Context Matters: Vision-Based Depression Detection Comparing Classical and Deep Approaches
Authors: Maneesh Bilalpur, Saurabh Hinduja, Sonish Sivarajkumar, Nicholas Allen, Yanshan Wang, Itir Onal Ertugrul, Jeffrey F. Cohn
Organizations: Intelligent Systems Program, University of Pittsburgh, Pittsburgh, USA · CGI Technologies and Solutions Inc, USA · University of Oregon, USA · Department of Health Information Management, University of Pittsburgh, Pittsburgh, USA · Utrecht University, the Netherlands · Department of Psychology, University of Pittsburgh, Pittsburgh, USA
The classical approach to detecting depression from vision emphasizes interpretable features, such as facial expression, and classifiers such as the Support Vector Machine (SVM). With the advent of deep learning, there has been a shift in feature representations and classification approaches. Contemporary approaches use learnt features from general-purpose vision models such as VGGNet to train machine learning models. Little is known about how classical and deep approaches compare in depression detection with respect to accuracy, fairness, and generalizability, especially across contexts. To address these questions, we compared classical and deep approaches to the detection of depression in the visual modality in two different contexts: Mother-child interactions in the TPOT database and patient-clinician interviews in the Pitt database. In the former, depression was operationalized as a history of depression per the DSM and current or recent clinically significant symptoms. In the latter, all participants met initial criteria for depression per DSM, and depression was reassessed over the course of treatment. The classical approach included handcrafted features with SVM classifiers. Learnt features were turn-level embeddings from the FMAE-IAT that were combined with Multi-Layer Perceptron classifiers. The classical approach achieved higher accuracy in both contexts. It was also significantly fairer than the deep approach in the patient-clinician context. Cross-context generalizability was modest at best for both approaches, which suggests that depression may be context-specific.
Figures & tables
Demographic
Subgroup
Mother-Child
Patient-Clinician
White
126
43 (119)
Race
Non-white 3 3 3 Non-white included Native American, Hawaiian American, Black, Asian, and multiple races.
20
7 (16)
Unknown
2
-
Men
-
18 (48)
Sex
Women
148
32 (87)
Total
148
50
TABLE I: Participant demographics. Numbers in parentheses are the sessions 2 2 2 Unlike the mother-child dataset, the participants in the patient-clinician dataset were interviewed at regular intervals during their treatment. Hence, the participants:sessions ratio was variable.
Total
Depressed
Non-depressed
# sessions
148
73
75
Mother-Child
# utterances
34,072
16,354
17,718
# turns
18,346
8,446
9,900
# sessions
135
81
54
Patient-Clinician
# utterances
16,302
10,759
5,543
# turns
12,363
8,031
4,332
TABLE II: Dataset statistics
Fig. 1: Overview of the deep approach using turn-level embeddings from the FMAE-IAT as features for the MLP classifier. Session-level predictions were aggregated using a majority-voting criterion.
Fig. 2: Turn representation: FMAE-IAT embeddings for all frames within an utterance are extracted. Average-pooling is performed to represent an utterance ( Ui ). Concatenation of utterances within a turn is used as the vision modality representation.
Database characteristics
TPOT
Pitt
Focal person
Mothers
Clinical trial participants
Participant sex
Women-only
Women and men
Task
Unstructured problem-solving
Depression severity assessment
Depression definition
History of depression and current symptoms
Current depression
Assessment & interaction lag
Variable lag between depression assessment and behavior sample
No lag
Recordings
Off-line-of-sight camera
Near line-of-sight camera
TABLE III: Overview of contextual differences between the TPOT and Pitt databases
Embedding layer
Mother-Child
Patient-Clinician
1
0.608
0.571
2
0.649
0.605
3
0.611
0.600
4
0.621
0.588
5
0.673
0.591
6
0.683
0.576
TABLE IV: Validation set accuracy to determine the optimal choice of embedding layer. Numbers in bold are the best embeddings.
Context
Features
ACC
PA
NA
Mother-Child
Deep
0.597
0.607
0.514
AU
0.603
0.618
0.560
FHD
0.470
0.366
0.525
AU + FHD
0.623
0.635
0.601
Patient-Clinician
Deep
0.583
0.448
0.532
AU
0.621
0.632
0.569
TABLE V: Performance comparison of deep to classical approach. * indicates a significant difference.
Context
Features
Race
Sex
Mother-Child
Deep
0.727
N/A
AU
0.646
N/A
FHD
0.686
N/A
AU + FHD
0.721
N/A
Patient-Clinician
Deep
0.541
0.741
AU
0.873
0.979
TABLE VI: Fairness comparison of deep to classical approach. Table presents the Equalized Odds Ratio (EOR) for race and Sex. EOR=1 implies most fair classifier.
Train → Test
Features
ACC
PA
NA
Mother-Child → Patient-Clinician
Deep
0.452
0.470
0.226
AU
0.536
0.166
0.689
FHD
0.500
0.097
0.522
AU + FHD
0.500
0.097
0.000
Patient-Clinician → Mother-Child
Deep
0.477
0.486
0.231
AU
0.544
0.381
0.559
TABLE VII: Cross-context generalizability comparison of deep to classical approach. A → B indicates model trained in context A and tested in context B.
Given the widespread prevalence of depression and its consequential impact on individuals and society, it is crucial to obtain objective measures for early diagnosis and intervention. As a multidisciplinary topic, these objective measures should be interpretable and accessible to health care professionals, ensuring effective collaboration and treatment planning in the realm of mental health care. Even though current automated depression diagnosis approaches improved over the last decade, a critical gap exists as they often lack affect-specificity and interpretability, limiting their practical application and potential impact on mental health care. In particular, interpretability from temporal activities from videos when deep models are used is not fully explored. In this study, we present a novel framework for analyzing Deep Neural Networks' decisions when trained on facial videos, specifically focusing on automatic depression severity diagnosis. By fine-tuning Deep Convolutional Neural Networks (DCNN) pre-trained on Action Recognition datasets on depression severity facial videos from AVEC depression dataset, our framework is able to interpret the model's saliency maps by examining face regions and temporal expression semantics. Our approach generates both visual and quantitative explanations for the model's decisions, providing greater insight into its reasoning. In addition to this interpretability, our video-based modeling has improved upon previous single-face benchmarks for visual depression diagnosis, resulting in enhanced predictive performance. Overall, our work demonstrates the successful development of a framework capable of generating hypotheses from a facial model's decisions while simultaneously improving depression's predictive capabilities.
Felipe Moreno, Sharifa Alghowinem, Hae Won Park +1
Depression remains widely underdiagnosed and undertreated because stigma and subjective symptom ratings hinder reliable screening. To address this challenge, we propose a coarse-to-fine, multi-stage framework that leverages large language models (LLMs) for accurate and interpretable detection. The pipeline performs binary screening, five-class severity classification, and continuous regression. At each stage, an LLM produces progressively richer clinical summaries that guide a multimodal fusion module integrating text, audio, and video features, yielding predictions with transparent rationale. The system then consolidates all summaries into a concise, human-readable assessment report. Experiments on the E-DAIC and CMDC datasets show significant improvements over state-of-the-art baselines in both accuracy and interpretability.
Shiyu Teng, Jiaqing Liu, Hao Sun +6
College of Information Science and Engineering, Ritsumeikan University, Shiga, Japan · College of Computer Science and Technology, Zhejiang University, Hangzhou, China · Faculty of Engineering, University of the Ryukyus, Japan
Automatic depression detection using speech signals with acoustic and textual modalities is a promising approach for early diagnosis. Depression-related patterns exhibit sparsity in speech: diagnostically relevant features occur in specific segments rather than being uniformly distributed. However, most existing methods treat all frames equally, assuming depression-related information is uniformly distributed and thus overlooking this sparsity. To address this issue, we proposes a depression detection network based on Adaptive Cross-Modal Gating (ACMG) that adaptively reassigns frame-level weights across both modalities, enabling selective attention to depression-related segments. Experimental results show that the depression detection system with ACMG outperforms baselines without it. Visualization analyses further confirm that ACMG automatically attends to clinically meaningful patterns, including low-energy acoustic segments and textual segments containing negative sentiments.
Hangbin Yu, Yudong Yang, Rongfeng Su +2
Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, China · University of Chinese Academy of Sciences · Key Laboratory of Biomedical Imaging Science and System, Chinese Academy of Sciences, China