to depression may have implications for psychotherapy.
    Psychotherapy and Psychosomatics 02/1992; 57(3):102-7. · 9.38 Impact Factor
  • R Kellner, J Samet, D Pathak
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    ABSTRACT: In order to examine the relationship of dyspnea to anxiety and depression, the authors rated dyspnea using several methods in 50 patients with chronic respiratory impairment. Anxiety and depression were measured by the Symptom Checklist-90 and the Symptom Questionnaire. Results varied with the method of assessing dyspnea. Physician-rated dyspnea was significantly associated with patients' self-ratings of breathlessness as well as with pulmonary function tests, but not with any of the self-rating scales of emotions. Self-rated breathlessness was significantly associated with self-rated depression. In multiple regression analyses, depression was predictive of breathlessness. When the sample was limited to patients with chronic obstructive pulmonary disease, the results remained the same. The patients were significantly more depressed and anxious than matched family practice patients. In the study of the complex relationship of dyspnea to physical and emotional factors, it is desirable to use more than one measure of dyspnea because the results depend in part on the method of assessment.
    General Hospital Psychiatry 02/1992; 14(1):20-8. · 2.98 Impact Factor
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    ABSTRACT: A cohort of 3469 males with at least 1 y of underground uranium mining experience in New Mexico was assembled and mortality followed up through 31 December 1985. The mean and median cumulative exposures for the cohort were 0.39 J h m-3 and 0.12 J h m-3 (111.4 and 35.0 Working Level Months [WLM]), respectively. Overall, mortality in the cohort was significantly increased (standardized mortality ratio [SMR] = 1.1, 95% confidence interval [CI] = 1.02-1.2) relative to the general population of the state. By cause, significant increases were observed for lung cancer (SMR = 4.0, 95% CI 3.1-5.1) and for external causes of death (SMR = 1.5, 95% CI 1.3-1.7). The risk of lung cancer increased for exposure categories above 100 WLM; the excess relative risk increased by 0.5% per mJ h m-3, 95% CI 0.2-1.5 (1.8% per WLM, 95% CI 0.7-5.4). Data were consistent with a multiplicative interaction between smoking and exposure to Rn progeny in an exponential relative risk model. The risk of lung cancer varied substantially with age at observation; the odds ratios rose more steeply with exposure to Rn progeny for those less than age 55 y at observation.
    Health Physics 01/1992; 61(6):745-52. · 1.02 Impact Factor
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    ABSTRACT: The relationship of reproductive factors, such as nulliparous vs ever-parous status, age at first birth, and total parity, with morphologic prevalence of fibrocystic changes were examined using autopsy material from three ethnic/racial groups at varying risks for breast cancer. Although there was a trend toward a protective effect of ever-parous status, there was no statistically significant difference in the prevalence of fibrocystic disease in any group defined by parity status. The ethnic differences in the prevalence of fibrocystic changes were not explained by the differences in parity status distribution for the three ethnic/racial groups.
    British Journal of Cancer 07/1991; 63(6):1005-9. · 5.08 Impact Factor

Publication Stats

1k Citations
326.35 Total Impact Points

Institutions

  • 1979–1996
    • University of New Mexico Hospitals
      Albuquerque, New Mexico, United States
    • Universitetet i Tromsø
      Tromsø, Troms, Norway
  • 1972–1993
    • University of New Mexico
      • • Department of Psychiatry
      • • Division of Hospital Medicine
      • • School of Medicine
      Albuquerque, NM, United States