Analyzing Generative AI and Machine Learning in Auto-Assessing Schizophrenia's Negative Symptoms

Traditional assessments of schizophrenia's negative symptoms rely on subjective and time-consuming psychiatric interviews. To provide more objective and efficient evaluations, this study examines the efficacy of an automated system utilizing generative AI (GenAI) and machine learning (ML) to assess negative symptoms of schizophrenia, including expression (EXP) and motivation and pleasure (MAP) domains.

A semi-structured interview protocol based on the Clinical Assessment Interview for Negative Symptoms was used to conduct interviews with schizophrenia patients. An experienced senior psychiatrist carried out these interviews, which were audio- and video-recorded, at the National Taiwan University Hospital between July 2022 and August 2023. An ML-based system analyzed visual and audio data for EXP assessment, while GenAI analyzed interview transcripts for MAP assessment.

The study cohort consisted of 69 males and 91 females with a mean age of 41.68 years (SD = 10.46). The ML-based EXP assessment showed moderate to substantial reliability, with an intraclass correlation coefficient (3, 1) (ICC3,1) of 0.65 and a weighted kappa of 0.62. The GenAI-based MAP assessment demonstrated good reliability, with an ICC3,1 of 0.82 and a weighted kappa of 0.77. The system achieved strong linear correlations with clinician ratings (Pearson's correlation coefficient ≥ 0.54) and maintained low error rates (mean absolute error ≤ 0.81; root mean square error ≤ 1.16) for each assessment item.

The study demonstrates the efficacy of GenAI and ML in the automated assessment of schizophrenia's negative symptoms, highlighting their potential to enhance the consistency and efficiency of clinical evaluations.