Machine Learning-Based Behavioral Diagnostic Tools for Depression: Advances, Challenges, and Future Directions

Development of a machine learning-based risk assessment model for loneliness among elderly Chinese: a cross-sectional study based on Chinese longitudinal healthy longevity survey

BACKGROUND

Loneliness is prevalent among the elderly and has intensified due to global aging trends. It adversely affects both mental and physical health. Traditional scales for measuring loneliness may yield biased results due to varying definitions. The advancements in machine learning offer new opportunities for improving the measurement and assessment of loneliness through the development of risk assessment models.

METHODS

Data from the 2018 Chinese Longitudinal Healthy Longevity Survey, involving about 16,000 participants aged ≥ 65 years, were used. The study examined the relationships between loneliness and factors such as functional limitations, living conditions, environmental influences, age-related health issues, and health behaviors. Using R 4.4.1, seven assessment models were developed: logistic regression, ridge regression, support vector machines, K-nearest neighbors, decision trees, random forests, and multi-layer perceptron. Models were evaluated based on ROC curves, accuracy, precision, recall, F1 scores, and AUC.

RESULTS

Loneliness prevalence among elderly Chinese was 23.4%. Analysis identified 15 evaluative factors and evaluated seven models. Multi-layer perceptron stands out for its strong nonlinear mapping capability and adaptability to complex data, making it one of the most effective models for assessing loneliness risk.

CONCLUSION

The study found a 23.4% prevalence of loneliness among elderly individuals in China. SHAP values indicated that marital status has the strongest evaluative value across all forecasting periods. Specifically, elderly individuals who are never married, widowed, divorced, or separated are more likely to experience loneliness compared to their married counterparts.

Can Loneliness be Predicted? Development of a Risk Prediction Model for Loneliness among Elderly Chinese: A Study Based on CLHLS

Background

Loneliness is prevalent among the elderly, worsened by global aging trends. It impacts mental and physiological health. Traditional scales for measuring loneliness may be biased due to cognitive decline and varying definitions. Machine learning advancements offer potential improvements in risk prediction models.

Methods

Data from the 2018 Chinese Longitudinal Healthy Longevity Survey (CLHLS), involving over 16,000 participants aged ≥65 years, were used. The study examined the relationships between loneliness and factors such as cognitive function, functional limitations, living conditions, environmental influences, age-related health issues, and health behaviors. Using R 4.4.1, seven predictive models were developed: logistic regression, ridge regression, support vector machines, K-nearest neighbors, decision trees, random forests, and multi-layer perceptron. Models were evaluated based on ROC curves, accuracy, precision, recall, F1 scores, and AUC.

Results

Loneliness prevalence among elderly Chinese was 23.4%. Analysis identified 16 predictive factors and evaluated seven models. Logistic regression was the most effective model for predicting loneliness risk due to its economic and operational advantages.

Conclusion

The study found a 23.4% prevalence of loneliness among elderly individuals in China. SHAP values indicated that higher MMSE scores correlate with lower loneliness levels. Logistic regression was the superior model for predicting loneliness risk in this population.

Developing prediction algorithms for late-life depression using wearable devices: a cohort study protocol

INTRODUCTION

Despite the high prevalence of major depressive disorder (MDD) among the elderly population, the rate of treatment is low due to stigmas and barriers to medical access. Wearable devices such as smartphones and smartwatches can help to screen MDD symptoms earlier in a natural setting while forgoing these concerns. However, previous research using wearable devices has mostly targeted the younger population. By collecting longitudinal data using wearable devices from the elderly population, this research aims to produce prediction algorithms for late-life depression and to develop strategies that strengthen medical access in community care systems.

METHODS AND ANALYSIS

The current cohort study recruited a subsample of 685 elderly people from the Korean Genome and Epidemiology Study-Cardiovascular Disease Association Study, a national large cohort established in 2004. The current study has been conducted over a 3-year period to explore the development patterns of late-life depression. Participants have completed three annual face-to-face interviews (baseline, the first follow-up and the second follow-up) and 2 years of app-based surveys and passive sensing data collection. All the data collection will end at the second follow-up interview. The collected self-report, observational and passive sensing data will be primarily analysed by machine learning.

ETHICS AND DISSEMINATION

This study protocol has been reviewed and approved by the Yonsei University Mirae Campus Institutional Review Board (1041849-2 02 111 SB-180-06) in South Korea. All participants provided written informed consent. The findings of this research will be disseminated by academic publications and conference presentations.

Disorder-specific versus transdiagnostic cognitive mechanisms in anxiety and depression: Machine-learning-based prediction of symptom severity

INTRODUCTION

Psychiatric evaluation of anxiety and depression is currently based on self-reported symptoms and their classification into discrete disorders. Yet the substantial overlap between these disorders as well as their within-disorder heterogeneity may contribute to the mediocre success rates of treatments. The proposed research examines a new framework for diagnosis that is based on alterations in underlying cognitive mechanisms. In line with the Research Domain Criteria (RDoC) approach, the current study directly compares disorder-specific and transdiagnostic cognitive patterns in predicting the severity of anxiety and depression symptoms.

METHODS

The sample included 237 individuals exhibiting differing levels of anxiety and depression symptoms, as measured by the STAI-T and BDI-II. Random Forest regressors were used to analyze their performance on a battery of six computerized cognitive-behavioral tests targeting selective and spatial attention, expectancy, interpretation, memory, and cognitive control biases.

RESULTS

Unique anxiety-specific biases were found, as well as shared anxious-depressed bias patterns. These cognitive biases exhibited relatively high fitting rates when predicting symptom severity (questionnaire scores common range 0-60, MAE = 6.03, RMSE = 7.53). Interpretation and expectancy biases exhibited the highest association with symptoms, above all other individual biases.

LIMITATIONS

Although internal validation methods were applied, models may suffer from potential overfitting due to sample size limitations.

CONCLUSION

In the context of the ongoing dispute regarding symptom-centered versus transdiagnostic approaches, the current study provides a unique comparison of these two views, yielding a novel intermediate approach. The results support the use of mechanism-based dimensional diagnosis for adding precision and objectivity to future psychiatric evaluations.

Enhancing the efficacy of depression detection system using optimal feature selection from EHR

Diagnosing depression at an early stage is crucial and majorly depends on the clinician's skill. The present work aims to develop an automated tool for assisting the diagnostic procedure of depression using multiple machine-learning techniques. The dataset of sample size 4184 used in this study contains biometric and demographic information of individuals with or without depression, accessed from the University of Nice Sophia-Antipolis. The Artificial Neural Network (ANN), Support Vector Machine (SVM), Random Forest (RF) and Extreme Gradient Boosting (XGBoost) are used for classifying the depressed from the control group. To enhance the computational efficiency, various feature selection algorithms like Recursive Feature Elimination (RFE), Mutual Information (MI) and three bio-inspired techniques, viz. Particle Swarm Optimization (PSO), Genetic Algorithm (GA) and Firefly Algorithms (FA) have been incorporated. To enhance the feature selection process further, majority voting is carried out in all possible combinations of three, four and five feature selection techniques. These feature selection techniques bring down the feature set size significantly to a mean of 33 from the actual size of 61 which is a reduction of 45.90%. The classification accuracy of the enhanced model varies between 84.18% and 88.46%, which is a significant improvement in performance as compared to the pre-existing models (83.76-85.89%). The proposed predictive models outperform the pre-existing classification models without feature selection and thereby enhancing both the performance and efficiency of the diagnostic process.

Digital health technologies and major depressive disorder

There is an urgent need to improve the clinical management of major depressive disorder (MDD), which has become increasingly prevalent over the past two decades. Several gaps and challenges in the awareness, detection, treatment, and monitoring of MDD remain to be addressed. Digital health technologies have demonstrated utility in relation to various health conditions, including MDD. Factors related to the COVID-19 pandemic have accelerated the development of telemedicine, mobile medical apps, and virtual reality apps and have continued to introduce new possibilities across mental health care. Growing access to and acceptance of digital health technologies present opportunities to expand the scope of care and to close gaps in the management of MDD. Digital health technology is rapidly evolving the options for nonclinical support and clinical care for patients with MDD. Iterative efforts to validate and optimize such digital health technologies, including digital therapeutics and digital biomarkers, continue to improve access to and quality of personalized detection, treatment, and monitoring of MDD. The aim of this review is to highlight the existing gaps and challenges in depression management and discuss the current and future landscape of digital health technology as it applies to the challenges faced by patients with MDD and their healthcare providers.

Impact of mobile connectivity on students' wellbeing: Detecting learners' depression using machine learning algorithms

Depression is a psychological state of mind that often influences a person in an unfavorable manner. While it can occur in people of all ages, students are especially vulnerable to it throughout their academic careers. Beginning in 2020, the COVID-19 epidemic caused major problems in people's lives by driving them into quarantine and forcing them to be connected continually with mobile devices, such that mobile connectivity became the new norm during the pandemic and beyond. This situation is further accelerated for students as universities move towards a blended learning mode. In these circumstances, monitoring student mental health in terms of mobile and Internet connectivity is crucial for their wellbeing. This study focuses on students attending an International University of Bangladesh to investigate their mental health due to their continual use of mobile devices (e.g., smartphones, tablets, laptops etc.). A cross-sectional survey method was employed to collect data from 444 participants. Following the exploratory data analysis, eight machine learning (ML) algorithms were used to develop an automated normal-to-extreme severe depression identification and classification system. When the automated detection was incorporated with feature selection such as Chi-square test and Recursive Feature Elimination (RFE), about 3 to 5% increase in accuracy was observed by the method. Similarly, a 5 to 15% increase in accuracy has been observed when a feature extraction method such as Principal Component Analysis (PCA) was performed. Also, the SparsePCA feature extraction technique in combination with the CatBoost classifier showed the best results in terms of accuracy, F1-score, and ROC-AUC. The data analysis revealed no sign of depression in about 44% of the total participants. About 25% of students showed mild-to-moderate and 31% of students showed severe-to-extreme signs of depression. The results suggest that ML models, incorporating a proper feature engineering method can serve adequately in multi-stage depression detection among the students. This model might be utilized in other disciplines for detecting early signs of depression among people.

An Elevated FIB-4 Score Is Associated with an Increased Incidence of Depression among Outpatients in Germany

Background: Liver disease and depression are known to be closely associated. Non-invasive tests (NIT), such as the FIB-4 score, have been recommended by different guidelines to rule out advanced fibrosis and to stratify the risk of liver-related outcomes in patients with chronic liver diseases. However, the predictive value of an elevated FIB-4 score regarding the development of depression and/or anxiety disorders among the general population is unknown. Methods: By using the Disease Analyzer database (IQVIA), which compiles diagnoses and laboratory values as well as basic medical and demographic data of patients followed in general practices in Germany, we identified 370,756 patients with available lab values for FIB-4 score calculation between 2005 and 2019. Patients with an FIB-4 score < 2 were matched 1:1 to patients with an FIB-4 index ≥ 2 by age, sex and yearly consultation frequency. Results: In regression analysis, the incidence rate ratio (IRR) of depression was significantly higher among patients with an FIB-4 score ≥ 2.0 compared to patients with a lower FIB-4 score <2.0 (IRR: 1.12, p < 0.001). This association was significant for both female (IRR: 1.10, p = 0.004) and male (IRR: 1.15, p < 0.001) patients and strongest in the age groups ≤50 years (IRR: 1.42, p < 0.001) and 51-60 years (IRR: 1.34, p < 0.001). There was no significant association between an elevated FIB-4 score ≥ 2.0 and the incidence of depression among patients aged 60 years and older. There was no significant increase in the IRR of anxiety disorders for patients with high or low FIB-4 scores. Conclusion: Our study suggests a previously unknown association between an elevated FIB-4 score and an increased incidence of depression. This finding suggests that the FIB-4 score is not only a valuable tool for the prediction of liver-specific endpoints but also may be of relevance for the prediction of extrahepatic comorbidities, which in turn may argue for clinical screening programs in patients with an elevated FIB-4.

Empirical Investigation for Predicting Depression from Different Machine Learning Based Voice Recognition Techniques

Over the past few decades, the rate of diagnosing depression and mental illness among youths in both genders has been emerging as a challenging issue in the present society. Adequate numbers of cases that have been prevailing had unheard of symptoms linked to mental depression that are able to be detected using their voice recordings and their messages in social media websites. Due to the wide spread usage of mobile phones, services and social sites emotion prediction and analyzing have been an indispensable part of providing vital care for the eminence of youth's life. In addition to dynamicity and popularity of mobile applications and services, it is really a challenge to provide an emotion prediction system that can collect, analyze, and process emotional communications in real time and as well as in a highly accurate manner with minimal computation time. Few depression prediction researchers have analyzed and examined that various social networking sites and its activities may be merged to low self-confidence, particularly in young people and adolescents. Moreover, the researchers suggest that several objective voice acoustic measures affected by depression can be detected reliably over the smart phones. And also in some observational study, it is stated that speech samples of patients from the telephone were obtained each week using an IVR system, and voice recording files from smart phones have been under process for predicting the depression. Such that several telephonic standards for obtaining voice data were identified as a crucial factor influencing the reliability and eminence of speech data. Hence, this article investigates on different process applied in different machine learning algorithms in recognizing voice signals which in turn will be used for scrutinizing the techniques for detecting depression levels in future. This will make a blooming change in the youth's life and solve the social unethical issues in hand.

Wearable Sensing Systems for Monitoring Mental Health

Wearable systems for monitoring biological signals have opened the door to personalized healthcare and have advanced a great deal over the past decade with the development of flexible electronics, efficient energy storage, wireless data transmission, and information processing technologies. As there are cumulative understanding of mechanisms underlying the mental processes and increasing desire for lifetime mental wellbeing, various wearable sensors have been devised to monitor the mental status from physiological activities, physical movements, and biochemical profiles in body fluids. This review summarizes the recent progress in wearable healthcare monitoring systems that can be utilized in mental healthcare, especially focusing on the biochemical sensors (i.e., biomarkers associated with mental status, sensing modalities, and device materials) and discussing their promises and challenges.