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Postnatal depression is common and may have severe consequences for women and their children. Locally validated screening tools are required to identify at-risk women in marginalised populations. The Edinburgh Postnatal Depression Scale (EPDS) is one of the most frequently used tools globally. This cross-sectional study assessed the validity and acceptability of the EPDS in Karen and Burmese among postpartum migrant and refugee women on the Thai-Myanmar border. The EPDS was administered to participants and results compared with a diagnostic interview. Local staff provided feedback on the acceptability of the EPDS through a focus group discussion. Results from 670 women showed high accuracy and reasonable internal consistency of the EPDS. However, acceptability to local staff was low, limiting the utility of the EPDS in this setting despite its good psychometrics. Further work is required to identify a tool that is acceptable and sensitive to cultural manifestations of depression in this vulnerable population.

Original publication




Journal article


Trop Doct

Publication Date





339 - 347


Edinburgh Postnatal Depression Scale (EPDS), Postnatal depression, migrant, refugee, Adolescent, Adult, Cross-Cultural Comparison, Cross-Sectional Studies, Depression, Postpartum, Developing Countries, Female, Humans, Mass Screening, Middle Aged, Myanmar, Psychiatric Status Rating Scales, Psychometrics, Refugees, Reproducibility of Results, Surveys and Questionnaires, Thailand, Women's Health, Young Adult