Aya E. Fouda

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.