Conceptual Model of an Expert System from Systematic Literature Review: Mental Health Screening in Pregnancy During the COVID-19 Pandemic
Main Article Content
Abstract
Background: The COVID-19 pandemic has triggered increased anxiety and depression in pregnant women, while the ability of health workers to detect early symptoms of anxiety and depression in pregnancy remains poor. Expert system transfers expert intelligence into a computer to provide prediction and interpretation of mental health screening results. This expert system provides easy access to mental health services for pregnant women and reduces the workload for health workers so that obstacles to access to services during and after the COVID-19 pandemic can be resolved.
Objectives: We propose a conceptual model based on expert systems to allow early detection of anxiety and depression symptoms in pregnancy.
Methods: In this model, a systematic literature review was used to choose the instrument for the expert system. Next, to assess symptoms of anxiety and depression in pregnancy, we designed a decision table and produced an algorithm in a screening chart using the rule-based expert system procedure.
Results: Based on the results of the systematic literature review, there were 15 studies that had validated the screening instrument for symptoms of anxiety and depression in pregnant women. The results of the systematic review stated that the Edinburgh Postnatal Depression Scale (EPDS) had good sensitivity and specificity. Therefore, EPDS that be used in mental health screening based of expert system. Acquiring experts’ knowledge into a computer program, seven algorithms were designed on screening chart to detect anxiety and or depression symptoms in pregnancy.
Conclusion: We illustrate that mental health screening in pregnancy using EPDS based on an expert system will provide accessibility of health services, accurate and fast results, a new approach for maternal mental health care, and avenues for future research.
Article Details
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References
Al-Hajji, A., AlSuhainabi, F., & AlHarbi, N. (2019). An Online expert system for psychiatric diagnosis. International Journal of Artificial Intelligence & Applications, 10(02), 59–76. https://doi.org/10.5121/ijaia.2019.10206
Awodele, O., Kasali, F. A., Kuyoro, S., & Osisanwo, F. Y. (2016). Design of a user centered web based expert system for assisted via result confirmation in Nigeria. Journal of Emerging Trends in Computing and Information Sciences, 7(11), 1–13.
Baron, E. C., Hanlon, C., Mall, S., Honikman, S., Breuer, E., Kathree, T., Luitel, N. P., Nakku, J., Lund, C., Medhin, G., Patel, V., & Petersen, I. (2016). Maternal mental health in primary care in five low-and middle-income countries: a situational analysis. BMC Health Services Research. https://doi.org/10.1186/s12913-016-1291-z
Bauer, A., Knapp, M., & Parsonage, M. (2016). Lifetime costs of perinatal anxiety and depression. Journal of Affective Disorders, 192, 83–90. https://doi.org/10.1016/j.jad.2015.12.005
Cox, J. L., Holden, J. M., & Sagovsky, R. (1987). Detection of postnatal depression: development of the 10-item Edinburgh postnatal depression scale. British Journal of Psychiatry, 150, 782–786. https://doi.org/10.1192/bjp.150.6.782
Demetriou, C., Ozer, B. U., & Essau, C. A. (2015). Self-report questionnaires. In R. L. Cautin & S. O. Lilienfeld (Eds.), The Encyclopedia of Clinical Psychology (1st ed.). John Wiley & Sons, Inc. https://doi.org/10.1002/9781118625392.wbecp507
Direktorat Kesehatan dan Gizi Masyarakat. (2020). Dari pembelajaran COVID-19 ke reformasi sistem kesehatan nasional. Persi.or.id. http://persi.or.id/wp-content/uploads/2020/03/materi_bappenas200520.pdf
Fernandes, M. C., Srinivasan, K., Stein, A. L., Menezes, G., Sumithra, R. S., & Ramchandani, P. G. (2011). Assessing prenatal depression in the rural developing world: A comparison of two screening measures. Archives of Women’s Mental Health, 14(3), 209–216. https://doi.org/10.1007/s00737-010-0190-2
Gudu, J., Gichoya, D., Nyongesa, P., & Muumbo, A. (2012). Development of a medical expert system as an expert knowledge sharing tool on diagnosis and treatment of hypertension in pregnancy. International Journal of Bioscience, Biochemistry and Bioinformatics, 2(5), 297–300. https://doi.org/10.7763/ijbbb.2012.v2.120
Isinkaye, F. O., Awosupin, S. O., & Soyemi, J. (2017). A Mobile based expert system for disease diagnosis and medical advice provisioning. International Journal of Computer Science and Information Security (IJCSIS), 15(1), 568–572. https://sites.google.com/site/ijcsis/
Jha, S., Salve, H. R., Goswami, K., Sagar, R., & Kant, S. (2018). Burden of common mental disorders among pregnant women: A systematic review. Asian Journal of Psychiatry, 36, 46–53. https://doi.org/10.1016/j.ajp.2018.06.020
Joshi, U., Lyngdoh, T., & Shidhaye, R. (2020). Validation of Hindi version of Edinburgh Postnatal Depression Scale as a screening tool for antenatal depression. Asian Journal of Psychiatry, 48, 1–7. https://doi.org/10.1016/j.ajp.2019.101919
Kassaw, C., & Pandey, D. (2020). The prevalence of general anxiety disorder and its associated factors among women’s attending at the perinatal service of Dilla University referral hospital, Dilla town, Ethiopia, April, 2020 in Covid pandemic. Heliyon, 6(11), e05593. https://doi.org/10.1016/j.heliyon.2020.e05593
Kementerian Kesehatan Republik Indonesia. (2021). Peraturan Menteri Kesehatan Republik Indonesia nomor 21 tahun 2021 tentang penyelenggaraan pelayanan kesehatan masa sebelum hamil, persalinan, dan masa sesudah melahirkan, pelayanan kontrasepsi, dan pelayanan kesehatan seksual (pp. 1–184). https://jdih.kemkes.go.id/
Kingston, D., Austin, M.-P., Heaman, M., Mcdonald, S., Lasiuk, G., Sword, W., Giallo, R., Hegadoren, K., Vermeyden, L., Veldhuyzen, S., Zanten, V., Kingston, J., Jarema, K., & Biringer, A. (2015). Barriers and facilitators of mental health screening in pregnancy. Journal of Affective Disorders, 186, 350–357. https://doi.org/10.1016/j.jad.2015.06.02
Lebel, C., MacKinnon, A., Bagshawe, M., Tomfohr-Madsen, L., & Giesbrecht, G. (2020). Elevated depression and anxiety symptoms among pregnant individuals during the COVID-19 pandemic. Journal of Affective Disorders, 277(July), 5–13. https://doi.org/10.1016/j.jad.2020.07.126
Lopez-Morales, H., del Valle, M. V., Canet-Juric, L., Andres, M. L., Galli, J. I., Poo, F., & Urquijo, S. (2021). Mental health of pregnant women during the COVID-19 pandemic: A longitudinal study. Psychiatry Research, 295. https://doi.org/10.1016/j.psychres.2020.113567
Marsay, C., Manderson, L., & Subramaney, U. (2017). Validation of the Whooley Questions for antenatal depression and anxiety among low-income women in urban South Africa. South African Journal of Psychiatry, 23(1). https://doi.org/10.4102/sajpsychiatry.v23i0.1013
Nevid, J. S., Rathus, S. A., & Greene, B. (2014). Abnormal psychology in a changing world. In Pearson (9th ed.). Pearson Education, Inc. https://doi.org/10.1017/CBO9781107415324.004
Onah, M. N., Field, S., Bantjes, J., & Honikman, S. (2017). Perinatal suicidal ideation and behaviour: psychiatry and adversity. Archives of Women’s Mental Health, 20(2), 321–331. https://doi.org/10.1007/s00737-016-0706-5
POGI. (2020). Revisi rekomendasi POGI untuk ibu hamil dengan COVID-19. pogi.or.id. https://pogi.or.id/publish/wp-content/uploads/2021/06/Revisi-Rekomendasi-POGI-utk-Bumil-dengan-Covid-19-.pdf
Stewart, R. C., Umar, E., Tomenson, B., & Creed, F. (2013). Validation of screening tools for antenatal depression in Malawi- A comparison of the Edinburgh Postnatal Depression Scale and Self Reporting Questionnaire. Journal of Affective Disorders 150 (2013) 1041–1047, 150, 1041–1047. https://doi.org/10.1016/j.jad.2013.05.036
Unicef. (2017). Roadmap of SDGs Indonesia: A Highlight (pp. 1–124).
Windriyani, P., Wiharto, & Sihwi, S. W. (2013). Expert system for detecting mental disorder with forward chaining method. International Conference on ICT for Smart Society, 1–7. https://doi.org/10.1109/ICTSS.2013.6588068
Woldetensay, Y. K., Belachew, T., Tesfaye, M., Spielman, K., Biesalski, H. K., Kantelhardt, E. J., & Scherbaum, V. (2018). Validation of the Patient Health Questionnaire (PHQ-9) as a screening tool for depression in pregnant women: Afaan Oromo version. Plos One, 13(2), 1–15. https://doi.org/10.1371/journal.pone.0191782
Wu, Y., Zhang, C., Liu, H., Duan, C., Li, C., Fan, J., Li, H., Chen, L., Xu, H., Li, X., Guo, Y., Wang, Y., Li, X., Li, J., Zhang, T., You, Y., Li, H., Yang, S., Tao, X., … Huang, H. feng. (2020). Perinatal depressive and anxiety symptoms of pregnant women during the coronavirus disease 2019 outbreak in China. American Journal of Obstetrics and Gynecology, 223(2), 240.e1-240.e9. https://doi.org/10.1016/j.ajog.2020.05.009
Xavier, S., Bento, E., Azevedo, J., Marques, M., Soares, M. J., Freitas, V., Mota, D., Macedo, A., & Pereira, A. T. (2016). Validation of the Depression, Anxiety and Stress Scale – DASS-21 in a community sample of Portuguese pregnant women. 24th European Congress of Psychiatry, S239. https://doi.org/10.1016/j.eurpsy.2016.01.600
Zainiyah, Z., & Susanti, E. (2020). Anxiety in pregnant women during Coronavirus (COVID-19) pandemic in East Java, Indonesia. Majalah Kedokteran Bandung, 52(45), 149–153. https://doi.org/10.15395/mkb.v52n3.2043
Zangmo, R., Kumari, A., Garg, D., & Sharma, K. A. (2020). Redesigning routine antenatal care in low resource setting during COVID?19 Pandemic. Journal of Family Medicine and Primary Care, 9, 4547–4551. https://doi.org/10.4103/jfmpc.jfmpc_831_20
Zhong, Q. Y., Gelaye, B., Zaslavsky, A. M., Fann, J. R., Rondon, M. B., Sánchez, S. E., & Williams, M. A. (2015). Diagnostic validity of the Generalized Anxiety Disorder - 7 (GAD-7) among pregnant women. PLoS ONE, 10(4), 1–17. https://doi.org/10.1371/journal.pone.0125096