Cross-Cultural Identification of Acoustic Voice Features for Depression: A Cross-Sectional Study of Vietnamese and...

Acoustic voice analysis demonstrates potential as a non-invasive biomarker for depression, yet its generalizability across languages remains underexplored. This cross-sectional study aimed to identify a set of cross-culturally consistent acoustic features for depression screening using distinct Vietnamese and Japanese voice datasets. We analyzed anonymized recordings from 251 participants, comprising 123 Vietnamese individuals assessed via the self-report Beck Depression Inventory (BDI) and 128 Japanese individuals assessed via the clinician-rated Hamilton Depression Rating Scale (HAM-D). From 6373 features extracted with openSMILE, a multi-stage selection pipeline identified 12 cross-cultural features, primarily from the auditory spectrum (AudSpec), Mel-Frequency Cepstral Coefficients (MFCCs), and logarithmic Harmonics-to-Noise Ratio (logHNR) domains. The cross-cultural model achieved a combined Area Under the Curve (AUC) of 0.934, with performance disparities observed between the Japanese (AUC = 0.993) and Vietnamese (AUC = 0.913) cohorts. This disparity may be attributed to dataset heterogeneity, including mismatched diagnostic tools and differing sample compositions (clinical vs. mixed community). Furthermore, the limited number of high-risk cases (n = 33) warrants cautious interpretation regarding the reliability of reported AUC values for severe depression classification. These findings suggest the presence of a core acoustic signature related to physiological psychomotor changes that may transcend linguistic boundaries. This study advances the exploration of global vocal biomarkers but underscores the need for prospective, standardized multilingual trials to overcome the limitations of secondary data analysis.