Measuring Depressive Symptoms in Heart Failure: Validity and Reliability of the Patient Health Questionnaire-8
Abstract
BACKGROUND: Depressive symptoms are common in patients with heart failure, but few investigators have reported the validity and reliability of measures of depressive symptoms among these patients. OBJECTIVES: To evaluate the validity and reliability of a measure of depressive symptoms, the Patient Health Questionnaire-8 (PHQ-8), among 249 patients with chronic heart failure. METHODS: As part of a larger study, patients completed the PHQ-8 and the Living With Heart Failure Questionnaire. New York Heart Association class was assessed as a measure of the severity of heart failure. Construct validity of the PHQ-8 was evaluated by confirmatory factor analysis, Pearson correlation coefficients, and analysis of variance. Internal consistency reliability was estimated by using the Cronbach α. RESULTS: The sample was 63% men, with a mean age of 63 years, and 67% reported their race as white. Construct validity of the PHQ-8 was supported. The confirmatory factor analysis model reflected the emotional and somatic dimensions of depressive symptoms and displayed a good fit with the data. The χ(2) value of the PHQ-8 was 24.75 with 18 degrees of freedom (P =.13) and the goodness-of-fit index was 0.98. The PHQ-8 was significantly correlated with the total and subscale scores on the Living With Heart Failure Questionnaire (P <.001 for all correlations). Differences in the PHQ-8 scores were found among New York Heart Association classes (F=20.4, P<.001). The PHQ-8 internal consistency reliability (Cronbach α) was 0.82. CONCLUSIONS: The PHQ-8 demonstrated satisfactory validity and reliability; these results support its use to measure depressive symptoms in patients with heart failure.
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PHQ-8 is clinically validated for the assessment of depression severity, has high internal consistency (Cronbach α=.82), and has been used in several previous studies.
“Although the depression assessments were self-reported, the PHQ-8 is clinically validated for the assessment of depression severity, has high internal consistency (Cronbach α=.82), and has been used in several previous studies [3,7,41].”
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- Authors
- Pressler, S. J., Subramanian, U., Perkins, S. M., Gradus-Pizlo, I., Kareken, D., Kim, J., Ding, Y., Sauve, M. J., & Sloan, R.
- Affiliations
- University of Michigan (US)
- Indiana University Bloomington (US)
- Ajou University (KR)
- Indiana University – Purdue University Indianapolis (US)
- Venue
- American Journal of Critical Care
- Publisher
- AACN Publishing
- Published
- 2010-04-08
- Volume
- 20
- Issue
- 2
- Pages
- 146-152
- ISSN
- 1062-3264 (ISSN-L)
- 1937-710X
- OpenAlex
- W2120571294
- Cited by
- 147
- References
- 28
- Citations by year
- 2026: 11 · 2025: 18 · 2024: 12 · 2023: 13 · 2022: 14 · 2021: 20 · 2020: 9 · 2019: 10 · 2018: 4 · 2017: 11 · 2016: 5 · 2015: 6 · 2014: 1 · 2013: 7 · 2012: 1
- FWCI
- 2.85
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- American Journal of Critical Care (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institute of Nursing Research (R01NR008147)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Health and Mental Health
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Social Sciences › Education › Health Education and Validation
- Keywords
- depressive symptoms, heart failure, PHQ-8, construct validity, internal consistency, NYHA functional class, psychometric validation
- MeSH terms
- Adult, Aged, Aged, 80 and over, Ambulatory Care Facilities, Depression, Factor Analysis, Statistical, Female, Heart Failure, Humans, Male, Middle Aged, Surveys and Questionnaires, Midwestern United States, Young Adult
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