Objective
There are many barriers to accessing mental health assessments including cost and stigma. Even when individuals receive professional care, assessments are intermittent and may be limited partly due to the episodic nature of psychiatric symptoms. Therefore, machineâlearning technology using speech samples obtained in the clinic or remotely could one day be a biomarker to improve diagnosis and treatment. To date, reviews have only focused on using acoustic features from speech to detect depression and schizophrenia. Here, we present the first systematic review of studies using speech for automated assessments across a broader range of psychiatric disorders.
Methods
We followed the Preferred Reporting Items for Systematic Reviews and MetaâAnalysis (PRISMA) guidelines. We included studies from the last 10âyears using speech to identify the presence or severity of disorders within the Diagnostic and Statistical Manual of Mental Disorders (DSMâ5). For each study, we describe sample size, clinical evaluation method, speechâeliciting tasks, machine learning methodology, performance, and other relevant findings.
Results
1395 studies were screened of which 127 studies met the inclusion criteria. The majority of studies were on depression, schizophrenia, and bipolar disorder, and the remaining on postâtraumatic stress disorder, anxiety disorders, and eating disorders. 63% of studies built machine learning predictive models, and the remaining 37% performed nullâhypothesis testing only. We provide an online database with our search results and synthesize how acoustic features appear in each disorder.
Conclusion
Speech processing technology could aid mental health assessments, but there are many obstacles to overcome, especially the need for comprehensive transdiagnostic and longitudinal studies. Given the diverse types of dataâsets, feature extraction, computational methodologies, and evaluation criteria, we provide guidelines for both acquiring data and building machine learning models with a focus on testing hypotheses, open science, reproducibility, and generalizability.
Level of Evidence
3a