MentalSeek-Dx: Towards Progressive Hypothetico-Deductive Reasoning for Real-world Psychiatric Diagnosis
Xiao Sun, Ymyang, Xinyi Jiang, Yu Tian, Junnan Zhu Institute of automation, Chinese academy of science, Chinese Academy of Sciences, Jiang Zhong Chongqing University, Qin Lei Chongqing Medical University, Jingwang Huang 等 12 位作者
原文摘要
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 demonstrate that MentalSeek-Dx achieves state-of-the-art (SOTA) performance with only 14B parameters, establishing a clinically grounded framework for reliable psychiatric diagnosis. The dataset and code are available.
cs.CL
Proceedings of the 64th Annual Meeting of the Association for Computational Linguistics (Volume 1: Long Papers) · 2026 · 正式发表