Depression Detection

This paper investigates whether combining cognitively grounded linguistic features with transformer-based embeddings improves automated detection of depression in online text. Using Beck's Cognitive Theory of Depression, the study extracts cognitive distortions as measurable features, including first-person pronoun density, absolutist words, and negative emotion in Reddit posts from depression-related and control communities. Using a subset of the Kaggle Reddit Suicide and Depression Detection dataset, two classification pipelines are compared, a TF-IDF embedding with Naive Bayes as a baseline, and a hybrid model that concatenates DistilBERT sentence embeddings with Holographic Reduced Representation (HRR) vectors encoding the cognitive-linguistic features, followed by Logistic Regression. The hybrid DistilBERT HRR model achieves a macro F1 score of 0.94 versus 0.80 for the TD-IDF baseline, with 5-fold cross validation F1 improving from 0.83 to 0.92, and AUC from 0.958 to 0.981.

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.

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.

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.

Major depressive disorder (MDD) is a prevalent mental disorder associated with complex neurobiological changes that cannot be fully captured using a single imaging modality. The use of multimodal magnetic resonance imaging (MRI) provides a more comprehensive understanding of brain changes by combining structural and functional data. Despite this, the effective integration of these modalities remains challenging. In this study, we propose a dual cross-attention-based multimodal fusion framework that explicitly models bidirectional interactions between structural MRI (sMRI) and resting-state functional MRI (rs-fMRI) representations. The proposed approach is tested on the large-scale REST-meta-MDD dataset using both structural and functional brain atlas configurations. Numerous experiments conducted under a 10-fold stratified cross-validation demonstrated that the proposed fusion algorithm achieves robust and competitive performance across all atlas types. The proposed method consistently outperforms conventional feature-level concatenation for functional atlases, while maintaining comparable performance for structural atlases. The most effective dual cross-attention multimodal model obtained 84.71% accuracy, 86.42% sensitivity, 82.89% specificity, 84.34% precision, and 85.37% F1-score. These findings emphasize the importance of explicitly modeling cross-modal interactions for multimodal neuroimaging-based MDD classification.

With the emergence of AI techniques for depression diagnosis, the conflict between high demand and limited supply for depression screening has been significantly alleviated. Among various modal data, audio-based depression diagnosis has received increasing attention from both academia and industry since audio is the most common carrier of emotion transmission. Unfortunately, audio data also contains User-sensitive Identity Information (ID), which is extremely vulnerable and may be maliciously used during the smart diagnosis process. Among previous methods, the clarification between depression features and sensitive features has always serve as a barrier. It is also critical to the problem for introducing a safe encryption methodology that only encrypts the sensitive features and a powerful classifier that can correctly diagnose the depression. To track these challenges, by leveraging adversarial loss-based Subspace Decomposition, we propose a first practical framework \name presented for Trustable Audio Affective Computing, to perform automated depression detection through audio within a trustable environment. The key enablers of TAAC are Differentiating Features Subspace Decompositor (DFSD), Flexible Noise Encryptor (FNE) and Staged Training Paradigm, used for decomposition, ID encryption and performance enhancement, respectively. Extensive experiments with existing encryption methods demonstrate our framework's preeminent performance in depression detection, ID reservation and audio reconstruction. Meanwhile, the experiments across various setting demonstrates our model's stability under different encryption strengths. Thus proving our framework's excellence in Confidentiality, Accuracy, Traceability, and Adjustability.

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.

Dynamic functional connectivity (dFC) derived from resting-state functional magnetic resonance imaging (fMRI) has been extensively utilized in brain science research. The sliding window correlation (SWC) method is a widely used approach for constructing dFC by computing correlation coefficients between amplitude time series of signals from pairs of brain regions. In this study, we propose an integrated approach that incorporates both amplitude and phase information of fMRI signals to improve the detection of brain disorders. Specifically, we introduce a multi-scale fusion learning framework, namely MSFL, which leverages two complementary dFC features derived from SWC and phase synchronization (PS). Here, SWC captures amplitude correlations, while PS measures phase coherence within dFC. We evaluated the efficacy of MSFL in classifying autism spectrum disorder and major depressive disorder using two publicly available datasets: ABIDE I and REST-meta-MDD, respectively. The results indicate that MSFL significantly outperforms existing comparative models. Moreover, we performed model explanation analysis using the SHAP framework, which showed that both types of dFC features from SWC and PS contribute to detecting brain disorders.

Depression is a severe mental disorder, and reliable identification plays a critical role in early intervention and treatment. Multimodal depression detection aims to improve diagnostic performance by jointly modeling complementary information from multiple modalities. Recently, numerous multimodal learning approaches have been proposed for depression analysis; however, these methods suffer from the following limitations: 1) inter-modal inconsistency and depression-unrelated interference, where depression-related cues may conflict across modalities while substantial irrelevant content obscures critical depressive signals, and 2) diverse individual depressive presentations, leading to individual differences in modality and cue importance that hinder reliable fusion. To address these issues, we propose Individual-aware Multimodal Depression-related Representation Learning Framework (IDRL) for robust depression diagnosis. Specifically, IDRL 1) disentangles multimodal representations into a modality-common depression space, a modality-specific depression space, and a depression-unrelated space to enhance modality alignment while suppressing irrelevant information, and 2) introduces an individual-aware modality-fusion module (IAF) that dynamically adjusts the weights of disentangled depression-related features based on their predictive significance, thereby achieving adaptive cross-modal fusion for different individuals. Extensive experiments demonstrate that IDRL achieves superior and robust performance for multimodal depression detection.

Depression is underdiagnosed in primary care, yet timely identification remains critical. Recorded clinical encounters, increasingly common with digital scribing technologies, present an opportunity to detect depression from naturalistic dialogue. We investigated automated depression detection from 1,108 audio-recorded primary care encounters in the Establishing Focus study, with depression defined by PHQ-9 (n=253 depressed, n=855 non-depressed). We compared three supervised approaches, Sentence-BERT + Logistic Regression (LR), LIWC+LR and ModernBERT, against a zero-shot GPT-OSS. GPT-OSS achieved the strongest performance (AUPRC=0.510, AUROC=0.774), with LIWC+LR competitive among supervised models (AUPRC=0.500, AUROC=0.742). Combined dyadic transcripts outperformed single-speaker configurations, with providers linguistically mirroring patients in depression encounters, an additive signal not captured by either speaker alone. Meaningful detection is achievable from the first 128 patient tokens (AUPRC=0.356, AUROC=0.675), supporting in-the-moment clinical decision support. These findings argue for passively collected clinical audio as a low-burden complement to existing screening workflows.

Speech-based detection of cognitive impairment (CI) offers a promising non-invasive approach for early diagnosis, yet performance disparities across demographic and clinical subgroups remain underexplored, raising concerns around fairness and generalizability. This study presents a systematic bias analysis of acoustic-based CI and depression classification using the DementiaBank Pitt Corpus. We compare traditional acoustic features (MFCCs, eGeMAPS) with contextualized speech embeddings from Wav2Vec 2.0 (W2V2), and evaluate classification performance across gender, age, and depression-status subgroups. For CI detection, higher-layer W2V2 embeddings outperform baseline features (UAR up to 80.6%), but exhibit performance disparities; specifically, females and younger participants demonstrate lower discriminative power ($AUC$: 0.769 and 0.746, respectively) and substantial specificity disparities ($Δ_{spec}$ up to 18% and 15%, respectively), leading to a higher risk of misclassifications than their counterparts. These disparities reflect representational biases, defined as systematic differences in model performance across demographic or clinical subgroups. Depression detection within CI subjects yields lower overall performance, with mild improvements from low and mid-level W2V2 layers. Cross-task generalization between CI and depression classification is limited, indicating that each task depends on distinct representations. These findings emphasize the need for fairness-aware model evaluation and subgroup-specific analysis in clinical speech applications, particularly in light of demographic and clinical heterogeneity in real-world applications.

EEG-based neural decoding models often fail to generalize across acquisition sites due to structured, site-dependent biases implicitly exploited during training. We reformulate cross-site clinical EEG learning as a bias-factorized generalization problem, in which domain shifts arise from multiple interacting sources. We identify three fundamental bias factors and propose a general training framework that mitigates their influence through data standardization and representation-level constraints. We construct a standardized multi-site EEG benchmark for Major Depressive Disorder and introduce CRCC, a two-stage training paradigm combining encoder-decoder pretraining with joint fine-tuning via cross-subject/site contrastive learning and site-adversarial optimization. CRCC consistently outperforms state-of-the-art baselines and achieves a 10.7 percentage-point improvement in balanced accuracy under strict zero-shot site transfer, demonstrating robust generalization to unseen environments.

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