Radwa J. Hanafy

Abdelrahman Hanafi, Mohammed Saad, Noureldin Zahran et al.

Large Language Models (LLMs) have shown promise in various domains, including healthcare, with significant potential to transform mental health applications by enabling scalable and accessible solutions. This study aims to provide a comprehensive evaluation of 33 LLMs, ranging from 2 billion to 405+ billion parameters, in performing key mental health tasks using social media data across six datasets. To our knowledge, this represents the largest-scale systematic evaluation of modern LLMs for mental health applications. Models such as GPT-4, Llama 3, Claude, Gemma, Gemini, and Phi-3 were assessed for their zero-shot (ZS) and few-shot (FS) capabilities across three tasks: binary disorder detection, disorder severity evaluation, and psychiatric knowledge assessment. Key findings revealed that models like GPT-4 and Llama 3 exhibited superior performance in binary disorder detection, achieving accuracies up to 85% on certain datasets, while FS learning notably enhanced disorder severity evaluations, reducing the Mean Absolute Error (MAE) by 1.3 points for the Phi-3-mini model. Recent models, such as Llama 3.1 405b, demonstrated exceptional psychiatric knowledge assessment accuracy at 91.2%, while prompt engineering played a crucial role in improving performance across tasks. However, the ethical constraints imposed by many LLM providers limit their ability to respond to sensitive queries, hampering comprehensive performance evaluations. This work highlights both the capabilities and limitations of LLMs in mental health contexts, offering valuable insights for future applications in psychiatry.

Aya E. Fouda, Abdelrahamn A. Hassan, Radwa J. Hanafy et al.

Large language models (LLMs) hold great promise in enhancing psychiatric practice, from improving diagnostic accuracy to streamlining clinical documentation and therapeutic support. However, existing evaluation resources heavily rely on small clinical interview corpora, social media posts, or synthetic dialogues, which limits their clinical validity and fails to capture the full complexity of psychiatric reasoning. In this work, we introduce PsychiatryBench, a rigorously curated benchmark grounded exclusively in authoritative, expert-validated psychiatric textbooks and casebooks. PsychiatryBench comprises eleven distinct question-answering tasks ranging from diagnostic reasoning and treatment planning to longitudinal follow-up, management planning, clinical approach, sequential case analysis, and multiple-choice/extended matching formats totaling over 5,300 expert-annotated items. We evaluate a diverse set of frontier LLMs (including Google Gemini, DeepSeek, LLaMA 3, and QWQ-32) alongside leading open-source medical models (e.g., OpenBiloLLM, MedGemma) using both conventional metrics and an "LLM-as-judge" similarity scoring framework. Our results reveal substantial gaps in clinical consistency and safety, particularly in multi-turn follow-up and management tasks, underscoring the need for specialized model tuning and more robust evaluation paradigms. PsychiatryBench offers a modular, extensible platform for benchmarking and improving LLM performance in high-stakes mental health applications.

Abdelrahman A. Ali, Aya E. Fouda, Radwa J. Hanafy et al.

Mental health disorders are increasingly prevalent worldwide, creating an urgent need for innovative tools to support early diagnosis and intervention. This study explores the potential of Large Language Models (LLMs) in multimodal mental health diagnostics, specifically for detecting depression and Post Traumatic Stress Disorder through text and audio modalities. Using the E-DAIC dataset, we compare text and audio modalities to investigate whether LLMs can perform equally well or better with audio inputs. We further examine the integration of both modalities to determine if this can enhance diagnostic accuracy, which generally results in improved performance metrics. Our analysis specifically utilizes custom-formulated metrics; Modal Superiority Score and Disagreement Resolvement Score to evaluate how combined modalities influence model performance. The Gemini 1.5 Pro model achieves the highest scores in binary depression classification when using the combined modality, with an F1 score of 0.67 and a Balanced Accuracy (BA) of 77.4%, assessed across the full dataset. These results represent an increase of 3.1% over its performance with the text modality and 2.7% over the audio modality, highlighting the effectiveness of integrating modalities to enhance diagnostic accuracy. Notably, all results are obtained in zero-shot inferring, highlighting the robustness of the models without requiring task-specific fine-tuning. To explore the impact of different configurations on model performance, we conduct binary, severity, and multiclass tasks using both zero-shot and few-shot prompts, examining the effects of prompt variations on performance. The results reveal that models such as Gemini 1.5 Pro in text and audio modalities, and GPT-4o mini in the text modality, often surpass other models in balanced accuracy and F1 scores across multiple tasks.

Noureldin Zahran, Aya E. Fouda, Radwa J. Hanafy et al.

Mental health disorders pose a growing public health concern in the Arab world, emphasizing the need for accessible diagnostic and intervention tools. Large language models (LLMs) offer a promising approach, but their application in Arabic contexts faces challenges including limited labeled datasets, linguistic complexity, and translation biases. This study comprehensively evaluates 8 LLMs, including general multi-lingual models, as well as bi-lingual ones, on diverse mental health datasets (such as AraDepSu, Dreaddit, MedMCQA), investigating the impact of prompt design, language configuration (native Arabic vs. translated English, and vice versa), and few-shot prompting on diagnostic performance. We find that prompt engineering significantly influences LLM scores mainly due to reduced instruction following, with our structured prompt outperforming a less structured variant on multi-class datasets, with an average difference of 14.5\%. While language influence on performance was modest, model selection proved crucial: Phi-3.5 MoE excelled in balanced accuracy, particularly for binary classification, while Mistral NeMo showed superior performance in mean absolute error for severity prediction tasks. Few-shot prompting consistently improved performance, with particularly substantial gains observed for GPT-4o Mini on multi-class classification, boosting accuracy by an average factor of 1.58. These findings underscore the importance of prompt optimization, multilingual analysis, and few-shot learning for developing culturally sensitive and effective LLM-based mental health tools for Arabic-speaking populations.

Abdelrahaman A. Hassan, Radwa J. Hanafy, Mohammed E. Fouda

The growing prevalence and complexity of mental health disorders present significant challenges for accurate diagnosis and treatment, particularly in understanding the interplay between co-occurring conditions. Mental health disorders, such as depression and Anxiety, often co-occur, yet current datasets derived from social media posts typically focus on single-disorder labels, limiting their utility in comprehensive diagnostic analyses. This paper addresses this critical gap by proposing a novel methodology for cleaning, sampling, labeling, and combining data to create versatile multi-label datasets. Our approach introduces a synthetic labeling technique to transform single-label datasets into multi-label annotations, capturing the complexity of overlapping mental health conditions. To achieve this, two single-label datasets are first merged into a foundational multi-label dataset, enabling realistic analyses of co-occurring diagnoses. We then design and evaluate various prompting strategies for large language models (LLMs), ranging from single-label predictions to unrestricted prompts capable of detecting any present disorders. After rigorously assessing multiple LLMs and prompt configurations, the optimal combinations are identified and applied to label six additional single-disorder datasets from RMHD. The result is SPAADE-DR, a robust, multi-label dataset encompassing diverse mental health conditions. This research demonstrates the transformative potential of LLM-driven synthetic labeling in advancing mental health diagnostics from social media data, paving the way for more nuanced, data-driven insights into mental health care.

Abdelrahaman A. Hassan, Abdelrahman A. Ali, Aya E. Fouda et al.

The increasing global prevalence of mental disorders, such as depression and PTSD, requires objective and scalable diagnostic tools. Traditional clinical assessments often face limitations in accessibility, objectivity, and consistency. This paper investigates the potential of multimodal machine learning to address these challenges, leveraging the complementary information available in text, audio, and video data. Our approach involves a comprehensive analysis of various data preprocessing techniques, including novel chunking and utterance-based formatting strategies. We systematically evaluate a range of state-of-the-art embedding models for each modality and employ Convolutional Neural Networks (CNNs) and Bidirectional LSTM Networks (BiLSTMs) for feature extraction. We explore data-level, feature-level, and decision-level fusion techniques, including a novel integration of Large Language Model (LLM) predictions. We also investigate the impact of replacing Multilayer Perceptron classifiers with Support Vector Machines. We extend our analysis to severity prediction using PHQ-8 and PCL-C scores and multi-class classification (considering co-occurring conditions). Our results demonstrate that utterance-based chunking significantly improves performance, particularly for text and audio modalities. Decision-level fusion, incorporating LLM predictions, achieves the highest accuracy, with a balanced accuracy of 94.8% for depression and 96.2% for PTSD detection. The combination of CNN-BiLSTM architectures with utterance-level chunking, coupled with the integration of external LLM, provides a powerful and nuanced approach to the detection and assessment of mental health conditions. Our findings highlight the potential of MMML for developing more accurate, accessible, and personalized mental healthcare tools.