Beyond Baseline Severity: Temporal and Disease-Specific Predictors of Depression Outcomes Following Mindfulness Interventions

Depression screening from large-scale behavioral data is challenged by fragmented circadian indicators, limited interpretability, and the lack of intervention-oriented analysis. Existing approaches typically analyze sleep, activity, and social behaviors in isolation, failing to capture their joint circadian structure. To address this limitation, we first propose the Circadian Rhythm Score (CRS), a composite index that compresses multi-domain daily behaviors into a unified representation of circadian rhythm. CRS is constructed to maximize discriminative power for depression screening while preserving behavioral semantics through non-negativity constraints. Empirical results demonstrate near-lossless compression, where a single CRS retains almost the full predictive capability compared with multiple raw behavioral indicators. Building upon CRS, we develop an interpretable depression screening framework based on gradient-boosted trees and SHAP analysis, revealing nonlinear and saturation-like associations between circadian rhythm and depression risk. Beyond risk prediction, we further integrate interaction modeling and counterfactual regression to estimate heterogeneous and dose-dependent behavioral effects, enabling intervention-oriented reasoning under different circadian contexts. Experiments on the China Health and Retirement Longitudinal Study (CHARLS, n=15,233), demonstrate robust screening performance (ROC-AUC=0.825) and identify actionable behavioral thresholds, including a minimum effective exercise dose of approximately 300 MET-min/week and an optimal restorative nap duration of approximately 65 minutes for sleep-deprived individuals. By bridging supervised representation learning and interpretable modeling, this work provides a scalable framework for depression screening and intervention-aware healthcare data mining.

Depression is the leading cause of disability worldwide, and early detection of symptom change is essential for timely intervention. Validated instruments such as the Patient Health Questionnaire-9 (PHQ-9) support symptom monitoring at scale, but real-world completion rates are low, introducing response bias and systematic missingness. Passive approaches that infer severity from routinely generated data could close this gap. We address this by predicting PHQ-9 total scores directly from transcripts of conversations between users and an AI mental health application, requiring only conversation text and no additional clinical data. We fine-tune a Qwen3.5-27B backbone with a regression head, augment 3,111 ground-truth labels with pseudolabels generated by a reasoning model (Claude Opus) and iteratively trained intermediate models, for a combined dataset of 6,283 users. On a held-out test set of 842 users, our best model achieves MAE = 2.6, RMSE = 4.0, Pearson r = 0.80, and AUC = 0.91 at the PHQ-9 >= 10 clinical threshold. We also find AUC > 0.87 at every severity threshold from PHQ-9 >= 3 to PHQ-9 >= 24, demonstrating that the model captures depression severity across the full clinical spectrum. This work opens the door to passive, continuous symptom monitoring in AI mental health platforms, without requiring users to complete self-report measures.

Tracking depression from multi-session counseling dialogues requires estimating both current symptom severity and how it changes across sessions. Yet progress on this task is constrained by the scarcity of longitudinal counseling data with standardized session-level depression labels. Existing resources typically provide either multi-session conversations without depression labels or labeled interviews in a single session. Building such a benchmark poses three challenges: maintaining longitudinal consistency and diversity, grounding symptom progression in empirical patterns, and expressing controlled depression states naturally without exposing target labels. To address these challenges, we introduce LongCounsel-8, a benchmark suite of three independently generated datasets totaling 7,749 five-session counseling trajectories, grounded in real-world client profiles, depression trajectories, symptom compositions, and counseling patterns. We combine profile-grounded simulation, empirically informed state construction, and indirect behavioral realization to address these challenges. Across the benchmark, simulated self-reports closely recover the controlled states, supporting label fidelity. Experiments on existing depression tracking methods reveal three key findings: (1) lower single-session score error does not guarantee accurate identification of trend, i.e., improvement or worsening; (2) existing methods are consistently less reliable on worsening trajectories; and (3) additional session history may reduce the accuracy of trend prediction. Together, these findings establish LongCounsel-8 as a foundation for advancing depression assessment from static, single-session prediction toward reliable longitudinal tracking of mental-health change.