Department of Biostatistics and Health Informatics, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
Department of Biostatistics and Health Informatics, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK; Chair of Embedded Intelligence for Health Care and Wellbeing, University of Augsburg, Germany.
J Affect Disord. 2023 Nov 15;341:128-136. doi: 10.1016/j.jad.2023.08.097. Epub 2023 Aug 18.
Speech contains neuromuscular, physiological and cognitive components, and so is a potential biomarker of mental disorders. Previous studies indicate that speaking rate and pausing are associated with major depressive disorder (MDD). However, results are inconclusive as many studies are small and underpowered and do not include clinical samples. These studies have also been unilingual and use speech collected in controlled settings. If speech markers are to help understand the onset and progress of MDD, we need to uncover markers that are robust to language and establish the strength of associations in real-world data.
We collected speech data in 585 participants with a history of MDD in the United Kingdom, Spain, and Netherlands as part of the RADAR-MDD study. Participants recorded their speech via smartphones every two weeks for 18 months. Linear mixed models were used to estimate the strength of specific markers of depression from a set of 28 speech features.
Increased depressive symptoms were associated with speech rate, articulation rate and intensity of speech elicited from a scripted task. These features had consistently stronger effect sizes than pauses.
Our findings are derived at the cohort level so may have limited impact on identifying intra-individual speech changes associated with changes in symptom severity. The analysis of features averaged over the entire recording may have underestimated the importance of some features.
Participants with more severe depressive symptoms spoke more slowly and quietly. Our findings are from a real-world, multilingual, clinical dataset so represent a step-change in the usefulness of speech as a digital phenotype of MDD.
言语包含神经肌肉、生理和认知成分,因此是精神障碍的潜在生物标志物。先前的研究表明,语速和停顿与重度抑郁症(MDD)有关。然而,由于许多研究规模较小且缺乏效力,并且不包括临床样本,因此结果尚无定论。这些研究也都是单语的,并且使用在受控环境中收集的言语。如果言语标志物有助于了解 MDD 的发作和进展,我们需要发现对语言具有稳健性的标志物,并在真实世界的数据中确定关联的强度。
我们在英国、西班牙和荷兰的 RADAR-MDD 研究中收集了 585 名有 MDD 病史的参与者的言语数据。参与者通过智能手机每两周记录他们的言语,持续 18 个月。线性混合模型用于从一组 28 个言语特征中估计抑郁特定标志物的强度。
抑郁症状的增加与语速、发音率和脚本任务诱发的言语强度有关。这些特征的效应大小始终强于停顿。
我们的发现是在队列水平上得出的,因此可能对识别与症状严重程度变化相关的个体内言语变化的影响有限。对整个录音平均的特征进行分析可能低估了某些特征的重要性。
抑郁症状较严重的参与者说话速度较慢且声音较小。我们的发现来自于真实世界、多语言的临床数据集,因此代表了言语作为 MDD 的数字化表型的有用性的重大转变。