Uncertainty-Gated SHAP-Dirichlet Refinement for MRI-Based Depression Classification

Classification models based on resting-state functional magnetic resonance imaging (rs-fMRI) often show lower performance at imaging sites not included during model development, which can limit their use in clinical settings. Domain generalization (DG) addresses this issue by learning representations from source sites that remain effective for unseen target sites. However, existing DG approaches for psychiatric disorder classification commonly rely on a single imaging modality and may not fully account for site-specific acquisition effects on the learned representation space. Subjects scanned at the same site share scanner hardware, acquisition settings, and preprocessing characteristics, which can cause representations to reflect acquisition conditions rather than diagnostic information. In this work, we present M2LG-DG, a source-only multimodal local-global framework for cross-site major depressive disorder (MDD) classification. The framework employs a dual-stream rs-fMRI encoder, where the global pathway models inter-regional dependencies through self-attention and the local pathway performs graph-constrained aggregation over functional connectivity-derived brain graphs. Imaging and non-imaging representations are decomposed into shared and private components and integrated through bidirectional cross-attention with a learned modality gate. A cross-site supervised contrastive objective forms positive pairs from same-class subjects acquired at different source sites, encouraging the fused representation to preserve diagnostic information across acquisition domains. On four held-out REST-meta-MDD sites, M2LG-DG achieves an AUC of 69.48% and exceeds the closest comparison method by 2.18 percentage points. Experiments on the Autism Brain Imaging Data Exchange (ABIDE) dataset further support its applicability to other psychiatric neuroimaging classification tasks.

Recent advances in deep learning have enabled increasingly accurate electroencephalography (EEG)-based classification of Major Depressive Disorder (MDD), but the decision-making processes of high-capacity models remain difficult to interpret. This study investigates multiple post-hoc explainability methods applied to an InceptionTime architecture trained for EEG-based MDD detection. The analysis includes Shapley-based, gradient-based, and perturbation-based attribution approaches: DeepSHAP, Integrated Gradients, GradCAM, Occlusion, and Permutation Feature Importance. Explainability analysis was performed within a subject-level stratified 5-fold cross-validation framework using global attribution aggregation across EEG segments and subjects. The evaluated methods revealed partially convergent attribution patterns, with recurring emphasis on frontal, temporal, and posterior EEG regions, particularly in the right hemisphere. Quantitative comparison demonstrated substantial agreement between gradient- and perturbation-based approaches, while DeepSHAP produced comparatively distinct attribution distributions. At the same time, variability between explainability methods highlighted the influence of methodological assumptions on the resulting explanations. Overall, the results suggest that different post-hoc explainability approaches capture partially overlapping relevance structures in EEG-based deep learning models for depression detection. Although the observed attribution patterns are broadly consistent with several previous EEG studies of MDD, the analysis should be interpreted as exploratory rather than evidence of definitive neurophysiological biomarkers or clinical applicability. The study highlights both the usefulness and limitations of post-hoc explainability for interpreting black-box EEG classifiers in psychiatric applications.

Major depressive disorder (MDD) severely impacts daily activities and quality of life. Detecting MDD involves multimodal data, such as interview recordings and sensor measurements. This is particularly challenging, as these heterogeneous modalities often demand distinct, customized prediction pipelines. Existing efforts to address this challenge have explored both manually engineered multimodal architectures and agent-assisted pipeline development. Despite their progress, it remains challenging to autonomously revise pipelines based on experimental feedback and carry verified improvements forward into subsequent designs. To this end, we propose Multimodal Exploration via Recursive Self-Improvement Agents for Major Depression Analysis (MERID). The framework develops depression pipelines through experience-based recursive self-improvement (RSI). Grounded State Construction (GSC) grounds experience by aligning multimodal records with subject-level depression targets. Coupled Pipeline Exploration (CPE) jointly modifies representations, fusion, and predictors to build successor pipelines for classification and severity estimation. Evidence-Guided Evolution (EGE) guides revisions through feedback and verifies gains under uncertainty in small depression cohorts before inheritance. Extensive experiments on depression benchmarks show that MERID achieves the best results on multiple tasks compared with multimodal and agent-based baselines. Further analysis highlights the value of acoustic and linguistic cues for depression detection. Our code is available at https://github.com/DiscoAILab/MERID