搜索结果：The Psychiatric quarterly

This paper addresses the methodology for the quarterly estimation of Compensation of Employees paid by the General Government (GG) sector, in accordance with the European System of Accounts (ESA 2010). Due to the limited high-frequency data availability and the need to guarantee the consistency with annual constraints, quarterly estimation relies on indirect temporal disaggregation techniques. These methods use specific infra-annual indicators as proxies for the variables being estimated. The specific case of the quarterly estimation of Compensation of employees presents several additional challenges. Firstly, the information provided by the sources, based on cash or legal-accrual data, is elaborated to define indicators which respect the accrual ESA 2010 principle as the annual estimates, based on more compliant data sources such as final budgets of public entities. Secondly, at a quarterly level the extraordinary events - such as the recording of delayed collective bargaining agreements which result in arrears - have a strong impact on quarterly indicators, whereas their effect is mitigated at annual level. To attribute these flows to the period when the work is performed, multi-

Negative patient descriptions and stigmatizing language can contribute to generating healthcare disparities in two ways: (1) read by patients, they can harm their trust and engagement with the medical center; (2) read by physicians, they may negatively influence their perspective of a future patient. In psychiatry, the patient-clinician therapeutic alliance is a major determinant of clinical outcomes. Therefore, language usage in psychiatric clinical notes may not only create healthcare disparities, but also perpetuate them. Recent advances in NLP systems have facilitated the efforts to detect discriminatory language in healthcare. However, such attempts have only focused on the perspectives of the medical center and its physicians. Considering both physicians and non-physicians' point of view is a more translatable approach to identifying potentially harmful language in clinical notes. By leveraging pre-trained and large language models (PLMs and LLMs), this work aims to characterize potentially harmful language usage in psychiatric notes by identifying the sentiment expressed in sentences describing patients based on the reader's point of view. Extracting 39 sentences from the Mo

AI systems in healthcare research have shown potential to increase patient throughput and assist clinicians, yet progress is constrained by limited access to real patient data. To address this issue, we present a zero-shot, knowledge-guided framework for psychiatric tabular data in which large language models (LLMs) are steered via Retrieval-Augmented Generation using the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) and the International Classification of Diseases (ICD-10). We conducted experiments using different combinations of knowledge bases to generate privacy-preserving synthetic data. The resulting models were benchmarked against two state-of-the-art deep learning models for synthetic tabular data generation, namely CTGAN and TVAE, both of which rely on real data and therefore entail potential privacy risks. Evaluation was performed on six anxiety-related disorders: specific phobia, social anxiety disorder, agoraphobia, generalized anxiety disorder, separation anxiety disorder, and panic disorder. CTGAN typically achieves the best marginals and multivariate structure, while the knowledge-augmented LLM is competitive on pairwise structure and attains the lowe

The advent of Large Language Models (LLMs) offers potential solutions to address problems such as shortage of medical resources and low diagnostic consistency in psychiatric clinical practice. Despite this potential, a robust and comprehensive benchmarking framework to assess the efficacy of LLMs in authentic psychiatric clinical environments is absent. This has impeded the advancement of specialized LLMs tailored to psychiatric applications. In response to this gap, by incorporating clinical demands in psychiatry and clinical data, we proposed a benchmarking system, PsychBench, to evaluate the practical performance of LLMs in psychiatric clinical settings. We conducted a comprehensive quantitative evaluation of 16 LLMs using PsychBench, and investigated the impact of prompt design, chain-of-thought reasoning, input text length, and domain-specific knowledge fine-tuning on model performance. Through detailed error analysis, we identified strengths and potential limitations of the existing models and suggested directions for improvement. Subsequently, a clinical reader study involving 60 psychiatrists of varying seniority was conducted to further explore the practical benefits of ex

Psychiatric symptom identification on social media aims to infer fine-grained mental health symptoms from user-generated posts, allowing a detailed understanding of users' mental states. However, the construction of large-scale symptom-level datasets remains challenging due to the resource-intensive nature of expert labeling and the lack of standardized annotation guidelines, which in turn limits the generalizability of models to identify diverse symptom expressions from user-generated text. To address these issues, we propose SynSym, a synthetic data generation framework for constructing generalizable datasets for symptom identification. Leveraging large language models (LLMs), SynSym constructs high-quality training samples by (1) expanding each symptom into sub-concepts to enhance the diversity of generated expressions, (2) producing synthetic expressions that reflect psychiatric symptoms in diverse linguistic styles, and (3) composing realistic multi-symptom expressions, informed by clinical co-occurrence patterns. We validate SynSym on three benchmark datasets covering different styles of depressive symptom expression. Experimental results demonstrate that models trained solel

Depression is a widespread mental disorder that affects millions worldwide. While automated depression assessment shows promise, most studies rely on limited or non-clinically validated data, and often prioritize complex model design over real-world effectiveness. In this paper, we aim to unveil the landscape of clinical depression assessment. We introduce C-MIND, a clinical neuropsychiatric multimodal diagnosis dataset collected over two years from real hospital visits. Each participant completes three structured psychiatric tasks and receives a final diagnosis from expert clinicians, with informative audio, video, transcript, and functional near-infrared spectroscopy (fNIRS) signals recorded. Using C-MIND, we first analyze behavioral signatures relevant to diagnosis. We train a range of classical models to quantify how different tasks and modalities contribute to diagnostic performance, and dissect the effectiveness of their combinations. We then explore whether LLMs can perform psychiatric reasoning like clinicians and identify their clear limitations in realistic clinical settings. In response, we propose to guide the reasoning process with clinical expertise and consistently i

Large Language Models (LLMs) offer promising opportunities to support mental healthcare workflows, yet they often lack the structured clinical reasoning needed for reliable diagnosis and may struggle to provide the emotionally attuned communication essential for patient trust. Here, we introduce WiseMind, a novel multi-agent framework inspired by the theory of Dialectical Behavior Therapy designed to facilitate psychiatric assessment. By integrating a "Reasonable Mind" Agent for evidence-based logic and an "Emotional Mind" Agent for empathetic communication, WiseMind effectively bridges the gap between instrumental accuracy and humanistic care. Our framework utilizes a Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5)-guided Structured Knowledge Graph to steer diagnostic inquiries, significantly reducing hallucinations compared to standard prompting methods. Using a combination of virtual standard patients, simulated interactions, and real human interaction datasets, we evaluate WiseMind across three common psychiatric conditions. WiseMind outperforms state-of-the-art LLM methods in both identifying critical diagnostic nodes and establishing accurate diff

The analysis of comorbidity is an open and complex research field in the branch of psychiatry, where clinical experience and several studies suggest that the relation among the psychiatric disorders may have etiological and treatment implications. In this paper, we are interested in applying latent feature modeling to find the latent structure behind the psychiatric disorders that can help to examine and explain the relationships among them. To this end, we use the large amount of information collected in the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC) database and propose to model these data using a nonparametric latent model based on the Indian Buffet Process (IBP). Due to the discrete nature of the data, we first need to adapt the observation model for discrete random variables. We propose a generative model in which the observations are drawn from a multinomial-logit distribution given the IBP matrix. The implementation of an efficient Gibbs sampler is accomplished using the Laplace approximation, which allows integrating out the weighting factors of the multinomial-logit likelihood model. We also provide a variational inference algorithm for this m

This paper presents an introduction and expository account of a beautiful, current, and active application of recursions to the computation of resistance distance. Resistance distance, also referred to as effective resistance, is a well-known graph metric that arises naturally by considering a graph as an electrical circuit; heuristically resistance distance measures both the number of paths between two vertices in a graph and the cost of each path. This topic finds applications in a rich array of fields including social, biological, ecological, and transportation networks, chemistry, graph theory, numerical linear algebra, and engineering. A variety of methods are used in the field to determine resistance distance including recursive, mathematical, and graphical techniques. Sequences familiar to the readers of the Fibonacci Quarterly such as the Fibonacci and Lucas sequences appear quite often in results in the literature. Twenty five to forty years ago there were a handful of papers on resistance that appeared in the Fibonacci Quarterly and the Proceedings and recently papers on the subject have appeared again. It is hoped that this introductory expository account will interest r

Large language models (LLMs) have attracted growing interest as supportive tools for psychiatric assessment and clinical decision support. However, existing mental health benchmarks largely rely on social media data or supportive dialogue settings, limiting their ability to assess whether models can apply formal diagnostic criteria and differential diagnostic rules. In this paper, we introduce MentalBench, a benchmark for evaluating whether LLMs can make DSM-grounded psychiatric diagnostic decisions under varying levels of clinical ambiguity. At the core of MentalBench is MentalKG, a psychiatrist-built and validated knowledge graph encoding DSM-5 diagnostic criteria and differential diagnostic rules for 23 psychiatric disorders. Using MentalKG as an expert-curated logical backbone, we generate 24,750 synthetic clinical cases that systematically vary in information completeness and diagnostic complexity, enabling DSM-grounded evaluation. Our experiments show that although state-of-the-art LLMs perform well on noise-free queries that probe DSM-5 knowledge, they struggle to calibrate their confidence when distinguishing between disorders with overlapping symptoms. These findings raise

Mental health disorders represent a burgeoning global public health challenge. While Large Language Models (LLMs) have demonstrated potential in psychiatric assessment, their clinical utility is severely constrained by benchmarks that lack ecological validity and fine-grained diagnostic supervision. To bridge this gap, we introduce \textbf{MentalDx Bench}, the first benchmark dedicated to disorder-level psychiatric diagnosis within real-world clinical settings. Comprising 712 de-identified electronic health records annotated by board-certified psychiatrists under ICD-11 guidelines, the benchmark covers 76 disorders across 16 diagnostic categories. Evaluation of 18 LLMs reveals a critical \textit{paradigm misalignment}: strong performance at coarse diagnostic categorization contrasts with systematic failure at disorder-level diagnosis, underscoring a gap between pattern-based modeling and clinical hypothetico-deductive reasoning. In response, we propose \textbf{MentalSeek-Dx}, a medical-specialized LLM trained to internalize this clinical reasoning process through supervised trajectory construction and curriculum-based reinforcement learning. Experiments on MentalDx Bench demonstrat

Data scarcity and unreliable self-reporting -- such as concealment or exaggeration -- pose fundamental challenges to psychiatric intake and assessment. We propose a multi-agent synthesis framework that explicitly models patient deception to generate high-fidelity, publicly releasable synthetic psychiatric intake records. Starting from DAIC-WOZ interviews, we construct enriched patient profiles and simulate a four-role workflow: a \emph{Patient} completes self-rated scales and participates in a semi-structured interview under a topic-dependent honesty state; an \emph{Assessor} selects instruments based on demographics and chief complaints; an \emph{Evaluator} conducts the interview grounded in rater-administered scales, tracks suspicion, and completes ratings; and a \emph{Diagnostician} integrates all evidence into a diagnostic summary. Each case links the patient profile, self-rated and rater-administered responses, interview transcript, diagnostic summary, and honesty state. We validate the framework through four complementary evaluations: diagnostic consistency and severity grading, chain-of-thought ablations, human evaluation of clinical realism and dishonesty modeling, and LLM-

Psychiatric research has been hampered by an explanatory gap between psychiatric symptoms and their neural underpinnings, which has resulted in poor treatment outcomes. This situation has prompted us to shift from symptom-based diagnosis to data-driven diagnosis, aiming to redefine psychiatric disorders as disorders of neural circuitry. Promising candidates for data-driven diagnosis include resting-state functional connectivity MRI (rs-fcMRI)-based biomarkers. Although biomarkers have been developed with the aim of diagnosing patients and predicting the efficacy of therapy, the focus has shifted to the identification of biomarkers that represent therapeutic targets, which would allow for more personalized treatment approaches. This type of biomarker (i.e., theranostic biomarker) is expected to elucidate the disease mechanism of psychiatric conditions and to offer an individualized neural circuit-based therapeutic target based on the neural cause of a condition. To this end, researchers have developed rs-fcMRI-based biomarkers and investigated a causal relationship between potential biomarkers and disease-specific behavior using functional MRI (fMRI)-based neurofeedback on functiona

Preclinical models of neurodevelopmental and psychiatric conditions often rely on inbred mouse strains like C57BL/6J (B6), which exhibit limited genetic and behavioral variability. This limitation hampers the modeling of phenotypic heterogeneity, characteristic of these conditions. Recent efforts have explored the use of multiple genetically diverse hybrid strains to address this. In this study, we examined whether one single mixed genetic mouse background, C57BL/6J;129S2/SvPas (B6;129), could simultaneously recapitulate behavioral variability and display improved phenotypes relevant to neurodevelopmental and psychiatric conditions. Compared to the inbred B6 strain, mixed B6;129 mice displayed enhanced sociability and self-grooming, two key discriminating parameters between the two mouse backgrounds and core features of such conditions, alongside a broader spectrum of individual behavioral variability. Although overall behavioral variability was comparable across backgrounds, B6;129 mice were less susceptible to the effects of chronic social isolation than their B6 counterparts. Together, these findings support that the B6;129 mixed background offers a more representative model of

In current medical practice, patients undergoing depression treatment must wait four to six weeks before a clinician can assess medication response due to the delayed noticeable effects of antidepressants. Identification of a treatment response at any earlier stage is of great importance, since it can reduce the emotional and economic burden connected with the treatment. We approach the prediction of a patient response to a treatment as a classification problem, by utilizing the dynamic properties of EEG recordings on the 7th day of the treatment. We present a novel framework that applies motif discovery to extract meaningful features from EEG data distinguishing between depression treatment responders and non-responders. We applied our framework also to classification tasks in other psychiatric EEG datasets, namely to patients with symptoms of schizophrenia, pediatric patients with intractable seizures, and Alzheimer disease and dementia. We achieved high classification precision in all data sets. The results demonstrate that the dynamic properties of the EEGs may support clinicians in decision making both in diagnosis and in the prediction depression treatment response as early a

Mental health has become a global priority, leading to a massive administrative burden in the coding of clinical diagnoses. This study proposes the automation of psychiatric diagnostic analysis by mapping free-text descriptions to the International Classification of Diseases (ICD) using Natural Language Processing (NLP) and Machine Learning (ML) techniques. Utilizing a specialized dataset of 145,513 Spanish psychiatric descriptions, various text representation paradigms were evaluated, ranging from classical frequency-based models (BoW, TF-IDF) to state-of-the-art Large Language Models (LLMs) such as e5\_large, BioLORD, and Llama-3-8B. Results indicate that transformer-based embeddings consistently outperform traditional methods by capturing implicit semantic cues and nuanced medical terminology. The e5\_large model, through end-to-end fine-tuning, achieved the highest performance with a $F1_{micro}$ score of 0.866. This research demonstrates that adapting LLMs to specific clinical nomenclature is essential for overcoming the challenges of ``long-tail'' label distributions and the inherent ambiguity of psychiatric discourse.

Automatic coding patient behaviors is essential to support decision making for psychotherapists during the motivational interviewing (MI), a collaborative communication intervention approach to address psychiatric issues, such as alcohol and drug addiction. While the behavior coding task has rapidly adapted machine learning to predict patient states during the MI sessions, lacking of domain-specific knowledge and overlooking patient-therapist interactions are major challenges in developing and deploying those models in real practice. To encounter those challenges, we introduce the Chain-of-Interaction (CoI) prompting method aiming to contextualize large language models (LLMs) for psychiatric decision support by the dyadic interactions. The CoI prompting approach systematically breaks down the coding task into three key reasoning steps, extract patient engagement, learn therapist question strategies, and integrates dyadic interactions between patients and therapists. This approach enables large language models to leverage the coding scheme, patient state, and domain knowledge for patient behavioral coding. Experiments on real-world datasets can prove the effectiveness and flexibilit

Psychiatric questionnaires are highly context sensitive and often only weakly predict subsequent symptom severity, which makes the prognostic relationship difficult to learn. Although flexible nonlinear models can improve predictive accuracy, their limited interpretability can erode clinical trust. In fields such as imaging and omics, investigators commonly address visit- and instrument-specific artifacts by extracting stable signal through preprocessing and then fitting an interpretable linear model. We adopt the same strategy for questionnaire data by decoupling preprocessing from prediction: we restrict nonlinear capacity to a baseline preprocessing module that estimates stable item values, and then learn a linear mapping from these stabilized baseline items to future severity. We refer to this two-stage method as REFINE (Redundancy-Exploiting Follow-up-Informed Nonlinear Enhancement), which concentrates nonlinearity in preprocessing while keeping the prognostic relationship transparently linear and therefore globally interpretable through a coefficient matrix, rather than through post hoc local attributions. In experiments, REFINE outperforms other interpretable approaches whil

Psychiatric intake is a sequential, high-stakes information-gathering process in which clinicians must decide what to ask, in what order, and how to interpret incomplete or ambiguous responses under limited time. Despite growing interest in conversational AI for healthcare, there is still limited infrastructure for conversational AI in this application. Accordingly, we formulate this task as a question-selection problem with clinically grounded questions, known target information, and controllable patient difficulty. We also introduce a task-specific question-selection benchmark based on a bank of 655 clinician-authored intake questions and corresponding synthetic patient vignettes with 5 different behavioral conditions. In our evaluation, we compare random questioning, a clinical psychiatric intake form baseline, and an LLM-guided adaptive policy across 300 interview sessions spanning four patients and five behavioral conditions. Across the benchmark, the clinically ordered fixed form substantially outperforms random questioning, and the LLM-guided policy achieves the strongest overall recovery. The advantage of adaptation grows sharply under patient behavior that is less amenable

Privacy represents one of the most critical yet underaddressed barriers to AI adoption in mental healthcare -- particularly in high-sensitivity operational environments such as military, correctional, and remote healthcare settings, where the risk of patient data exposure can deter help-seeking behavior entirely. Existing AI-enabled psychiatric decision support systems predominantly rely on cloud-based inference pipelines, requiring sensitive patient data to leave the device and traverse external servers, creating unacceptable privacy and security risks in these contexts. In this paper, we propose a zero-egress, on-device AI platform for privacy-preserving psychiatric decision support, deployed as a cross-platform mobile application. The proposed system extends our prior work on fine-tuned LLM consortiums for psychiatric diagnosis standardization by fundamentally re-architecting the inference pipeline for fully local execution -- ensuring that no patient data is transmitted to, processed by, or stored on any external server at any stage. The platform integrates a consortium of three lightweight, fine-tuned, and quantized open-source LLMs -- Gemma, Phi-3.5-mini, and Qwen2 -- selecte