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 ICES-DI in a sample of patients with rheumatoid ar thritis (RAJ, testing all of the alternative models suggested by the previo us evidence. Methods. The CES-D was administered to a group of RA patients (n = 685) dur ing 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. Conclusion. The factor structure of the CES-D previously found in the gener al population was replicated in an RA sample. The results are consistent wi th previous evidence of criterion contamination in the CES-D when used in a n RA sample and provide support for the view that a single summary score ma y not be the most informative index of the CES-D.