The piece was written shortly after two traumatic events in the life of the composer: the first presentation of debilitating muscular weakness that would eventually (in 1965) be diagnosed as a rare form of polio, and his reluctant joining of the Communist Party. According to the score, it is dedicated "to the victims of fascism and war"; his son, Maxim, interprets this as a reference to the victims of all totalitarianism, while his daughter Galina says that he dedicated it to himself, and that the published dedication was imposed by the Russian authorities. Shostakovich's friend, Lev Lebedinsky, said that Shostakovich thought of the work as his epitaph and that he planned to commit suicide around this time.

All of String Quartet No. 8 is about as intense or compelling as this one.