Word usage in spontaneous speech as a predictor of depressive symptoms among youth at high risk for mood disorders

Use of Artificial Intelligence in Adolescents' Mental Health Care: Systematic Scoping Review of Current Applications and Future Directions

Background

Given the increasing prevalence of mental health problems among adolescents, early intervention and appropriate management are needed to decrease mortality and morbidity. Artificial intelligence's (AI) potential contributions, although significant in the field of medicine, have not been adequately studied in the context of adolescents' mental health.

Objective

This review aimed to identify AI interventions that have been tested, implemented, or both, for use in adolescents' mental health care.

Methods

We used the Arksey and O'Malley framework, further refined by Levac et al, along with the Joanna Briggs Institute methodology, to guide this scoping review. We searched 5 electronic databases from the inception date through July 2024 (inclusive). Four independent reviewers screened the titles and abstracts, read the full texts, and extracted data using a validated data extraction form. Disagreements were resolved by consensus, and if this was not possible, the opinion of a fifth reviewer was sought. We evaluated the risk of bias (ROB) for prognosis and diagnosis-related studies using the Prediction Model Risk of Bias Assessment Tool. We followed the PRISMA-ScR (Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews) checklist for reporting.

Results

Of the papers screened, 88 papers relevant to our eligibility criteria were identified. Among the included papers, AI was most commonly used for diagnosis (n=78), followed by monitoring and evaluation (n=19), treatment (n=10), and prognosis (n=6). As some studies addressed multiple applications, categories are not mutually exclusive. For diagnosis, studies primarily addressed suicidal behaviors (n=11) and autism spectrum disorder (n=7). Machine learning was the most frequently reported AI method across all application areas. The overall ROB for diagnostic and prognostic models was predominantly unclear (58%), while 20% of studies had a high ROB and 22% were assessed as low risk.

Conclusions

In our review, we found that AI is being applied across various areas of adolescent mental health care, spanning diagnosis, treatment planning, symptom monitoring, and prognosis. Interestingly, most studies to date have concentrated heavily on diagnostic tools, leaving other important aspects of care relatively underexplored. This presents a key opportunity for future research to broaden the scope of AI applications beyond diagnosis. Moreover, future studies should emphasize the meaningful and active involvement of end users in the design, development, and validation of AI interventions, alongside improved transparency in reporting AI models, data handling, and analytical processes to build trust and support safe clinical implementation.

Utilizing natural language processing for precision prevention of mental health disorders among youth: A systematic review

BACKGROUND

The global mental health crisis has created barriers to youth mental healthcare, leaving many disorders unaddressed. Precision prevention, which identifies individual risks, offers the potential for tailored interventions. While natural language processing (NLP) has shown promise in the early detection of mental health disorders, no review has examined its role in youth mental health detection. We hypothesize that NLP can improve early detection and personalized care in mental healthcare among youth.

METHODOLOGY

After screening 1197 articles from 5 databases, 12 papers were included covering six categories: (1) mental health disorders, (2) data sources, (3) NLP objective for mental health detection, (4) annotation and validation techniques, (5) linguistic markers, and (6) performance and evaluation. Study quality was assessed using Hawker's checklist for disparate study designs.

RESULTS

Most studies focused on suicide risk (42 %), depression (25 %), and stress (17 %). Social media (42 %) and interviews (33 %) were the most common data sources, with linguistic inquiry and word count and support vector machines frequently used for analysis. While most studies were exploratory, one implemented a real-time tool for detecting mental health risks. Validation methods, including precision and recall metrics, showed strong predictive performance.

CONCLUSIONS

This review highlights the potential of NLP in youth mental health detection, addressing challenges such as bias, data quality, and ethical concerns. Future research should refine NLP models using diverse, multimodal datasets, addressing data imbalance, and improving real-time detection. Exploring transformer-based models and ensuring ethical, inclusive data handling will be key to advancing NLP-driven interventions.

Linguistic style as a digital marker for depression severity: An ambulatory assessment pilot study in patients with depressive disorder undergoing sleep deprivation therapy

BACKGROUND

Digital phenotyping and monitoring tools are the most promising approaches to automatically detect upcoming depressive episodes. Especially, linguistic style has been seen as a potential behavioral marker of depression, as cross-sectional studies showed, for example, less frequent use of positive emotion words, intensified use of negative emotion words, and more self-references in patients with depression compared to healthy controls. However, longitudinal studies are sparse and therefore it remains unclear whether within-person fluctuations in depression severity are associated with individuals' linguistic style.

METHODS

To capture affective states and concomitant speech samples longitudinally, we used an ambulatory assessment approach sampling multiple times a day via smartphones in patients diagnosed with depressive disorder undergoing sleep deprivation therapy. This intervention promises a rapid change of affective symptoms within a short period of time, assuring sufficient variability in depressive symptoms. We extracted word categories from the transcribed speech samples using the Linguistic Inquiry and Word Count.

RESULTS

Our analyses revealed that more pleasant affective momentary states (lower reported depression severity, lower negative affective state, higher positive affective state, (positive) valence, energetic arousal and calmness) are mirrored in the use of less negative emotion words and more positive emotion words.

CONCLUSION

We conclude that a patient's linguistic style, especially the use of positive and negative emotion words, is associated with self-reported affective states and thus is a promising feature for speech-based automated monitoring and prediction of upcoming episodes, ultimately leading to better patient care.

Artificial intelligence in mental health care: a systematic review of diagnosis, monitoring, and intervention applications

Artificial intelligence (AI) has been recently applied to different mental health illnesses and healthcare domains. This systematic review presents the application of AI in mental health in the domains of diagnosis, monitoring, and intervention. A database search (CCTR, CINAHL, PsycINFO, PubMed, and Scopus) was conducted from inception to February 2024, and a total of 85 relevant studies were included according to preestablished inclusion criteria. The AI methods most frequently used were support vector machine and random forest for diagnosis, machine learning for monitoring, and AI chatbot for intervention. AI tools appeared to be accurate in detecting, classifying, and predicting the risk of mental health conditions as well as predicting treatment response and monitoring the ongoing prognosis of mental health disorders. Future directions should focus on developing more diverse and robust datasets and on enhancing the transparency and interpretability of AI models to improve clinical practice.

Mobile health for mental health support: a survey of attitudes and concerns among mental health professionals in Poland over the period 2020-2023

Introduction

Mobile health (mHealth) has emerged as a dynamic sector supported by technological advances and the COVID-19 pandemic and have become increasingly applied in the field of mental health.

Aim

The aim of this study was to assess the attitudes, expectations, and concerns of mental health professionals, including psychiatrists, psychologists, and psychotherapists, towards mHealth, in particular mobile health self-management tools and telepsychiatry in Poland.

Material and methods

This was a survey conducted between 2020 and 2023. A questionnaire was administered to 148 mental health professionals, covering aspects such as telepsychiatry, mobile mental health tools, and digital devices.

Results

The majority of professionals expressed readiness to use telepsychiatry, with a peak in interest during the COVID-19 pandemic, followed by a gradual decline from 2022. Concerns about telepsychiatry were reported by a quarter of respondents, mainly related to difficulties in correctly assessing the patient's condition, and technical issues. Mobile health tools were positively viewed by professionals, with 86% believing they could support patients in managing mental health and 74% declaring they would recommend patients to use them. Nevertheless, 29% expressed concerns about the effectiveness and data security of such tools. Notably, the study highlighted a growing readiness among mental health professionals to use new digital technologies, reaching 84% in 2023.

Conclusion

These findings emphasize the importance of addressing concerns and designing evidence-based mHealth solutions to ensure long-term acceptance and effectiveness in mental healthcare. Additionally, the study highlights the need for ongoing regulatory efforts to safeguard patient data and privacy in the evolving digital health landscape.

Using HIPAA (Health Insurance Portability and Accountability Act)-Compliant Transcription Services for Virtual Psychiatric Interviews: Pilot Comparison Study

BACKGROUND

Automatic speech recognition (ASR) technology is increasingly being used for transcription in clinical contexts. Although there are numerous transcription services using ASR, few studies have compared the word error rate (WER) between different transcription services among different diagnostic groups in a mental health setting. There has also been little research into the types of words ASR transcriptions mistakenly generate or omit.

OBJECTIVE

This study compared the WER of 3 ASR transcription services (Amazon Transcribe [Amazon.com, Inc], Zoom-Otter AI [Zoom Video Communications, Inc], and Whisper [OpenAI Inc]) in interviews across 2 different clinical categories (controls and participants experiencing a variety of mental health conditions). These ASR transcription services were also compared with a commercial human transcription service, Rev (Rev.Com, Inc). Words that were either included or excluded by the error in the transcripts were systematically analyzed by their Linguistic Inquiry and Word Count categories.

METHODS

Participants completed a 1-time research psychiatric interview, which was recorded on a secure server. Transcriptions created by the research team were used as the gold standard from which WER was calculated. The interviewees were categorized into either the control group (n=18) or the mental health condition group (n=47) using the Mini-International Neuropsychiatric Interview. The total sample included 65 participants. Brunner-Munzel tests were used for comparing independent sets, such as the diagnostic groupings, and Wilcoxon signed rank tests were used for correlated samples when comparing the total sample between different transcription services.

RESULTS

There were significant differences between each ASR transcription service's WER (P<.001). Amazon Transcribe's output exhibited significantly lower WERs compared with the Zoom-Otter AI's and Whisper's ASR. ASR performances did not significantly differ across the 2 different clinical categories within each service (P>.05). A comparison between the human transcription service output from Rev and the best-performing ASR (Amazon Transcribe) demonstrated a significant difference (P<.001), with Rev having a slightly lower median WER (7.6%, IQR 5.4%-11.35 vs 8.9%, IQR 6.9%-11.6%). Heat maps and spider plots were used to visualize the most common errors in Linguistic Inquiry and Word Count categories, which were found to be within 3 overarching categories: Conversation, Cognition, and Function.

CONCLUSIONS

Overall, consistent with previous literature, our results suggest that the WER between manual and automated transcription services may be narrowing as ASR services advance. These advances, coupled with decreased cost and time in receiving transcriptions, may make ASR transcriptions a more viable option within health care settings. However, more research is required to determine if errors in specific types of words impact the analysis and usability of these transcriptions, particularly for specific applications and in a variety of populations in terms of clinical diagnosis, literacy level, accent, and cultural origin.