Validation of the Refugee Health Screener-15 for the assessment of perinatal depression among Karen and Burmese women on the Thai-Myanmar border

• Published in: PloS one Vol. 13; no. 5; p. e0197403
• Main Authors: Fellmeth, Gracia, Plugge, Emma, Fazel, Mina, Charunwattana, Prakaykaew, Nosten, François, Fitzpatrick, Raymond, Simpson, Julie A, McGready, Rose
• Format: Journal Article
• Language: English
• Published: United States Public Library of Science 21.05.2018; Public Library of Science (PLoS)
• Subjects: Adolescent; Adult; Biology and Life Sciences; Care and treatment; Children; Clinical medicine; Depression - diagnosis; Depression - epidemiology; Depression, Mental; Diagnosis; Education; Engineering and Technology; Epidemiology; Evaluation; Female; Geography; Health aspects; Health services; Health status indicators; Humans; Immigrants; Language; Malaria; Medical screening; Medicine; Medicine and Health Sciences; Mental depression; Mental disorders; Mental health care; Middle Aged; Migration; Myanmar - epidemiology; People and Places; Population; Pregnancy; Pregnancy Complications - diagnosis; Pregnancy Complications - epidemiology; Pregnancy, Complications of; Psychometrics - methods; Public health; Refugees; ROC Curve; Social Sciences; Surveys and Questionnaires; Thailand - epidemiology; Transients and Migrants; Womens health; Young Adult; Thailand; Myanmar; England; Myanmar (Burma); United Kingdom > UK
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0197403

Perinatal depression is common, and left untreated can have significant and long-lasting consequences for women, their children and their families. Migrant women are at particular risk of perinatal depression as a result of a multitude of stressors experienced before, during and after migration. Identification of perinatal depression among migrant women-particularly those living in low- and middle-income regions-remains challenging, partly due to the lack of locally-validated and culturally appropriate screens tools. This study formally validates Burmese and Sgaw Karen versions of the Refugee Health Screener-15 (RHS-15) as a screening tool for perinatal depression among migrant women living on the Thai-Myanmar border. The Structured Clinical Interview for the Diagnosis of DSM-IV Disorders (SCID) was used as the gold-standard comparator. Complete results were obtained for 235 Burmese-speaking and 275 Sgaw Karen-speaking women. Despite displaying reasonable psychometric properties, a number of shortcomings associated with the RHS-15 limited its utility in this setting. The Likert-type response categories of the RHS-15 proved problematic in this low-literacy population. Combined with the relative superiority and greater ease of administration of the SCID, the RHS-15 is not recommended as the tool of choice for detecting perinatal depression in this setting.