Femke Lamers

Yuezhou Zhang, Amos A Folarin, Judith Dineley et al.

Language use has been shown to correlate with depression, but large-scale validation is needed. Traditional methods like clinic studies are expensive. So, natural language processing has been employed on social media to predict depression, but limitations remain-lack of validated labels, biased user samples, and no context. Our study identified 29 topics in 3919 smartphone-collected speech recordings from 265 participants using the Whisper tool and BERTopic model. Six topics with a median PHQ-8 greater than or equal to 10 were regarded as risk topics for depression: No Expectations, Sleep, Mental Therapy, Haircut, Studying, and Coursework. To elucidate the topic emergence and associations with depression, we compared behavioral (from wearables) and linguistic characteristics across identified topics. The correlation between topic shifts and changes in depression severity over time was also investigated, indicating the importance of longitudinally monitoring language use. We also tested the BERTopic model on a similar smaller dataset (356 speech recordings from 57 participants), obtaining some consistent results. In summary, our findings demonstrate specific speech topics may indicate depression severity. The presented data-driven workflow provides a practical approach to collecting and analyzing large-scale speech data from real-world settings for digital health research.

Edward L. Campbell, Judith Dineley, Pauline Conde et al.

Major Depressive Disorder (MDD) is a common worldwide mental health issue with high associated socioeconomic costs. The prediction and automatic detection of MDD can, therefore, make a huge impact on society. Speech, as a non-invasive, easy to collect signal, is a promising marker to aid the diagnosis and assessment of MDD. In this regard, speech samples were collected as part of the Remote Assessment of Disease and Relapse in Major Depressive Disorder (RADAR-MDD) research programme. RADAR-MDD was an observational cohort study in which speech and other digital biomarkers were collected from a cohort of individuals with a history of MDD in Spain, United Kingdom and the Netherlands. In this paper, the RADAR-MDD speech corpus was taken as an experimental framework to test the efficacy of a Sequence-to-Sequence model with a local attention mechanism in a two-class depression severity classification paradigm. Additionally, a novel training method, HARD-Training, is proposed. It is a methodology based on the selection of more ambiguous samples for the model training, and inspired by the curriculum learning paradigm. HARD-Training was found to consistently improve - with an average increment of 8.6% - the performance of our classifiers for both of two speech elicitation tasks used and each collection site of the RADAR-MDD speech corpus. With this novel methodology, our Sequence-to-Sequence model was able to effectively detect MDD severity regardless of language. Finally, recognising the need for greater awareness of potential algorithmic bias, we conduct an additional analysis of our results separately for each gender.

Anastasiia Tokareva, Judith Dineley, Zoe Firth et al.

Background: Captured between clinical appointments using mobile devices, spoken language has potential for objective, more regular assessment of symptom severity and earlier detection of relapse in major depressive disorder. However, research to date has largely been in non-clinical cross-sectional samples of written language using complex machine learning (ML) approaches with limited interpretability. Methods: We describe an initial exploratory analysis of longitudinal speech data and PHQ-8 assessments from 5,836 recordings of 586 participants in the UK, Netherlands, and Spain, collected in the RADAR-MDD study. We sought to identify interpretable lexical features associated with MDD symptom severity with linear mixed-effects modelling. Interpretable features and high-dimensional vector embeddings were also used to test the prediction performance of four regressor ML models. Results: In English data, MDD symptom severity was associated with 7 features including lexical diversity measures and absolutist language. In Dutch, associations were observed with words per sentence and positive word frequency; no associations were observed in recordings collected in Spain. The predictive power of lexical features and vector embeddings was near chance level across all languages. Limitations: Smaller samples in non-English speech and methodological choices, such as the elicitation prompt, may have also limited the effect sizes observable. A lack of NLP tools in languages other than English restricted our feature choice. Conclusion: To understand the value of lexical markers in clinical research and practice, further research is needed in larger samples across several languages using improved protocols, and ML models that account for within- and between-individual variations in language.

Shaoxiong Sun, Amos Folarin, Yatharth Ranjan et al.

We aimed to explore the utility of the recently developed open-source mobile health platform RADAR-base as a toolbox to rapidly test the effect and response to NPIs aimed at limiting the spread of COVID-19. We analysed data extracted from smartphone and wearable devices and managed by the RADAR-base from 1062 participants recruited in Italy, Spain, Denmark, the UK, and the Netherlands. We derived nine features on a daily basis including time spent at home, maximum distance travelled from home, maximum number of Bluetooth-enabled nearby devices (as a proxy for physical distancing), step count, average heart rate, sleep duration, bedtime, phone unlock duration, and social app use duration. We performed Kruskal-Wallis tests followed by post-hoc Dunns tests to assess differences in these features among baseline, pre-, and during-lockdown periods. We also studied behavioural differences by age, gender, body mass index (BMI), and educational background. We were able to quantify expected changes in time spent at home, distance travelled, and the number of nearby Bluetooth-enabled devices between pre- and during-lockdown periods. We saw reduced sociality as measured through mobility features, and increased virtual sociality through phone usage. People were more active on their phones, spending more time using social media apps, particularly around major news events. Furthermore, participants had lower heart rate, went to bed later, and slept more. We also found that young people had longer homestay than older people during lockdown and fewer daily steps. Although there was no significant difference between the high and low BMI groups in time spent at home, the low BMI group walked more. RADAR-base can be used to rapidly quantify and provide a holistic view of behavioural changes in response to public health interventions as a result of infectious outbreaks such as COVID-19.

Yuezhou Zhang, Amos A Folarin, Shaoxiong Sun et al.

The Bluetooth sensor embedded in mobile phones provides an unobtrusive, continuous, and cost-efficient means to capture individuals' proximity information, such as the nearby Bluetooth devices count (NBDC). The continuous NBDC data can partially reflect individuals' behaviors and status, such as social connections and interactions, working status, mobility, and social isolation and loneliness, which were found to be significantly associated with depression by previous survey-based studies. This paper aims to explore the NBDC data's value in predicting depressive symptom severity as measured via the 8-item Patient Health Questionnaire (PHQ-8). The data used in this paper included 2,886 bi-weekly PHQ-8 records collected from 316 participants recruited from three study sites in the Netherlands, Spain, and the UK as part of the EU RADAR-CNS study. From the NBDC data two weeks prior to each PHQ-8 score, we extracted 49 Bluetooth features, including statistical features and nonlinear features for measuring periodicity and regularity of individuals' life rhythms. Linear mixed-effect models were used to explore associations between Bluetooth features and the PHQ-8 score. We then applied hierarchical Bayesian linear regression models to predict the PHQ-8 score from the extracted Bluetooth features. A number of significant associations were found between Bluetooth features and depressive symptom severity. Compared with commonly used machine learning models, the proposed hierarchical Bayesian linear regression model achieved the best prediction metrics, R2= 0.526, and root mean squared error (RMSE) of 3.891. Bluetooth features can explain an extra 18.8% of the variance in the PHQ-8 score relative to the baseline model without Bluetooth features (R2=0.338, RMSE = 4.547).