Feasibility study on using house-tree-person drawings for automatic analysis of depression

Major depression is a severe psychological disorder typically diagnosed using scale tests and through the subjective assessment of medical professionals. Along with the continuous development of machine learning techniques, computer technology has been increasingly employed to identify depression in recent years. Traditional methods of automatic depression recognition rely on using the patient's physiological data, such as facial expressions, voice, electroencephalography (EEG), and magnetic resonance imaging (MRI) as input. However, the acquisition cost of these data is relatively high, making it unsuitable for large-scale depression screening. Thus, we explore the possibility of utilizing a house-tree-person (HTP) drawing to automatically detect major depression without requiring the patient's physiological data. The dataset we used for this study consisted of 309 drawings depicting individuals at risk of major depression and 290 drawings depicting individuals without depression risk. We classified the eight features extracted from HTP sketches using four machine-learning models and used multiple cross-validations to calculate recognition rates. The best classification accuracy rate among these models reached 97.2%. Additionally, we conducted ablation experiments to analyze the association between features and information on depression pathology. The results of Wilcoxon rank-sum tests showed that seven of the eight features significantly differed between the major depression group and the regular group. We demonstrated significant differences in HTP drawings between patients with severe depression and everyday individuals, and using HTP sketches to identify depression automatically is feasible, providing a new approach for automatic identification and large-scale screening of depression.