Measuring depressive symptoms in heart failure: Validity and reliability of the patient health Questionnaire-8

Susan J. Pressler, Usha Subramanian, Susan M. Perkins, Irmina Gradus-Pizlo, David Kareken, Jin Shil Kim, Yan Ding, Mary Jane Sauvé, Rebecca Sloan

Research output: Contribution to journalArticle

40 Scopus citations


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 χ2 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 LivingWith Heart Failure Questionnaire (P < .001 for all correlations). Differences in the PHQ-8 scores were found among NewYork 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.

Original languageEnglish (US)
Pages (from-to)146-152
Number of pages7
JournalAmerican Journal of Critical Care
Issue number2
StatePublished - Mar 1 2011

ASJC Scopus subject areas

  • Critical Care

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