Sofia de la Fuente Garcia

Qingkun Deng, Saturnino Luz, Sofia de la Fuente Garcia

Depression is a common mental disorder. Automatic depression detection tools using speech, enabled by machine learning, help early screening of depression. This paper addresses two limitations that may hinder the clinical implementations of such tools: noise resulting from segment-level labelling and a lack of model interpretability. We propose a bi-modal speech-level transformer to avoid segment-level labelling and introduce a hierarchical interpretation approach to provide both speech-level and sentence-level interpretations, based on gradient-weighted attention maps derived from all attention layers to track interactions between input features. We show that the proposed model outperforms a model that learns at a segment level ($p$=0.854, $r$=0.947, $F1$=0.897 compared to $p$=0.732, $r$=0.808, $F1$=0.768). For model interpretation, using one true positive sample, we show which sentences within a given speech are most relevant to depression detection; and which text tokens and Mel-spectrogram regions within these sentences are most relevant to depression detection. These interpretations allow clinicians to verify the validity of predictions made by depression detection tools, promoting their clinical implementations.

Erfan Loweimi, Sofia de la Fuente Garcia, Saturnino Luz

We investigate the use of Large Language Models (LLMs) for zero-shot prediction of Ryff Psychological Well-Being (PWB) scores from spontaneous speech. Using a few minutes of voice recordings from 111 participants in the PsyVoiD database, we evaluated 12 instruction-tuned LLMs, including Llama-3 (8B, 70B), Ministral, Mistral, Gemma-2-9B, Gemma-3 (1B, 4B, 27B), Phi-4, DeepSeek (Qwen and Llama), and QwQ-Preview. A domain-informed prompt was developed in collaboration with experts in clinical psychology and linguistics. Results show that LLMs can extract semantically meaningful cues from spontaneous speech, achieving Spearman correlations of up to 0.8 on 80\% of the data. Additionally, to enhance explainability, we conducted statistical analyses to characterise prediction variability and systematic biases, alongside keyword-based word cloud analyses to highlight the linguistic features driving the models' predictions.

Erfan Loweimi, Sofia de la Fuente Garcia, Samira Loveymi et al.

LLMs can estimate Hospital Anxiety and Depression Scale (HADS) scores from speech in a zero-shot manner, but clinical deployment requires reliability across three dimensions: intra-model consistency, ASR robustness, and evidence faithfulness. We evaluate three LLMs (Phi-4, Gemma-2-9B, and Llama-3.1-8B) on 111 English-speaking participants using ground-truth transcripts and three Whisper ASR variants (Large, Medium, Small), with three independent runs per model-condition pair. We find that (i) Phi-4 and Gemma-2-9B achieve excellent intra-model consistency (ICC > 0.89) with minimal degradation under ASR; (ii) Llama-3.1-8B shows ASR-fragile consistency, with ICC dropping from 0.82 to 0.36 at 10% WER; (iii) predictive validity is largely preserved under ASR for robust models; and (iv) keyword groundedness exceeds 93% for Phi-4 and Gemma-2-9B but falls to 77-81% for Llama-3.1-8B. Inter-model keyword agreement is far lower than score-level agreement, revealing a score-evidence dissociation with implications for clinical interpretability.

Qingkun Deng, Saturnino Luz, Sofia de la Fuente Garcia

Speech-based depression detection tools could aid early screening. Here, we propose an interpretable speech foundation model approach to enhance the clinical applicability of such tools. We introduce a speech-level Audio Spectrogram Transformer (AST) to detect depression using long-duration speech instead of short segments, along with a novel interpretation method that reveals prediction-relevant acoustic features for clinician interpretation. Our experiments show the proposed model outperforms a segment-level AST, highlighting the impact of segment-level labelling noise and the advantage of leveraging longer speech duration for more reliable depression detection. Through interpretation, we observe our model identifies reduced loudness and F0 as relevant depression signals, aligning with documented clinical findings. This interpretability supports a responsible AI approach for speech-based depression detection, rendering such tools more clinically applicable.

Saturnino Luz, Sofia De La Fuente Garcia, Fasih Haider et al.

We present a novel benchmark dataset and prediction tasks for investigating approaches to assess cognitive function through analysis of connected speech. The dataset consists of speech samples and clinical information for speakers of Mandarin Chinese and English with different levels of cognitive impairment as well as individuals with normal cognition. These data have been carefully matched by age and sex by propensity score analysis to ensure balance and representativity in model training. The prediction tasks encompass mild cognitive impairment diagnosis and cognitive test score prediction. This framework was designed to encourage the development of approaches to speech-based cognitive assessment which generalise across languages. We illustrate it by presenting baseline prediction models that employ language-agnostic and comparable features for diagnosis and cognitive test score prediction. The models achieved unweighted average recall was 59.2% in diagnosis, and root mean squared error of 2.89 in score prediction.

Sofia de la Fuente Garcia, Craig Ritchie, Saturnino Luz

Language is a valuable source of clinical information in Alzheimer's Disease, as it declines concurrently with neurodegeneration. Consequently, speech and language data have been extensively studied in connection with its diagnosis. This paper summarises current findings on the use of artificial intelligence, speech and language processing to predict cognitive decline in the context of Alzheimer's Disease, detailing current research procedures, highlighting their limitations and suggesting strategies to address them. We conducted a systematic review of original research between 2000 and 2019, registered in PROSPERO (reference CRD42018116606). An interdisciplinary search covered six databases on engineering (ACM and IEEE), psychology (PsycINFO), medicine (PubMed and Embase) and Web of Science. Bibliographies of relevant papers were screened until December 2019. From 3,654 search results 51 articles were selected against the eligibility criteria. Four tables summarise their findings: study details (aim, population, interventions, comparisons, methods and outcomes), data details (size, type, modalities, annotation, balance, availability and language of study), methodology (pre-processing, feature generation, machine learning, evaluation and results) and clinical applicability (research implications, clinical potential, risk of bias and strengths/limitations). While promising results are reported across nearly all 51 studies, very few have been implemented in clinical research or practice. We concluded that the main limitations of the field are poor standardisation, limited comparability of results, and a degree of disconnect between study aims and clinical applications. Attempts to close these gaps should support translation of future research into clinical practice.