Depression Detection

Automated depression screening from clinical interviews requires attribution of utterances to the clinician or patient. We evaluate two datasets: DAIC-WOZ, where participant-only recordings require re-synthesizing both sides for controlled two-party evaluation, and PDCH-HAMD, comprising voice-converted real Chinese interviews for cross-lingual validation. Cascaded systems combine speaker diarization with role-assignment heuristics, so errors can propagate across stages. We propose an end-to-end model, which we named DiaWhisper, that fine-tunes Whisper-large-v3 with LoRA and an auxiliary frame-level role head for transcription and attribution, together with DiaWhisper-DPO, a failure-mined refinement that uses genuine decoding failures as DPO rejected completions without human preference annotation. On 29 DAIC-WOZ test sessions, DiaWhisper-DPO achieves 0.973 role accuracy and 0.119 DER, 72% below the strongest cascaded baseline, and reduces seed variation from σ = .205 to .002. Retrained on PDCH-HAMD, it achieves 0.757 role accuracy and improves all 78 session-seed pairs.

We describe the Snugi-AI-v2 submission to eRisk 2026 Task 2, the second edition of contextualized early depression detection from Reddit discussions. Our central contribution is a learned MLP stopping policy trained to directly optimize ERDE50, replacing the fixed and tiered threshold strategies used in all prior eRisk Task 2 submissions. Combined with a sustained confidence gate that commits only after N=3 consecutive rounds of high policy confidence, the system reduces false positives caused by transient emotional posts without sacrificing recall. The pipeline encodes each discussion thread with a frozen MentalRoBERTa model, maps the accumulated representation to a depression probability via an MLP classifier, and delegates the timing decision to the learned policy. Our best run achieves F1 = 0.73 (Run 1) and F_latency = 0.70 (Runs 0 and 3), with a median alert round of 8 out of 500, completing the full evaluation in 1 hour 26 minutes, the fastest among all complete-submission teams. We report a systematic ablation across five runs spanning two encoder variants, four stopping strategies, and three gate values, along with negative results from GRPO policy training, BDI-II post filtering, MentalLongformer encoding, and DeBERTa ensembling. Code: https://github.com/chiuyuwen91/erisk-2026

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.

Sentence-level recognition of depression symptoms is challenging because similar expressions can differ in symptom relevance, and language-model inference is insufficiently grounded in diagnostic definitions. This study proposes a two-stage framework separating symptom-candidate generation from definition-grounded verification. A contrastively fine-tuned sentence encoder generates a symptom candidate per sentence, and a fine-tuned language model verifies whether the candidate is present or absent using the sentence, its context, and a candidate-specific diagnostic definition, checking its judgment against that definition before answering. Evaluated against encoder, inference-based, medical, and general LLM baselines and a matched single-stage supervised classifier, the proposed pipeline attains the best accuracy and F1 scores of all methods, with rationales matching expert-authored annotations. A preliminary clinical audit indicates moderate alignment with diagnostic definitions, with explanation quality strongly dependent on prediction correctness. The results support decomposing symptom recognition into candidate generation and definition-grounded verification, though performance remains limited for rare categories.

Patients with depression present with diverse symptom profiles, yet clinical practice routinely reduces this variation to a single severity score. Large language models (LLMs) can potentially capture various symptoms and their severity from patient speech. However, how depressive symptoms are represented inside LLMs remains poorly understood, limiting clinical trust. To examine whether internal model activations match clinician judgment, we analyzed the residual stream of Gemma-3-27B-PT using mechanistic interpretability techniques. Recording activations across symptom descriptions drawn from validated clinical instruments, we found that symptom groups geometrically separated the most at layer 21 across multiple distance metrics. Using Semantic Projection, we then projected held-out naturalistic text onto Symptom Vectors constructed from these instruments. The resulting per-symptom coefficients preserved clinician-annotated rank ordering across mood, somatic, and suicidality axes. Furthermore, a single depression vector in Layer 21 separates held-out depressive from non-depressive text (AUC = 0.789), which can be used as an emotional valence gate that restricts symptom projection to depressive speech. These results reveal a decorrelated, clinician-aligned symptom signal readable directly from internal activations, offering a mechanistic foundation for interpretable depression-assessment tools.

Depression is a major mental disorder for which diagnosis relies primarily on clinical assessments. Automated methods to support its detection via the psychiatric MADRS scale are getting more and more attention. While existing solutions primarily focus on detecting the disorder from different text sources (e.g., online text, social media), there is still limited support for clinical trials, where clinical assessments are conducted through structured interviews based on standard guidelines such as SIGMA. In this work, we develop a LLM pipeline specifically designed to support clinicians in supporting the assessment of depression in patients enrolled in clinical trials. Our pipeline converts audio interviews into transcripts, maps them into the ten MADRS symptom items, estimates their severity, and identify problematic clinical ratings associated with them. Evaluation on real clinical interviews shows a strong overall correlation of 0.867 with expert ratings, providing interpretable support for future assessments in clinical trials.

This study identifies new depression biomarkers based on the dynamical properties of tract variables, which represent geometric features describing the configuration of the speech articulators. A key advantage of this approach lies in its ability to quantify aspects of the articulatory process that have not been previously explored in the context of depression, namely predictability, complexity, and randomness. These properties are respectively characterised using the Largest Lyapunov Exponent, the Correlation Dimension, and the Sample Entropy. Thorough experiments were conducted on the Androids Corpus, a publicly available dataset comprising 64 speakers diagnosed with depression by clinicians and 54 control speakers with no reported history of mental health conditions. The results indicate that the proposed biomarkers effectively discriminate between the depressed and control speakers, as evidenced by the high Cliffs delta values across both read and spontaneous speech.

Automatic depression detection with deep learning has shown promise but often suffers from limited generalization due to domain shift arising from inter-speaker variability. To address this critical issue, we present the first patient-independent multimodal depression detection framework that incorporates domain generalization (DG), jointly leveraging both acoustic and textual modalities. The proposed model integrates bidirectional Long Short-Term Memory (BiLSTM) with intra- and cross-modal attention mechanisms, accompanied by segment-level fusion for decision-making. Generalization is further enhanced by applying a gradient reversal layer inspired by Domain-Adversarial Training of Neural Networks (DANN), which promotes domain-invariant representations by adversarially limiting the model's ability to identify individual speakers, effectively reducing patient-specific bias. Conducting experiments on the Androids-Corpus dataset with a 5-fold cross-validation (CV) protocol, various pairings of audio and text feature extractors were evaluated over different segment durations, determining MelSpec and ItalianBERT as the optimal baseline at a 30-second segment duration. The addition of DG to this baseline yields a 2.5% increase in accuracy and 3.3% in F1-score, achieving 93.2% accuracy, 93.2% precision, 96.2% recall, and 94.2% F1-score, surpassing all existing benchmarks. Extensive ablation studies assess the impact of multimodal fusion, deep architectural choices, and DG, highlighting their combined contribution to robust and generalizable depression detection.

Repetitive transcranial magnetic stimulation (rTMS) is a non invasive therapy for Major Depressive Disorder (MDD). In this study, we generate images using two time frequency methods to represent EEG signals: Fourier-Bessel Series Expansion with Euclidean Distance (FBSE-ED) and Discrete Wavelet Transform (DWT). We propose an efficient deep learning classifier to predict the outcome of rTMS depression therapy. In this study, we use a private rTMS databases to train a lightweight custom Convolutional Neural Network (CNN) using 10-fold cross validation strategy in order to avoid any bias in our results. The results show that the FBSE-ED representation achieves the highest classification accuracy of 93.60%, outperforming traditional time-frequency technique (DWT). In addition, the proposed architecture with FBSE-ED image representation technique outperforms more complex EEG-Specific deep learning models (EEGNet, DeepConvNet, SleepEEGNet) by 3.62-10.72% and pretrained models (Xception, DenseNet201, and MobileNetV2) by 23.03-27.35%. For more experiments, we utilize another private rTMS database as test database to show the robustness of the proposed model. Our results suggest that integrating advanced signal decomposition with deep learning can facilitate early prediction of rTMS treatment response and support more targeted clinical decision-making. The proposed framework is interpretable, computationally efficient, and well-suited for deployment in real-world local psychiatric clinics.

We describe DS@GT's submission to the eRisk 2026 Task 1 challenge on conversational depression screening, in which systems interview LLM personas that simulate individuals with varying depression profiles and produce a Beck Depression Inventory II (BDI-II) score plus four key symptoms per persona, without directly asking sensitive mental health questions. Our pipeline evolved through three stages: a monolithic single-model prototype to start off, a baseline multi-agent architecture that separates conversational interviewing from BDI-II scoring under a coordinating orchestration layer, and a final hybrid configuration that replaces the paid GPT-5-nano interviewer with the open-source Gemma 27B. To offset the model's weaker reasoning and instruction-following, the hybrid adds three algorithmic components: a precomputed dialogue tree that standardizes interview openers and follow-ups, a reliability-weighted consensus aggregation inspired by the Weaver framework, and a cluster-based imputation step for unprobed symptoms. We submitted three fully automated runs across all 20 personas, with Run 1 from the paid baseline and Runs 2 and 3 from the hybrid. Hybrid Run 3 achieved an ADODL of 0.9063, ranking 3rd among all complete-submission runs and placing DS@GT 2nd among the 21 teams overall, while outperforming our paid baseline Run 1 (0.8841) at roughly one-quarter of the per-persona API cost. These results support our central hypothesis that with sufficient algorithmic supervision, a weaker open-source model can compete with a stronger proprietary model in the conversational interviewer role. Our source code is available at https://github.com/dsgt-arc/erisk-task1-2026.

Automatic depression detection using audio-visual data faces significant challenges, particularly in disentangling overlapping feature distributions and establishing robust decision boundaries. To address this, we propose a fine-grained multimodal framework featuring a temporal encoder and a mutual transformer to facilitate deep cross-modal fusion. Our core contribution is the Binary Advantage-weighting Ranking Loss, which optimizes the latent space distribution through two complementary mechanisms: Advantage-weighted Separation, which mines hard pairs by computing a pairwise prediction difference matrix and dynamically weighting them based on their difficulty; and Advantage-weighted Compactness, which minimizes intra-class variance to force features to cluster around their respective class centers. Extensive experiments on D-vlog and LMVD demonstrate that our model reconstructs the latent ordinal structure by prioritizing hard pairs, thereby achieving state-of-the-art performance.

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.

Online social media posts provide scalable signals for early depression screening, and recent studies mainly improve pre-classification evidence through risk-post selection, symptom grounding, and clinically informed feature construction. However, these screening-stage designs often leave final decisions to a single detector, overlooking how users heterogeneously express depressive risk after screening. A monolithic classifier must average across heterogeneous users, which may dilute localized evidence and cause misclassification, especially for non-self-disclosing users. To address this issue, we propose WPG-MoE, a weak-prior-guided dense mixture-of-experts framework built on a shared large language model (LLM) backbone. WPG-MoE derives user-level weak semantic priors to softly route users to experts matched to different evidence layouts. We formulate this process as learning using privileged information (LUPI): rich LLM-extracted structured evidence guides training-time routing, while inference retains only Patient Health Questionnaire-9 (PHQ-9) template screening and the deployable backbone. Experiments on Chinese and English datasets show that WPG-MoE outperforms strong baselines with interpretable routing behavior.

Automatic depression detection from clinical interviews typically models the semantic content and acoustic characteristics of participant speech. However, the interactional timing between the clinician and participant remains comparatively under-modeled. We investigate conversational temporal dynamics, specifically dyadic turn-pair timing, as a primary modality fused with self-supervised encoders. Evaluated on the DAIC-WOZ dataset, we compare a compact 24-dimensional timing module against frozen WavLM-large and RoBERTa-large baseline detectors. This temporal module achieves the highest single-modality performance on the development set. Furthermore, a convex-weighted late fusion strategy improves overall performance to 0.804 and 0.669 macro-F1 on the development and test sets, respectively. The learned fusion effectively assigns zero weight to acoustics, demonstrating that conversational timing serves as a lightweight, interpretable complement for dyadic depression screening.

Electroencephalography (EEG) offers a noninvasive approach for examining neurophysiological correlates of dimensional psychopathology, yet systematic evidence across EEG paradigms and feature granularities remains limited. Here, we develop a granularity-aware EEG feature pipeline that organizes multi-scale descriptors into global, regional, and channel levels. Using the Healthy Brain Network (HBN) cohort, we evaluate the prediction of four psychopathology dimensions: p-factor, internalizing, externalizing, and attention problems, across four EEG paradigms. Given the heterogeneity of pediatric psychopathology and the moderate reliability of questionnaire-derived scores, this setting represents a challenging feasibility test rather than a clinical screening scenario. Tree-based models and granularity-balanced feature selection showed promising improvements over conventional approaches in selected conditions, although effect sizes remained modest. Visualization of selected markers revealed dimension-specific spatial and spectral patterns that were broadly aligned with existing neurophysiological knowledge. An exploratory cross-dataset sanity check on the independent PEARL cohort suggested that the proposed selection principle remains technically feasible under protocol shifts, without claiming cross-dataset generalizability. Overall, multi-scale EEG features contain weak but detectable signals related to dimensional psychopathology, and granularity-aware selection may serve as a useful feature-reduction strategy for future EEG-based phenotyping studies.

Graph Neural Networks (GNNs) have been widely used to capture spatial functional connectivity patterns to improve electroencephalography (EEG)-based depression recognition performance. However, the functional connectivity of brain networks in patients with depression exhibits an inherent hierarchical structure, making it difficult to capture accurate connection patterns. To address these issues, this paper proposes a novel model named Sample-Adaptive Hyperbolic Graph Neural Network (SA-HGNN), which aims to accurately extract the authentic hierarchical structure of depression-affected brain networks. Specifically, the proposed model comprises three core modules. First, a Sample-Adaptive Graph Construction module dynamically constructs personalized brain network topologies to capture more complex spatial relationships within the brain network. Second, hyperbolic graph convolution is employed to overcome the representation bottlenecks of Euclidean space, leveraging hyperbolic geometry to precisely capture latent hierarchical relationships within the brain network. Finally, an Attention Pooling module adaptively filters out highly redundant noise channels in EEG signals, effectively mitigating the interference of inherent noise on the authentic hierarchical topology. Extensive experiments on public EEG datasets demonstrate the superior performance of our method across resting-state and task-related paradigms, validating its robustness to noise and efficacy in capturing abnormal functional connectivity patterns in brain networks of patients with depression.

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.

Dementia and depression are the most prevalent neuropsychiatric disorders in geriatric populations, and their overlapping symptoms pose major challenges for differential diagnosis. In this study, we investigate open-weights Large Language Models (LLMs) for predicting dementia and depression severity from speech samples collected during standardized history taking interviews with 154 German-speaking subjects. We introduce an observer-based Global Depression Scale (GDS-D) aligned with the established Global Deterioration Scale (GDS), enabling parallel global staging of affective and cognitive symptoms. We compare three LLMs (Mistral 3.1, DeepHermes, Qwen3) in two settings: (1) zero-shot prediction and (2) LLM-based feature extraction for Support Vector Regression, using human and pause-enriched transcripts. Results show that LLMs effectively predict depression severity in zero-shot settings (best MAE of 0.60), while dementia assessment benefits substantially from structured feature extraction (best MAE of 0.78), reducing errors by up to 35% over zero-shot baselines. Pause-enriched transcripts achieve competitive performance with human transcriptions, demonstrating the viability of fully automatic screening pipelines for differential neuropsychiatric assessment.

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.

The escalating demand for mental healthcare, driven by rising societal stress, highlights the limitations of traditional psychiatric diagnostics. Conventional methods - relying primarily on clinical interviews and patient self-reports - are inherently vulnerable to subjective bias and the varying empirical judgment of practitioners. To address the need for quantitative evaluation, biological signal-based detection, including electroencephalography (EEG) and functional near-infrared spectroscopy (fNIRS), has emerged as a promising objective alternative. Such technology is particularly vital for identifying latent depressive states that may be unrecognized by the subjects themselves. Furthermore, in aging populations, the high comorbidity between depression and dementia necessitates early differentiation to prevent mutual symptom exacerbation and maintain Quality of Life (QoL). This pilot study of eleven healthy students establishes a framework for biological signal-based depression detection, serving as a foundational step toward automated, objective diagnostic tools for clinical use.

Automatic Depression Detection (ADD) from clinical interviews is a pivotal task in computational mental health, yet it remains challenging due to two critical obstacles: 1) difficulty in modeling complex but sparsely distributed depression clues within lengthy, multi-topic clinical interviews, leading to superficial and unreliable reasoning; 2) scarcity of labeled data due to clinical privacy, together with high cost of training and fine-tuning, limiting the deployment of supervised ADD systems. To jointly address these challenges, we propose Dep-LLM, a training-free framework that mirrors the step-by-step reasoning of clinical psychiatrists and operates entirely on frozen off-the-shelf foundation LLMs. Dep-LLM comprises three stages. First, a Chain-of-Thought (CoT) Depression Multi-factor Analysis module structurally decomposes the long dialogue into five clinically aligned themes and produces evidence-grounded rationales, effectively handling long-context dependencies. Second, we introduce Confidence Analysis and Modulation module that quantifies the epistemic reliability from token-level entropy of each rationale and applies an intra-label and inter-theme modulation that amplifies trustworthy signals while suppressing uncertain ones without extra training. Third, a Collaborative Multi-factor Prediction module dynamically integrates multi-factor signals weighted by confidence into the final diagnosis. Extensive experiments on the DAIC-WOZ and E-DAIC datasets demonstrate the effectiveness and generalizability of Dep-LLM: it surpasses zero-shot baseline on nearly all 21 foundation LLMs across 9 metrics such as accuracy, macro F1 and weighted-average F1, and further outperforms state-of-the-art supervised domain-specific LLMs as well as the latest closed-source commercial LLMs, while requiring no extra training.

Speech-based mental health screening offers scalable depression detection, yet clinical deployment faces a significant barrier: users' privacy concerns about demographic information exposure. Current techniques struggle to resolve this conflict. Adversarial training often fails against unseen threats, whereas Differential Privacy tends to compromise diagnostic performance by injecting noise across all features. This paper presents InfoShield, which minimizes mutual information between speech representations and sensitive attributes while preserving depression classification accuracy. We identify that standard MINE estimators struggle with sequential speech due to temporal-static misalignment, and introduce TimeAwareMINE with cross-modal attention to align acoustic frames with attribute embeddings. Experiments on the Androids Corpus show InfoShield reduces gender inference from 92.6% to 55.5% and age inference from 55.7% to 30.3% with limited utility loss (6% F1 reduction), achieving F1=0.784 compared to prior SOTA's 0.723.

Deep learning-based Major Depressive Disorder (MDD) detection using Electroencephalography (EEG) is fundamentally constrained by the "small-sample dilemma." Prevailing generative data augmentation methods not only incur heavy computational overhead but also risk introducing synthetic noise, thereby blurring classification boundaries. To challenge the traditional "data quantity first" convention, we propose a novel framework "Beyond Augmentation": Score-Guided Classification (SGC). SGC does not synthesize pseudo-samples; instead, it utilizes an unsupervised generative network architecture to model the structural and statistical anomaly degrees of samples, serving as the core "Pathological Prior". This prior, after robust normalization, is explicitly fused with deep feature representations, thereby precisely guiding the classifier's decision boundary. Furthermore, to dynamically adapt to varying channel configurations, we propose a Cross-Channel Spatial Adaptation module, utilizing a spatial mapping mechanism to effectively resolve the hardware heterogeneity of mismatched channels in multi-center datasets. Extensive experiments on the Mumtaz2016 and high-density MODMA datasets demonstrate the effectiveness and exceptional generalizability of our method under the challenging "zero data augmentation" setting and at "zero sample synthesis cost". Keywords: Electroencephalography (EEG), Depression Detection, Anomaly Score, Diffusion Models, Few-Shot Learning

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.

Speech monologues recorded in naturalistic settings provide opportunities to characterize mental illness phenomenology and detect symptom exacerbation. Large language models (LLMs) offer new possibilities for automating this process, as they require annotated data primarily for evaluation rather than training. In this paper, we present a novel automated, multi-agent LLM pipeline for the fine-grained, multi-label extraction of language suggestive of delusional beliefs, associated affective responses, and behavioral responses from transcripts of naturalistic audio diaries collected from people with moderate persecutory ideation. Evaluating an ensemble of three foundation models, we demonstrate that detailed diagnostic prompt instructions successfully reduce false positives for delusional theme classification, but also constrain the interpretation of affective or behavioral responses. Furthermore, comparing multi-agent adjudication frameworks shows that complex conversational debate between agents diminishes accuracy on clinically ambiguous text by inducing premature consensus. Instead, majority voting establishes robust performance (Micro F1 of 0.872 and 0.779 for delusion detection and classification respectively). This work provides a validated and scalable pipeline for the automated detection and characterization of content suggesting delusional beliefs in naturalistic speech.

Speech and language technologies offer valuable opportunities for supporting mental health assessment through objective and interpretable cues. We present a systematic feature-based analysis framework leveraging perceptually grounded acoustic and linguistic characteristics, including prosody, vocal quality, semantic coherence, syntactic structure, and sarcasm. Using statistical analysis and interpretable machine learning (XGBoost with SHAP and LIME), we examine associations between speech features and validated symptom measures of depression, anxiety, and ADHD. Evaluated on both controlled benchmark datasets (StressID, DAIC-WOZ, Androids, EATD) and a real-world clinical dataset, the framework reveals stable and consistent relationships between symptom severity and vocal irregularities (e.g., shimmer, jitter), lexical-syntactic patterns, and affective tone. An ablation study conducted across all datasets further identifies the most informative feature groups. This work explores a transparent and clinically interpretable approach to speech-based mental health analysis.

Diagnosing Major Depressive Disorder (MDD) from functional magnetic resonance imaging (fMRI) using functional connectivity (FC) analysis requires large amounts of labeled data that are scarce in clinical settings. Existing augmentation methods synthesize FC matrices, which compress fMRI recordings into static pairwise summaries and discard temporal information. We propose fMRI-Diffusion, a framework that synthesizes region-of-interest (ROI)-level fMRI time series rather than FC matrices. A Temporal Transformer serves as the denoising network within a denoising diffusion probabilistic model, treating each time point as a token to capture temporal dependencies through self-attention. A supervised pretraining strategy initializes the Transformer with task-relevant representations before diffusion training, and FC matrices are derived from the synthesized time series for classification. Experiments on the REST-meta-MDD dataset show that augmenting training data with synthetic time series consistently improves diagnostic accuracy across ten classifiers, six parcellation atlases, and three acquisition sites. The method outperforms five recent FC-based synthesis approaches, with accuracy gains of up to 3.7 percentage points over the strongest baseline. Ablation studies confirm the contributions of both the Transformer-based denoiser and the pretraining strategy. Distributional fidelity metrics remain below 0.06 across all conditions, indicating close agreement between real and synthetic distributions. These findings suggest that synthesizing fMRI time series before FC computation preserves temporal information lost in matrix-level augmentation and provides a practical strategy for MDD diagnosis under limited data.

As demand for mental health care outpaces clinician-delivered assessment, scalable screening tools are increasingly needed. Large language models (LLMs) may identify psychiatric risk from patient narratives, but their reliability across diagnoses, demographic subgroups, and evidence-use patterns remains uncertain. We introduce a SCID-anchored benchmark of 555 semi-structured experiential interviews paired with diagnostic reference labels for anxiety disorder, major depressive disorder, post-traumatic stress disorder, and any current mental health disorder. Using zero-shot task-specific prompting, we evaluated five state-of-the-art LLMs and examined whether false-negative errors reflected missed psychiatric evidence or differential weighting of symptom, functional-impairment, and protective-context cues. Performance varied across tasks and models, with accuracy ranging from 0.49 to 0.86 and Matthews correlation coefficients from 0.16 to 0.38. GPT-4.1 Mini and GPT-5 Mini showed the most consistent disorder-specific accuracy. Subgroup analyses found higher depression-classification accuracy among male than female participants, no consistent age-related pattern, and modest non-uniform variation across race strata. Evidence-integration analyses showed that false-negative anxiety and PTSD classifications often contained explicit symptom evidence but were accompanied by preserved functioning, coping ability, or social support. Functional-impairment evidence shifted model outputs toward positive classifications, whereas protective-context evidence shifted outputs away. These findings suggest that LLMs may support scalable psychiatric screening, but their tendency to discount symptom evidence in the presence of preserved functioning or protective context requires careful validation before clinical deployment.

Text-based counseling provides a valuable source of information for assessing depression severity. We study prediction of the total score on the eight-item Patient Health Questionnaire (PHQ-8), a self-report measure of depression severity, from counseling transcripts. Clinical-based methods rely mainly on large language model (LLM) inference to obtain structured session-level assessments, but these assessments provide limited information about which utterances support each score. Training-based methods train predictors directly on sentences or their semantic embeddings and preserve local conversational detail, but must learn clinical structure from limited labeled transcripts. Integrating a small set of clinical feature scores with a long sequence of high-dimensional utterance representations is challenging, as simple fusion can overemphasize dialogue evidence and fail to link clinical features to supporting utterances. Combining structured clinical assessments with sentence-level semantics, we propose EmoTrack, which jointly encodes clinical feature scores and utterance representations to predict the total PHQ-8 score. For longitudinal assessment across successive sessions, the model can also incorporate a compressed representation of the preceding session as optional memory. On the real-world DAIC-WOZ benchmark, EmoTrack reduces mean absolute error from 2.8234 to 2.4708 relative to the strongest evaluated baseline. Across five settings covering single-session estimation, cross-dataset transfer without adaptation, and longitudinal assessment, it reduces normalized aggregate error by approximately 6.1% relative to the strongest baseline.

This paper reflects on twenty years of building NLP resources and research infrastructure for Arabic, a language spoken by hundreds of millions yet historically underserved relative to languages such as English or Chinese. The first decade focused on foundational linguistic infrastructure; the second shifted toward computational social science, social media analysis, and socially oriented applications. Rather than cataloguing outputs, the paper examines what the experience of building them revealed. Three counterintuitive lessons emerge: building datasets is as much a social process as a technical one; communities formed around shared tasks often matter more than the tasks themselves; and moving from language resources to computational social science exposes challenges that traditional NLP training does not address. We discuss three failures: a depression detection corpus that never reached clinical practice, a period of spreading across too many shared tasks without sufficient depth, and a long-standing assumption that Modern Standard Arabic infrastructure would transfer cleanly to dialectal tasks. These experiences suggest that the hardest problems in developing NLP for underserved communities are not linguistic but social, institutional, and epistemic, and require competencies the field rarely teaches.

Every day, users generate digital traces (e.g., social media posts, chats, and online interactions) that are inherently timestamped and may reflect aspects of their mental state. These traces can be organized into temporal trajectories that capture how a user's mental health signals evolve, including phases of improvement, deterioration, or stability. In this work, we propose an explainable framework for detecting and analyzing depression-related status shifts in user digital traces. The approach combines multiple BERT-based models to extract complementary signals across different dimensions (e.g., sentiment, emotion, and depression severity). Such signals are then aggregated over time to construct user-level trajectories that are analyzed to identify meaningful change points. To enhance interpretability, the framework integrates a large language model to generate concise and human-readable reports that describe the evolution of mental-health signals and highlight key transitions. We evaluate the framework on two social media datasets. Results show that the approach produces more coherent and informative summaries than direct LLM-based reporting, achieving higher coverage of user history, stronger temporal coherence, and improved sensitivity to change points. An ablation study confirms the contribution of each component, particularly temporal modeling and segmentation. Overall, the method provides an interpretable view of mental health signals over time, supporting research and decision making without aiming at clinical diagnosis.

This paper audits benchmark evaluation in clinical-interview depression detection through four complementary probes across DAIC/E-DAIC, CMDC, ANDROIDS, MODMA, and PDCH. First, we re-evaluate E-DAIC under strict subject-disjoint leave-one-subject-out cross-validation. A lightweight hybrid text-plus-LLM-score model reaches macro-F1 = 0.723 - the highest reported under this protocol, to our knowledge - providing a conservative out-of-fold reference point that does not depend on the privileged official holdout. Second, we test whether the E-DAIC official split supports fine-grained leaderboard rankings by sweeping 96 model configurations across modality bundles, pooling strategies, and learners. Development-side cross-validation and official-test rankings align only moderately: the best cross-validation configuration ranks twentieth on the official test, the official-test winner ranks forty-first by cross-validation, top-3 overlap is zero, and the apparent winner is rank-1 in only 32.3% of subject bootstraps. Third, we externally validate strong public CMDC and ANDROIDS baselines that achieve near-ceiling in-domain performance. Zero-shot transfer to external corpora is substantially weaker. Finally, we stress-test E-DAIC text and audio models using paired symptom-dense versus symptom-light interview slices defined by an SRDS-based annotator. Text scores rise sharply on symptom-dense slices, whereas audio scores remain nearly flat; the text-minus-audio gap is positive across all five seeds.

Mental health disorders affect millions worldwide, and healthcare systems are increasingly overwhelmed by the volume of clinical data generated from electronic records, telemedicine platforms, and population-level screening programs. At the same time, the emergence of novel AI-based approaches in healthcare calls for intelligent frameworks capable of processing domain-specific unstructured clinical information while adapting to patient-specific needs. This paper proposes an agentic framework for building robust LLM-based pipelines, where each stage is encapsulated as a LangChain agent governed by explicit policies and proxy-guided evaluation. Stages are incrementally locked once validated, ensuring that later adaptations cannot overwrite configurations without demonstrated improvement. The proposed framework evolves from feature-level exploration, through proxy-based tuning and freeze/rollback mechanisms, to full orchestration by an Orchestrator Agent that coordinates preprocessing, retrieval, selection, diversity, threshold optimization, and decoding. A proof-of-concept in transcript-based depression detection demonstrates that the framework converges to stable configurations, such as cosine similarity, dynamic Top-k, and threshold 0.75, while controlling evaluation costs and avoiding regressions. These results highlight the potential of agentic AI to enable population-level mental health screening over large clinical datasets, addressing critical challenges in trustworthiness, reproducibility, and adaptability required in healthcare environments.

Current approaches to detecting depression and anxiety from speech primarily rely on machine learning techniques that utilize hand-engineered paralinguistic features and related acoustic descriptors derived from time- and frequency-domain representations of speech signals. Applying deep learning methods directly to raw speech signals has the potential to produce biomarker representations with substantially greater predictive power. However, these approaches typically require large volumes of carefully annotated data to learn robust and clinically meaningful representations of the underlying biomarkers. In this paper, we describe our efforts toward developing a deep learning model trained on a large-scale proprietary dataset comprising ~65,000 utterances collected from more than 23,000 subjects representative of relevant United States demographics. We present the techniques employed and analyze their impact on model performance. Our results demonstrate that the proposed models can extract content-agnostic biomarker information, which, when combined with lexical features extracted from audio, yields improved predictive performance in production settings. Our models are evaluated on ~5000 unique subjects and achieve performance of 71% in terms of sensitivity and specificity. To foster further research in mental health assessment from speech, we release the best-performing model described in this paper on HuggingFace.

Modeling latent clinical constructs from unconstrained clinical interactions is a unique challenge in affective computing. We present ADAPTS (Agentic Decomposition for Automated Protocol-agnostic Tracking of Symptoms), a framework for automated rating of depression and anxiety severity using a mixture-of-agents LLM architecture. This approach decomposes long-form clinical interviews into symptom-specific reasoning tasks, producing auditable justifications while preserving temporal and speaker alignment. Generalization was evaluated across two independent datasets ($N=204$) with distinct interview structures. On high-discrepancy interviews, automated ratings approximated expert benchmarks ($\text{absolute error}=22$) more closely than original human ratings ($\text{absolute error}=26$). Implementing an ``extended'' protocol that incorporates qualitative clinical conventions significantly stabilized ratings, with absolute agreement reaching $\text{ICC(2,1)} = 0.877$. These findings suggest that the ADAPTS framework enables promising evaluations of psychiatric severity. While the current implementation is purely text-based, the underlying architecture is readily extensible to multimodal inputs, including acoustic and visual features. By approximating expert-level precision in a protocol-agnostic manner, this framework provides a foundation for objective and scalable psychiatric assessment, especially in resource-limited settings.

Digital biomarkers for depression have largely relied on static acoustic descriptors, pooled summary statistics, or conventional machine learning representations. Such approaches may miss nonlinear temporal organization embedded in conversational vocal dynamics. We hypothesized that depression is associated with altered recurrence structure in vocal state trajectories, reflecting changes in how the vocal system revisits acoustic states over time. Using the depression subset of the DAIC-WOZ corpus with 142 labeled participants, we modeled frame-level COVAREP trajectories as nonlinear dynamical systems and derived recurrence-based biomarkers from 74 vocal channels. Logistic regression with feature selection and stratified cross-validation evaluated classification performance. Recurrence-based biomarkers achieved a mean cross-validated AUC of 0.689, exceeding static acoustic baselines, entropy-dynamics features, Hurst exponent features, determinism features, and Lyapunov-like instability proxies. Permutation testing indicated statistical significance with $p=0.004$. Pooled cross-validated predictions yielded AUC 0.665 with a 95% bootstrap confidence interval of [0.568, 0.758]. These findings suggest that depression may be characterized by altered recurrence structure in conversational vocal dynamics and support nonlinear state-space analysis as a promising direction for digital psychiatric biomarkers.

Automated depression detection often relies on static aggregation of conversational signals, potentially obscuring clinically meaningful behavioral dynamics. We investigated whether entropy-driven temporal biomarkers improve depression detection beyond standard pooled features using the DAIC-WOZ corpus. Using 142 labeled participants, we reconstructed utterance-level acoustic trajectories and compared pooled temporal baselines, trajectory dynamics, Shannon entropy biomarkers, recurrence quantification, sample entropy, fractal complexity, and coupling biomarkers under leakage-aware validation. Static pooling achieved an AUC of 0.593, trajectory dynamics improved performance to 0.637, and entropy biomarkers produced the strongest statistically significant improvement over pooled baselines (AUC 0.646; nested cross-validated AUC 0.615; permutation p = 0.017). Entropy biomarkers outperformed recurrence, coupling, sample entropy, and fractalbased features, with several biomarkers stable across folds. These findings suggest depression-related signal may lie less in average acoustic levels than in entropy of conversational dynamics, supporting temporally informed digital phenotypes for mental-health assessment.

Automatic depression detection from conversational interactions holds significant promise for scalable screening but remains hindered by severe data scarcity and a lack of clinical interpretability. Existing approaches typically rely on black-box deep learning architectures that struggle to model the subtle, temporal evolution of depressive symptoms or account for participant-specific heterogeneity. In this work, we propose PsyGAT (Psychological Graph Attention Network), a psychologically grounded framework that models conversational sessions as dynamic temporal graphs. We introduce Psychological Expression Units (PEUs) to explicitly encode utterance-level clinical evidence, structuring the session graph to capture transitions in psychological states rather than mere semantic dependencies. To address the critical class imbalance in depression datasets, we employ clinically approved persona-based data augmentation, enable robust model learning. Additionally, we integrate session-level personality context directly into the graph structure to disentangle trait-based behavior from acute depressive symptoms. PsyGAT achieves state-of-the-art performance, surpassing both strong graph-based baselines and closed-source LLMs like GPT-5, achieving 89.99 and 71.37 Macro F1 scores in DAIC-WoZ and E-DAIC, respectively. We further introduce Causal-PsyGAT, an interpretability module that identifies symptom triggers. Experiments show a 20% improvement in MRR for identifying causal indicators, effectively bridging the gap between depression monitoring and clinical explainability. The full augmented dataset is publicly available at https://doi.org/10.6084/m9.figshare.31801921.

Early detection of mental health conditions, particularly stress and depression, from social media text remains a challenging open problem in computational psychiatry and natural language processing. Automated systems must contend with figurative language, implicit emotional expression, and the high noise inherent in user-generated content. Existing approaches either leverage external commonsense knowledge to model mental states explicitly, or apply self-augmentation and contrastive training to improve generalization, but seldom do both in a principled, unified framework. We propose K-SENSE (Knowledge-guided Self-augmented Encoder for Neuro-Semantic Evaluation of Mental Health), a framework that jointly exploits external psychological reasoning and internal representation robustness. K-SENSE adopts a three-stage encoding pipeline: (1) inferential commonsense knowledge is extracted from the COMET model across five mental state dimensions; (2) a semantic anchor is constructed by combining hidden representations from two parallel encoding streams, projected into a shared space before fusion; and (3) a supervised contrastive learning objective aligns same-class representations while encouraging the attention mechanism to suppress irrelevant knowledge noise. We evaluate K-SENSE on Dreaddit (stress detection) and Depression_Mixed (depression detection), achieving mean F1-scores of 86.1 (0.6%) and 94.3 (0.8%), respectively, over five independent runs. These represent improvements of approximately 2.6 and 1.5 percentage points over the strongest prior baselines. Ablation experiments confirm the contribution of each architectural component, including the temporal knowledge integration strategy and the choice to keep the knowledge encoder frozen during fine-tuning.

Depression is one of the most prevalent and debilitating mental health conditions worldwide, frequently underdiagnosed and undertreated. The proliferation of social media platforms provides a rich source of naturalistic linguistic signals for the automated monitoring of psychological well-being. In this work, we propose a system based on Large Language Models (LLMs) for depression risk assessment in Reddit posts, through multi-label classification of eight depression-associated emotions and the computation of a weighted severity index. The method is evaluated in a zero-shot setting on the annotated DepressionEmo dataset (~6,000 posts) and applied in-the-wild to 469,692 comments collected from four subreddits over the period 2024-2025. Our best model, gemma3:27b, achieves micro-F1 = 0.75 and macro-F1 = 0.70, results competitive with purpose-built fine-tuned models (BART: micro-F1 = 0.80, macro-F1 = 0.76). The in-the-wild analysis reveals consistent and temporally stable risk profiles across communities, with marked differences between r/depression and r/anxiety. Our findings demonstrate the feasibility of a cost-effective, scalable approach for large-scale psychological monitoring.

Speech-based automatic estimation of depression levels is essential for enabling early detection and timely intervention, particularly in resource-constrained mental health settings. In recent years, deep learning has demonstrated impressive success across various domains, including affective computing and mental health assessment. Most existing approaches rely on RNN-based architectures (such as LSTM and GRU) to model temporal information for depression estimation. However, the extracted features often emphasize only a few adjacent speech segments, limiting their ability to capture long-range dependencies. To overcome this limitation, we introduce a memory-based feature augmentation method that enhances the representational capacity of GRU-extracted features. Rather than indiscriminately incorporating historical data, our memory bank is designed to selectively integrate two types of components in order to reduce redundancy and irrelevance: (1) historical temporal features that closely resemble the current GRU output, offering complementary contextual information; and (2) dynamic memory features identified based on feature variability, which capture behavioral and emotional fluctuations indicative of depressive symptoms. To effectively fuse the memory-augmented features with GRU outputs, we further design a Hierarchical Attention Fusion (HAF) module. Our method is evaluated on the widely used DAIC-WOZ and E-DAIC datasets, achieving state-of-the-art performance.

Audio--visual recordings provide complementary cues for estimating depression severity, but their informativeness varies across time and modalities. Point predictions alone do not express the uncertainty associated with these estimates. We present EviDep, a multimodal evidential regression framework that integrates multi-scale temporal modeling and shared--private representation learning for uncertainty-aware depression estimation. Frequency-aware Feature Extraction decomposes behavioral feature sequences into multiple frequency bands and refines them with scale-specific experts. Disentangled Evidential Learning encourages the disentanglement of cross-modal shared and modality-specific information in the refined features. Multi-branch Evidential Regression maps the resulting shared and private representations to three Normal-Inverse-Gamma (NIG) outputs and uses evidence-weighted aggregation to estimate depression severity and quantify aleatoric and epistemic uncertainty. Experiments on AVEC 2013, AVEC 2014, DAIC-WOZ, and E-DAIC show competitive prediction accuracy, with ablation studies supporting the contributions of frequency-aware refinement and shared--private disentanglement. Further analyses show that estimated epistemic uncertainty helps identify higher-error predictions, while both uncertainty estimates generally increase under controlled feature degradation.

Automatic depression detection from doctor-patient conversations has gained momentum thanks to the availability of public corpora and advances in language modeling. However, interpretability remains limited: strong performance is often reported without revealing what drives predictions. We analyze three datasets: ANDROIDS, DAIC-WOZ, E-DAIC and identify a systematic bias from interviewer prompts in semi-structured interviews. Models trained on interviewer turns exploit fixed prompts and positions to distinguish depressed from control subjects, often achieving high classification scores without using participant language. Restricting models to participant utterances distributes decision evidence more broadly and reflects genuine linguistic cues. While semi-structured protocols ensure consistency, including interviewer prompts inflates performance by leveraging script artifacts. Our results highlight a cross-dataset, architecture-agnostic bias and emphasize the need for analyses that localize decision evidence by time and speaker to ensure models learn from participants' language.

Prior clinical psychology research shows that Western individuals with depression tend to report psychological symptoms, while Eastern individuals report somatic ones. We test whether Large Language Models (LLMs), which are increasingly used in mental health, reproduce these cultural patterns by prompting them with Western or Eastern personas. Results show that LLMs largely fail to replicate the patterns when prompted in English, though prompting in major Eastern languages (i.e., Chinese, Japanese, and Hindi) improves alignment in several configurations. Our analysis pinpoints two key reasons for this failure: the models' low sensitivity to cultural personas and a strong, culturally invariant symptom hierarchy that overrides cultural cues. These findings reveal that while prompt language is important, current general-purpose LLMs lack the robust, culture-aware capabilities essential for safe and effective mental health applications.

Large Language Model (LLM) studies that use language responses elicited from depression assessments to predict scores on those same assessments often report near-perfect prediction of depression. We refer to these as "Mirror" evaluations and demonstrate an applied case of criterion contamination. N = 110 participants completed both structured diagnostic depression interviews (Mirror condition) and life history interviews ("Non-Mirror" condition). LLMs were prompted to predict depression scores in each condition. As expected, Mirror evaluations were near-perfect. However, Non-Mirror evaluations also displayed prediction sizes considered outstanding in psychology. Further, both Mirror and Non-Mirror predictions correlated with Patient Health Questionnaire-9 scores at similar sizes, suggesting the Mirror condition's advantage collapses when predicting an independent depression measurement. Topic modeling revealed differing depression-related themes across interview types. Mirror evaluations are better considered as reliability evaluations than as validity evaluations. Incorporating Non-Mirror approaches in LLM depression assessment may support more valid and clinically-relevant applications. Keywords: large language models, psychological assessment, psychopathology, depression, reliability, validity, criterion contamination