Evaluation of Voice Acoustics as Predictors of Clinical Depression Scores.

OBJECTIVE The aim of the present study was to determine if acoustic measures of voice, characterizing specific spectral and timing properties, predict clinical ratings of depression severity measured in a sample of patients using the Hamilton Depression Rating Scale (HAMD) and Beck Depression Inventory (BDI-II). STUDY DESIGN This is a prospective study. METHODS Voice samples and clinical depression scores were collected prospectively from consenting adult patients who were referred to psychiatry from the adult emergency department or primary care clinics. The patients were audio-recorded as they read a standardized passage in a nearly closed-room environment. Mean Absolute Error (MAE) between actual and predicted depression scores was used as the primary outcome measure. RESULTS The average MAE between predicted and actual HAMD scores was approximately two scores for both men and women, and the MAE for the BDI-II scores was approximately one score for men and eight scores for women. Timing features were predictive of HAMD scores in female patients while a combination of timing features and spectral features was predictive of scores in male patients. Timing features were predictive of BDI-II scores in male patients. CONCLUSION Voice acoustic features extracted from read speech demonstrated variable effectiveness in predicting clinical depression scores in men and women. Voice features were highly predictive of HAMD scores in men and women, and BDI-II scores in men, respectively. The methodology is feasible for diagnostic applications in diverse clinical settings as it can be implemented during a standard clinical interview in a normal closed room and without strict control on the recording environment.

[1]  Zheng Fang,et al.  Comparison of different implementations of MFCC , 2001 .

[2]  Jan Fawcett,et al.  Clinical correlates of inpatient suicide. , 2003, The Journal of clinical psychiatry.

[3]  Dror Lederman,et al.  Classification of cries of infants with cleft-palate using parallel hidden Markov models , 2008, Medical & Biological Engineering & Computing.

[4]  R Jouvent,et al.  Speech pause time and the retardation rating scale for depression (ERD). Towards a reciprocal validation. , 1984, Journal of affective disorders.

[5]  G. Papakostas Cognitive symptoms in patients with major depressive disorder and their implications for clinical practice. , 2014, The Journal of clinical psychiatry.

[6]  Paul E. Croarkin,et al.  Psychomotor retardation in depression: Biological underpinnings, measurement, and treatment , 2011, Progress in Neuro-Psychopharmacology and Biological Psychiatry.

[7]  I. Hickie,et al.  Sub-typing depression, I. Is psychomotor disturbance necessary and sufficient to the definition of melancholia? , 1995, Psychological Medicine.

[8]  Thaweesak Yingthawornsuk Acoustic analysis of vocal output characteristics for suicidal risk assessment , 2007 .

[9]  N. Dantchev,et al.  The measurement of retardation in depression. , 1998, The Journal of clinical psychiatry.

[10]  A. Mitchell,et al.  Suicide Assessment in Hospital Emergency Departments: Implications for Patient Satisfaction and Compliance. , 2005, Topics in emergency medicine.

[11]  H Hollien,et al.  [Vocal and speech patterns of depressive patients]. , 1977, Folia phoniatrica.

[12]  L. Zun,et al.  Undiagnosed mental illness in the emergency department. , 2012, The Journal of emergency medicine.

[13]  Å. Nilsonne Speech characteristics as indicators of depressive illness , 1988, Acta psychiatrica Scandinavica.

[14]  Stanley S. Newman,et al.  ANALYSIS OF SPOKEN LANGUAGE OF PATIENTS WITH AFFECTIVE DISORDERS , 1938 .

[15]  C. Bradshaw,et al.  Elongation of Pause-Time in Speech: A Simple, Objective Measure of Motor Retardation in Depression , 1976, British Journal of Psychiatry.

[16]  D. Mitchell Wilkes,et al.  Investigation of vocal jitter and glottal flow spectrum as possible cues for depression and near-term suicidal risk , 2004, IEEE Transactions on Biomedical Engineering.

[17]  E. Vajda Handbook of the International Phonetic Association: A Guide to the Use of the International Phonetic Alphabet , 2000 .

[18]  Christian Poellabauer,et al.  Using isolated vowel sounds for classification of Mild Traumatic Brain Injury , 2013, 2013 IEEE International Conference on Acoustics, Speech and Signal Processing.

[19]  D. Mitchell Wilkes,et al.  Acoustical properties of speech as indicators of depression and suicidal risk , 2000, IEEE Transactions on Biomedical Engineering.

[20]  J. Pearson,et al.  Contact with mental health and primary care providers before suicide: a review of the evidence. , 2002, The American journal of psychiatry.

[21]  B. Efron,et al.  The Jackknife: The Bootstrap and Other Resampling Plans. , 1983 .

[22]  J. Fowler Suicide risk assessment in clinical practice: pragmatic guidelines for imperfect assessments. , 2012, Psychotherapy.

[23]  Michael Cannizzaro,et al.  Voice acoustical measurement of the severity of major depression , 2004, Brain and Cognition.

[24]  Emily Mower Provost,et al.  Ecologically valid long-term mood monitoring of individuals with bipolar disorder using speech , 2014, 2014 IEEE International Conference on Acoustics, Speech and Signal Processing (ICASSP).

[25]  Renata Sisto,et al.  Neonatal pain analyzer: development and validation , 2006, Medical and Biological Engineering and Computing.

[26]  M. Hamilton A RATING SCALE FOR DEPRESSION , 1960, Journal of neurology, neurosurgery, and psychiatry.

[27]  T. Pozzo,et al.  Psychomotor Retardation in Depression: A Systematic Review of Diagnostic, Pathophysiologic, and Therapeutic Implications , 2013, BioMed research international.

[28]  M. Desseilles,et al.  Is it valid to measure suicidal ideation by depression rating scales? , 2012, Journal of affective disorders.

[29]  H H Stassen,et al.  Speaking behavior and voice sound characteristics in depressive patients during recovery. , 1993, Journal of psychiatric research.

[30]  J Sundberg,et al.  Measuring the rate of change of voice fundamental frequency in fluent speech during mental depression. , 1988, The Journal of the Acoustical Society of America.

[31]  J. Endicott,et al.  The motor agitation and retardation scale: a scale for the assessment of motor abnormalities in depressed patients. , 1998, The Journal of neuropsychiatry and clinical neurosciences.

[32]  A. Beck,et al.  Relationships between the Beck Depression Inventory and the Hamilton Psychiatric Rating Scale for Depression in depressed outpatients , 1987 .

[33]  D. Mitchell Wilkes,et al.  Analysis of Vocal Tract Characteristics for Near-term Suicidal Risk Assessment , 2004, Methods of Information in Medicine.

[34]  J. Mundt,et al.  Voice acoustic measures of depression severity and treatment response collected via interactive voice response (IVR) technology , 2007, Journal of Neurolinguistics.