A confirmatory factor analysis of the Center for Epidemiologic Studies Depression Scale in rheumatoid arthritis patients: additional evidence for a four-factor model.
OBJECTIVE
To examine the factor structure of the Center for Epidemiologic Studies Depression Scale (CES-D) in a sample of patients with rheumatoid arthritis (RA), testing all of the alternative models suggested by the previous evidence.


METHODS
The CES-D was administered to a group of RA patients (n = 685) during a structured telephone interview. The telephone interview was repeated 6 months later (n = 537) and 12 months later (n = 453). Confirmatory factor analyses were conducted to test alternative models.


RESULTS
The correlated 4-factor model and the second-order 4-factor model were the best fitting models.


CONCLUSIONS
The factor structure of the CES-D previously found in the general population was replicated in an RA sample. The results are consistent with previous evidence of criterion contamination in the CES-D when used in an RA sample and provide support for the view that a single summary score may not be the most informative index of the CES-D.
Rhee
S H
SH
Harry S. Truman Memorial Veterans' Hospital, Columbia, Missouri 65201, USA.
Petroski
G F
GF
Parker
J C
JC
Smarr
K L
KL
Wright
G E
GE
Multon
K D
KD
Buchholz
J L
JL
Komatireddy
G R
GR
D001172:Arthritis, Rheumatoid / Q000150:complications* / Q000523:psychology*; D003866:Depressive Disorder / Q000175:diagnosis* / Q000209:etiology*; D005163:Factor Analysis, Statistical; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011569:Psychiatric Status Rating Scales / Q000592:standards*