Challenges for Artificial Intelligence in Recognizing Mental Disorders

Exploring depression in adults over a decade: a review of longitudinal studies

Depression, as a prevalent global mental health disorder, stands as one of the main causes of disability worldwide, imposing significant individual, societal, and economic burdens. While its heterogeneous nature is well recognized, growing evidence highlights the importance of understanding depression trajectories, which describe the long-term course and variability of depressive symptoms over time. These trajectories are shaped by a complex interplay of biological, psychological, and social factors. However, despite extensive research on depression's prevalence and risk factors, a comprehensive synthesis of trajectory patterns, their determinants, and their long-term implications remains limited. This review systematically examines the existing literature on depression trajectories in adults, identifying key influences such as age, gender, socioeconomic status, early life experiences, social support, physical health, lifestyle factors, and external stressors, including pandemics. By integrating findings from longitudinal and epidemiological studies, this review provides novel insights into the bidirectional relationship between depression and chronic health conditions, underscoring the need for a holistic, trajectory-based approach to mental health care. The findings have important implications for clinical practice, public health, and future research. Recognizing distinct trajectory patterns may facilitate earlier identification of high-risk individuals, inform the development of personalized interventions, and optimize the allocation of mental health resources. Furthermore, by elucidating the complex interconnections between depression and broader health determinants, this review establishes a foundation for advancing targeted, evidence-based interventions aimed at reducing the long-term burden of depression, particularly among vulnerable populations.

An enhanced CNN-Bi-transformer based framework for detection of neurological illnesses through neurocardiac data fusion

Classical approaches to diagnosis frequently rely on self-reported symptoms or clinician observations, which can make it difficult to examine mental health illnesses due to their subjective and complicated nature. In this work, we offer an innovative methodology for predicting mental illnesses such as epilepsy, sleep disorders, bipolar disorder, eating disorders, and depression using a multimodal deep learning framework that integrates neurocardiac data fusion. The proposed framework combines MEG, EEG, and ECG signals to create a more comprehensive understanding of brain and cardiac function in individuals with mental disorders. The multimodal deep learning approach uses an integrated CNN-Bi-Transformer, i.e., CardioNeuroFusionNet, which can process multiple types of inputs simultaneously, allowing for the fusion of various modalities and improving the performance of the predictive representation. The proposed framework has undergone testing on data from the Deep BCI Scalp Database and was further validated on the Kymata Atlas dataset to assess its generalizability. The model achieved promising results with high accuracy (98.54%) and sensitivity (97.77%) in predicting mental problems, including neurological and psychiatric conditions. The neurocardiac data fusion has been found to provide additional insights into the relationship between brain and cardiac function in neurological conditions, which could potentially lead to more accurate diagnosis and personalized treatment options. The suggested method overcomes the shortcomings of earlier studies, which tended to concentrate on single-modality data, lacked thorough neurocardiac data fusion, and made use of less advanced machine learning algorithms. The comprehensive experimental findings, which provide an average improvement in accuracy of 2.72%, demonstrate that the suggested work performs better than other cutting-edge AI techniques and generalizes effectively across diverse datasets.

Machine learning-driven development of a stratified CES-D screening system: optimizing depression assessment through adaptive item selection

OBJECTIVE

To develop a stratified screening tool through machine learning approaches for the Center for Epidemiologic Studies Depression Scale (CES-D-20) while maintaining diagnostic accuracy, addressing the efficiency limitations in large-scale applications.

METHODS

Data were derived from the Chinese Psychological Health Guard Project (primary sample: n = 179,877; age 9-18) and China Labor-force Dynamics Survey (validation samples across age spans). We employed a two-stage machine learning approach: first applying Recursive Feature Elimination with multiple linear regression to identify core predictive items for total depression scores, followed by logistic regression for optimizing depression classification (CES-D ≥ 16). Model performance was systematically evaluated through discrimination (ROC analysis), calibration (Brier score), and clinical utility analyses (decision curve analysis), with additional validation using random forest and support vector machine algorithms across independent samples.

RESULTS

The resulting stratified screening system consists of an initial four-item rapid screening layer (encompassing emotional, cognitive, and interpersonal dimensions) for detecting probable depression (AUC = 0.982, sensitivity = 0.945, specificity = 0.926), followed by an enhanced assessment layer with five additional items. Together, these nine items enable accurate prediction of the full CES-D-20 total score (R2 = 0.957). This stratified approach demonstrated robust generalizability across age groups (R2 > 0.94, accuracy > 0.91) and time points. Calibration analyses and decision curve analyses confirmed optimal clinical utility, particularly in the critical risk threshold range (0.3-0.6).

CONCLUSIONS

This study contributes to the refinement of CES-D by developing a machine learning-derived stratified screening version, offering an efficient and reliable approach that optimizes assessment burden while maintaining excellent psychometric properties. The stratified design makes it particularly valuable for large-scale mental health screening programs, enabling efficient risk stratification and targeted assessment allocation.

Artificial intelligence in the detection and treatment of depressive disorders: a narrative review of literature

Modern psychiatry aims to adopt precision models and promote personalized treatment within mental health care. However, the complexity of factors underpinning mental disorders and the variety of expressions of clinical conditions make this task arduous for clinicians. Globally, major depression is a common mental disorder and encompasses a constellation of clinical manifestations and a variety of etiological factors. In this context, the use of Artificial Intelligence might help clinicians in the screening and diagnosis of depression on a wider scale and could also facilitate their task in predicting disease outcomes by considering complex interactions between prodromal and clinical symptoms, neuroimaging data, genetics, or biomarkers. In this narrative review, we report on the most significant evidence from current international literature regarding the use of Artificial Intelligence in the diagnosis and treatment of major depression, specifically focusing on the use of Natural Language Processing, Chatbots, Machine Learning, and Deep Learning.

Mapping the neurodevelopmental predictors of psychopathology

Neuroimaging research has uncovered a multitude of neural abnormalities associated with psychopathology, but few prediction-based studies have been conducted during adolescence, and even fewer used neurobiological features that were extracted across multiple neuroimaging modalities. This gap in the literature is critical, as deriving accurate brain-based models of psychopathology is an essential step towards understanding key neural mechanisms and identifying high-risk individuals. As such, we trained adaptive tree-boosting algorithms on multimodal neuroimaging features from the Lifespan Human Connectome Developmental (HCP-D) sample that contained 956 participants between the ages of 8 to 22 years old. Our feature space consisted of 1037 anatomical, 1090 functional, and 192 diffusion MRI features, which were used to derive models that separately predicted internalizing symptoms, externalizing symptoms, and the general psychopathology factor. We found that multimodal models were the most accurate, but all brain-based models of psychopathology yielded out-of-sample predictions that were weakly correlated with actual symptoms (r2 < 0.15). White matter microstructural properties, including orientation dispersion indices and intracellular volume fractions, were the most predictive of general psychopathology, followed by cortical thickness and functional connectivity. Spatially, the most predictive features of general psychopathology were primarily localized within the default mode and dorsal attention networks. These results were mostly consistent across all dimensions of psychopathology, except orientation dispersion indices and the default mode network were not as heavily weighted in the prediction of internalizing and externalizing symptoms. Taken with prior literature, it appears that neurobiological features are an important part of the equation for predicting psychopathology but relying exclusively on neural markers is clearly not sufficient, especially among adolescent samples with subclinical symptoms. Consequently, risk factor models of psychopathology may benefit from incorporating additional sources of information that have also been shown to explain individual differences, such as psychosocial factors, environmental stressors, and genetic vulnerabilities.

The Use of AI in Mental Health Services to Support Decision-Making: Scoping Review

BACKGROUND

Recent advancements in artificial intelligence (AI) have changed the care processes in mental health, particularly in decision-making support for health care professionals and individuals with mental health problems. AI systems provide support in several domains of mental health, including early detection, diagnostics, treatment, and self-care. The use of AI systems in care flows faces several challenges in relation to decision-making support, stemming from technology, end-user, and organizational perspectives with the AI disruption of care processes.

OBJECTIVE

This study aims to explore the use of AI systems in mental health to support decision-making, focusing on 3 key areas: the characteristics of research on AI systems in mental health; the current applications, decisions, end users, and user flow of AI systems to support decision-making; and the evaluation of AI systems for the implementation of decision-making support, including elements influencing the long-term use.

METHODS

A scoping review of empirical evidence was conducted across 5 databases: PubMed, Scopus, PsycINFO, Web of Science, and CINAHL. The searches were restricted to peer-reviewed articles published in English after 2011. The initial screening at the title and abstract level was conducted by 2 reviewers, followed by full-text screening based on the inclusion criteria. Data were then charted and prepared for data analysis.

RESULTS

Of a total of 1217 articles, 12 (0.99%) met the inclusion criteria. These studies predominantly originated from high-income countries. The AI systems were used in health care, self-care, and hybrid care contexts, addressing a variety of mental health problems. Three types of AI systems were identified in terms of decision-making support: diagnostic and predictive AI, treatment selection AI, and self-help AI. The dynamics of the type of end-user interaction and system design were diverse in complexity for the integration and use of the AI systems to support decision-making in care processes. The evaluation of the use of AI systems highlighted several challenges impacting the implementation and functionality of the AI systems in care processes, including factors affecting accuracy, increase of demand, trustworthiness, patient-physician communication, and engagement with the AI systems.

CONCLUSIONS

The design, development, and implementation of AI systems to support decision-making present substantial challenges for the sustainable use of this technology in care processes. The empirical evidence shows that the evaluation of the use of AI systems in mental health is still in its early stages, with need for more empirically focused research on real-world use. The key aspects requiring further investigation include the evaluation of the use of AI-supported decision-making from human-AI interaction and human-computer interaction perspectives, longitudinal implementation studies of AI systems in mental health to assess the use, and the integration of shared decision-making in AI systems.

Beyond clinical observations: a scoping review of AI-detectable observable cues in borderline personality disorder

Borderline Personality Disorder (BPD), impacting approximately 2% of adults worldwide, presents a formidable challenge in psychiatric diagnostics. Often underdiagnosed or misdiagnosed, BPD is associated with high morbidity and mortality. This scoping review embarks on a comprehensive exploration of observable cues in BPD, encompassing language patterns, speech nuances, facial expressions, nonverbal communication, and physiological measurements. The findings unveil distinctive features within the BPD population, including language patterns emphasizing external viewpoints and future tense, specific linguistic characteristics, and unique nonverbal behaviors. Physiological measurements contribute to this exploration, shedding light on emotional responses and physiological arousal in individuals with BPD. These cues offer the potential to enhance diagnostic accuracy and complement existing diagnostic methods, enabling early identification and management in response to the urgent need for precise psychiatric care in the digital era. By serving as possible digital biomarkers, they could provide objective, accessible, and stress-reducing assessments, representing a significant leap towards improved psychiatric assessments and an invaluable contribution to the field of precision psychiatry.

Decoding Schizophrenia: How AI-Enhanced fMRI Unlocks New Pathways for Precision Psychiatry

Schizophrenia, a highly complex psychiatric disorder, presents significant challenges in diagnosis and treatment due to its multifaceted neurobiological underpinnings. Recent advancements in functional magnetic resonance imaging (fMRI) and artificial intelligence (AI) have revolutionized the understanding and management of this condition. This manuscript explores how the integration of these technologies has unveiled key insights into schizophrenia's structural and functional neural anomalies. fMRI research highlights disruptions in crucial brain regions like the prefrontal cortex and hippocampus, alongside impaired connectivity within networks such as the default mode network (DMN). These alterations correlate with the cognitive deficits and emotional dysregulation characteristic of schizophrenia. AI techniques, including machine learning (ML) and deep learning (DL), have enhanced the detection and analysis of these complex patterns, surpassing traditional methods in precision. Algorithms such as support vector machines (SVMs) and Vision Transformers (ViTs) have proven particularly effective in identifying biomarkers and aiding early diagnosis. Despite these advancements, challenges such as variability in methodologies and the disorder's heterogeneity persist, necessitating large-scale, collaborative studies for clinical translation. Moreover, ethical considerations surrounding data integrity, algorithmic transparency, and patient individuality must guide AI's integration into psychiatry. Looking ahead, AI-augmented fMRI holds promise for tailoring personalized interventions, addressing unique neural dysfunctions, and improving therapeutic outcomes for individuals with schizophrenia. This convergence of neuroimaging and computational innovation heralds a transformative era in precision psychiatry.

Toward molecular diagnosis of major depressive disorder by plasma peptides using a deep learning approach

Major depressive disorder (MDD) is a severe psychiatric disorder that currently lacks any objective diagnostic markers. Here, we develop a deep learning approach to discover the mass spectrometric features that can discriminate MDD patients from health controls. Using plasma peptides, the neural network, termed as CMS-Net, can perform diagnosis and prediction with an accuracy of 0.9441. The sensitivity and specificity reached 0.9352 and 0.9517 respectively, and the area under the curve was enhanced to 0.9634. Using the gradient-based feature importance method to interpret crucial features, we identify 28 differential peptide sequences from 14 precursor proteins (e.g. hemoglobin, immunoglobulin, albumin, etc.). This work highlights the possibility of molecular diagnosis of MDD with the aid of chemical and computer science.

Ethical trade-offs in AI for mental health

It is expected that machine learning algorithms will enable better diagnosis, prognosis, and treatment in psychiatry. A central argument for deploying algorithmic methods in clinical decision-making in psychiatry is that they may enable not only faster and more accurate clinical judgments but also that they may provide a more objective foundation for clinical decisions. This article argues that the outputs of algorithms are never objective in the sense of being unaffected by human values and possibly biased choices. And it suggests that the best way to approach this is to ensure awareness of and transparency about the ethical trade-offs that must be made when developing an algorithm for mental health.

Psychotherapy, artificial intelligence and adolescents: ethical aspects

Artificial intelligence (AI) has rapidly advanced in various domains, including its application in psychotherapy. AI-powered psychotherapy tools present promising solutions for increasing accessibility to mental health care. However, the integration of AI in psychotherapy raises significant ethical concerns that require thorough consideration and regulation to ensure ethical practice, patient safety, and data privacy. This article discusses the ethical considerations surrounding the utilization of AI in psychotherapy, emphasizing the need for responsible implementation, patient privacy, and the human-AI interaction. The challenge raised by the use of artificial intelligence requires a comprehensive approach. Schools, in particular, are crucial in providing both knowledge and ethical guidance, helping young individuals decipher the complexities of online content. Additionally, parental support is essential, requiring the provision of time, fostering relationships, encouraging dialogue, and creating a safe environment to share experiences amidst the intricacies of adolescence. Reimagining social and healthcare services tailored for adolescents is equally crucial, taking into account recent societal changes. The integration of AI in psychotherapy has vast potential to transform mental healthcare. However, ensuring its accuracy and effectiveness demands a proactive approach to address associated ethical considerations. By adopting responsible practices, preserving patient autonomy, and continually refining AI systems, the field can leverage the benefits of AI in psychotherapy while maintaining high ethical standards.

Depressive Disorder Recognition Based on Frontal EEG Signals and Deep Learning

Depressive disorder (DD) has become one of the most common mental diseases, seriously endangering both the affected person's psychological and physical health. Nowadays, a DD diagnosis mainly relies on the experience of clinical psychiatrists and subjective scales, lacking objective, accurate, practical, and automatic diagnosis technologies. Recently, electroencephalogram (EEG) signals have been widely applied for DD diagnosis, but mainly with high-density EEG, which can severely limit the efficiency of the EEG data acquisition and reduce the practicability of diagnostic techniques. The current study attempts to achieve accurate and practical DD diagnoses based on combining frontal six-channel electroencephalogram (EEG) signals and deep learning models. To this end, 10 min clinical resting-state EEG signals were collected from 41 DD patients and 34 healthy controls (HCs). Two deep learning models, multi-resolution convolutional neural network (MRCNN) combined with long short-term memory (LSTM) (named MRCNN-LSTM) and MRCNN combined with residual squeeze and excitation (RSE) (named MRCNN-RSE), were proposed for DD recognition. The results of this study showed that the higher EEG frequency band obtained the better classification performance for DD diagnosis. The MRCNN-RSE model achieved the highest classification accuracy of 98.48 ± 0.22% with 8-30 Hz EEG signals. These findings indicated that the proposed analytical framework can provide an accurate and practical strategy for DD diagnosis, as well as essential theoretical and technical support for the treatment and efficacy evaluation of DD.

Harnessing Artificial Intelligence: Strategies for Mental Health Nurses in Optimizing Psychiatric Patient Care

This narrative review explores the transformative impact of Artificial Intelligence (AI) on mental health nursing, particularly in enhancing psychiatric patient care. AI technologies present new strategies for early detection, risk assessment, and improving treatment adherence in mental health. They also facilitate remote patient monitoring, bridge geographical gaps, and support clinical decision-making. The evolution of virtual mental health assistants and AI-enhanced therapeutic interventions are also discussed. These technological advancements reshape the nurse-patient interactions while ensuring personalized, efficient, and high-quality care. The review also addresses AI's ethical and responsible use in mental health nursing, emphasizing patient privacy, data security, and the balance between human interaction and AI tools. As AI applications in mental health care continue to evolve, this review encourages continued innovation while advocating for responsible implementation, thereby optimally leveraging the potential of AI in mental health nursing.

AI for Psychometrics: Validating Machine Learning Models in Measuring Emotional Intelligence with Eye-Tracking Techniques

AI, or artificial intelligence, is a technology of creating algorithms and computer systems that mimic human cognitive abilities to perform tasks. Many industries are undergoing revolutions due to the advances and applications of AI technology. The current study explored a burgeoning field-Psychometric AI, which integrates AI methodologies and psychological measurement to not only improve measurement accuracy, efficiency, and effectiveness but also help reduce human bias and increase objectivity in measurement. Specifically, by leveraging unobtrusive eye-tracking sensing techniques and performing 1470 runs with seven different machine-learning classifiers, the current study systematically examined the efficacy of various (ML) models in measuring different facets and measures of the emotional intelligence (EI) construct. Our results revealed an average accuracy ranging from 50-90%, largely depending on the percentile to dichotomize the EI scores. More importantly, our study found that AI algorithms were powerful enough to achieve high accuracy with as little as 5 or 2 s of eye-tracking data. The research also explored the effects of EI facets/measures on ML measurement accuracy and identified many eye-tracking features most predictive of EI scores. Both theoretical and practical implications are discussed.

Use of pain-related gene features to predict depression by support vector machine model in patients with fibromyalgia

The prevalence rate of depression is higher in patients with fibromyalgia syndrome, but this is often unrecognized in patients with chronic pain. Given that depression is a common major barrier in the management of patients with fibromyalgia syndrome, an objective tool that reliably predicts depression in patients with fibromyalgia syndrome could significantly enhance the diagnostic accuracy. Since pain and depression can cause each other and worsen each other, we wonder if pain-related genes can be used to differentiate between those with major depression from those without. This study developed a support vector machine model combined with principal component analysis to differentiate major depression in fibromyalgia syndrome patients using a microarray dataset, including 25 fibromyalgia syndrome patients with major depression, and 36 patients without major depression. Gene co-expression analysis was used to select gene features to construct support vector machine model. The principal component analysis can help reduce the number of data dimensions without much loss of information, and identify patterns in data easily. The 61 samples available in the database were not enough for learning based methods and cannot represent every possible variation of each patient. To address this issue, we adopted Gaussian noise to generate a large amount of simulated data for training and testing of the model. The ability of support vector machine model to differentiate major depression using microarray data was measured as accuracy. Different structural co-expression patterns were identified for 114 genes involved in pain signaling pathway by two-sample KS test (p &lt; 0.001 for the maximum deviation D = 0.11 &gt; Dcritical = 0.05), indicating the aberrant co-expression patterns in fibromyalgia syndrome patients. Twenty hub gene features were further selected based on co-expression analysis to construct the model. The principal component analysis reduced the dimension of the training samples from 20 to 16, since 16 components were needed to retain more than 90% of the original variance. The support vector machine model was able to differentiate between those with major depression from those without in fibromyalgia syndrome patients with an average accuracy of 93.22% based on the expression levels of the selected hub gene features. These findings would contribute key information that can be used to develop a clinical decision-making tool for the data-driven, personalized optimization of diagnosing depression in patients with fibromyalgia syndrome.