Scientists at the University of Liverpool have developed a therapy programme to treat depression in women in developing countries.

Although depression is a major health problem world-wide, experts say its impact is greatest in developing countries where 80% of the population live. Often there are no resources available to treat sufferers.

Professor Atif Rahman from the School of Population, Community and Behavioural Sciences developed a therapy programme while working as a Wellcome Trust Career Fellow in Tropical Medicine in Rawalpindi, Pakistan.

"Depression is one of the leading causes of mental illness in the world and when the condition affects mothers with newborn babies, it can lead to serious consequences" he says. "The impacts include low birth-weight, poor growth, frequent diarrhoea and the mother failing to ensure the child is properly immunised. These conditions tend to remain untreated in countries like Pakistan where only a fraction of the Government's budget is spent on health.

The programme, which is designed to be integrated into the routine work of ordinary village-based health workers, has been tested in Rawalpindi. Community health workers visiting expectant mothers are trained to use principles of cognitive behaviour therapy as treatment. Patients attend sessions every week in the last month of pregnancy, followed by three sessions in the first post-natal month, and nine monthly sessions thereafter.

The largest trial of the treatment of depression using community health workers from any country in the developing world involved 903 mothers 463 of whom were in the therapy group. The mothers from this control group were twice as likely to be depressed as those given the therapy after six and 12 months.

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