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Linical depression is a risk factor for heart disease1, 2 and is associated with increased mortality after acute myocardial infarction MI ; .3 The increased cardiovascular risk among patients with depression has been hypothesized to be attributable to abnormalities in the sympathoadrenal system, the autonomic nervous system, and platelet function.4 Selective serotonin reuptake inhibitors SSRIs ; have been demonstrated to be effective for the treatment of depression5 and are associated with fewer cardiovascular side-effects compared with other antidepressants.6, 7 Along with their effect on depression, SSRIs have an inhibitory effect on platelet activation8 11 and, therefore, may protect against MI. Although several studies have examined the cardiac side effects of SSRIs, 6, 7, 12, only one has examined the possible protective effect against MI.14 Although there was a reduced odds of MI in users of SSRIs odds ratio [OR] 0.8 ; , the study was statistically underpowered to detect a meaningful reduction in risk and could not adjust for potential confounding that might have masked a significant inverse association between.
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107 other group. In a very few instances a Group A person was reclassified as Group B, or a Group B person was reclassified as Group A. The general agreement was 95 per cent. 2. Thirty-three of the patients had specific psychiatric interviews. Most patients had five or six sessions of about one hour each. They were conducted by one of us W.A.T. ; who had not done the group classification. In every case the groupclassification was not known at the time of the interview. The results of the interviews were then interpreted in terms of the group classification. The two methods agreed in 27 cases or in 82 per cent. In one case a patient who was.thought to be an the rough method was classified as a C virtue, of information, received from the interviews. In 2 cases an original A classification as a B, and in 3 cases an original B classification was interpreted as an A. Rorschach tests were done on 12 patients by a. consulting psychologist. * He was assigned some A, B, and C types without his knowledge of this, classification. With this small number it is difficult to be dogmatic about the results. It can be said, however, that no one personality type predominated There also are consistent differences between our three groups in terms of Rorschach factors which agreed with the criteria we used in determing these groups. 4. An attempt was made at an objective assessment of personality by using the sixteen-personality-factor questionnaire designed by R. B. Cattell, D. R. Saunders and G. Stice 2 ; . Some of their factors contained a number of traits that could well be applied to the people in our various groups. Examination of the first 15 of these studies shows excellent correlation with our original personality grouping. The detailed study of the personality types in Parkinson's disease with the Rorschach tests and the Catell questionnaire in the full group of patients will form the subject of a subsequent communication. Thus in all four of the methods used to test the original group, there is a sufficient measure of agreement to suggest that the utilitarian classification was a good approximation. II. Response to Treatment All our patients, out patients and office patients, were treated with a variety of drugs. These included hyoscine, stramonium, belladonna, artane, parpanit, The Rorschach studies were done under the supervision of Dr. Samuel Waldfogel and Mr. Richard York, and the authors thank them for their cooperation and help.
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