ORIGINAL ARTICLE Assessing the measurement invariance of the Center for Epidemiologic Studies Depression Scale across immigrant and non-immigrant women in the postpartum period Ryan J. Van Lieshout & Kristin Cleverley & Jennifer M. Jenkins & Katholiki Georgiades Received: 16 May 2011 /Accepted: 7 September 2011 /Published online: 20 September 2011 # Springer-Verlag 2011 Abstract To assess the measurement invariance of the Center for Epidemiologic Studies Depression Scale (CES-D) 2 months after delivery in 656 English-speaking immigrant and non-immigrant women who had at least one other child under 16 and who gave birth in one of two urban Canadian centers. We also compared levels of depression in these two groups using this scale. Multiple group confirmatory factor analysis showed that configural, metric and partial scalar invariances were present and allowed for meaningful sub- stantive comparisons to be made between immigrants and non-immigrants using linear and logistic regressions on an invariant 15-item version of the scale. We observed a novel 4- factor structure for the CES-D in postpartum women and established a 15-item version of this scale that was invariant across immigrant and non-immigrant groups. This suggests that women conceptualize postpartum depression (PPD) in similar ways using the 15-item version of this scale and that meaningful substantive comparisons can be made using it. Indeed, immigrants manifested higher levels of depres- sive symptoms than non-immigrants (unstandardized b = 1.34, p =0.02) and an increased risk of being a potential case of PPD (OR=2.16, 95%CI 1.10–4.19), even after adjustment for other risk factors. Immigrant and non-immigrant women appear to conceptualize PPD in similar ways using this 15-item version of the CES-D. Immigrants may develop more depressive symptoms and be at increased risk of developing an episode of PPD. Keywords Depression . Postpartum . Immigrants . Ethnic groups . Measurement invariance . Measurement equivalence Up to 15% of women living in developed countries will experience clinically significant levels of depressive symp- toms in the postpartum period (Gavin et al. 2005). While the manifestations and labeling of postpartum depression (PPD) may differ across cultures, it appears as if it is experienced by women around the world (Goldbort 2006). Postpartum depression has a complex and multifactorial etiology. Stressful life events, partner conflict, poor social support, abuse, a past personal or family history of PPD or other nonpuerperal psychiatric problems all appear to increase one's risk for developing PPD (Robertson et al. 2004; Pearlstein et al. 2009). Postpartum depression The authors declare that they have no conflicts of interest. Electronic supplementary material The online version of this article (doi:10.1007/s00737-011-0236-0) contains supplementary material, which is available to authorized users. R. J. Van Lieshout : K. Cleverley : K. Georgiades Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada R. J. Van Lieshout : K. Cleverley : K. Georgiades The Offord Centre for Child Studies, McMaster University, Hamilton, Ontario, Canada J. M. Jenkins Department of Human Development and Applied Psychology, University of Toronto, Toronto Ontario, Canada R. J. Van Lieshout (*) Department of Psychiatry and Behavioural Neurosciences, Hamilton Health Sciences, Chedoke Division, McMaster University, Box 2000, Central Building Rm 304, 1200 Main Street West, Hamilton, Ontario, Canada L8N 3Z5 e-mail: vanlierj@mcmaster.ca Arch Womens Ment Health (2011) 14:413–423 DOI 10.1007/s00737-011-0236-0