Matthew M. Nour

Agnes Norbury, George Fairs, Alexandra L. Georgescu et al.

During psychiatric assessment, clinicians observe not only what patients report, but important nonverbal signs such as tone, speech rate, fluency, responsiveness, and body language. Weighing and integrating these different information sources is a challenging task and a good candidate for support by intelligence-driven tools - however this is yet to be realized in the clinic. Here, we argue that several important barriers to adoption can be addressed using Bayesian network modelling. To demonstrate this, we evaluate a model for depression and anxiety symptom prediction from voice and speech features in large-scale datasets (30,135 unique speakers). Alongside performance for conditions and symptoms (for depression, anxiety ROC-AUC=0.842,0.831 ECE=0.018,0.015; core individual symptom ROC-AUC>0.74), we assess demographic fairness and investigate integration across and redundancy between different input modality types. Clinical usefulness metrics and acceptability to mental health service users are explored. When provided with sufficiently rich and large-scale multimodal data streams and specified to represent common mental conditions at the symptom rather than disorder level, such models are a principled approach for building robust assessment support tools: providing clinically-relevant outputs in a transparent and explainable format that is directly amenable to expert clinical supervision.

Sebastian Dohnány, Zeb Kurth-Nelson, Eleanor Spens et al.

Artificial intelligence chatbots have achieved unprecedented adoption, with millions now using these systems for emotional support and companionship in contexts of widespread social isolation and capacity-constrained mental health services. While some users report psychological benefits, concerning edge cases are emerging, including reports of suicide, violence, and delusional thinking linked to perceived emotional relationships with chatbots. To understand this new risk profile we need to consider the interaction between human cognitive and emotional biases, and chatbot behavioural tendencies such as agreeableness (sycophancy) and adaptability (in-context learning). We argue that individuals with mental health conditions face increased risks of chatbot-induced belief destabilization and dependence, owing to altered belief-updating, impaired reality-testing, and social isolation. Current AI safety measures are inadequate to address these interaction-based risks. To address this emerging public health concern, we need coordinated action across clinical practice, AI development, and regulatory frameworks.