Validation of the Arabic Version of the Refugee Health Screener-13 Among Perinatal Syrian Refugees in Lebanon

Background: Refugee mothers are at a significantly increased risk of suffering from perinatal depression. However, available tools to screen for it often use a western paradigm of mental health, may not be culturally appropriate, and may not account for the background stress experienced by refugees. The objective of this study is to test and validate RHS-13, which was developed by consultation with refugees from different backgrounds, among a group of Syrian refugee mothers living in Beka’s valley in Lebanon. Methodology: The tool was tested on a sample of 103 women. Internal consistency of the items for each subscale was assessed using Cronbach’s alpha. An interitem correlation was performed to examine the most correlated items on the scale. Pearson correlation coefficient was calculated between each subscale and its diagnostic proxy. To find the best fit cut-point between sensitivity and specificity, ROC curves were used. Results: RHS-13 is a reliable and valid tool to detect depression and anxiety among perinatal Syrian mothers (Internal consistency 0.803) (correlation with PHQ: 0.63), (correlation with GAD-7: 0.73). The best fit cut-points were 12, 15, and 25 indicating the severity of symptoms from mild to severe, respectively. Conclusion: RHS-13 is a valid tool among perinatal refugees in Lebanon and can be used by primary care physicians, mental health providers, social workers working with refugees from the Middle East to screen mothers for depression and anxiety.