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arXiv:2606.17973 · v2

Fine-tuning LLMs for Passive Depression Severity Estimation from AI Mental Health Dialogue

首次提交 2026-06-16 22:28
版本更新 2026-11-04 21:48
雷达观测 2026-11-05 12:13
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摘要

Depression is a leading cause of disability worldwide, yet validated questionnaires such as the Patient Health Questionnaire-9 (PHQ-9) often go uncompleted, yielding sparse, biased data. Users of AI mental health applications often describe their mood, sleep and functioning unprompted, producing a continuous record of symptoms. Here, we predict PHQ-9 scores from these conversations alone. As in many clinical language tasks, labels are scarce and imbalanced. We address both by fine-tuning Qwen 3.5 27B with a regression head and augmenting 3,111 ground-truth labels with pseudo-labels from a frontier reasoning model and iteratively trained intermediate models, expanding to 5,524 users with more balanced scores. On 422 held-out users, the model achieved MAE $= 3.98$, Pearson $r = 0.67$, and AUC $= 0.88$ at the clinical threshold (PHQ-9 $\geq 10$); AUC was $> 0.80$ across severity thresholds from PHQ-9 $\geq 3$ to PHQ-9 $\geq 24$, demonstrating that the model captures depression severity across the full clinical spectrum. These results support passive depression monitoring without self-report.

作者备注:12 pages, 2 figures

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v2 · 2026-11-04 21:48 · 最新观测版本

Fine-tuning LLMs for Passive Depression Severity Estimation from AI Mental Health Dialogue

Depression is a leading cause of disability worldwide, yet validated questionnaires such as the Patient Health Questionnaire-9 (PHQ-9) often go uncompleted, yielding sparse, biased data. Users of AI mental health applications often describe their mood, sleep and functioning unprompted, producing a continuous record of symptoms. Here, we predict PHQ-9 scores from these conversations alone. As in many clinical language tasks, labels are scarce and imbalanced. We address both by fine-tuning Qwen 3.5 27B with a regression head and augmenting 3,111 ground-truth labels with pseudo-labels from a frontier reasoning model and iteratively trained intermediate models, expanding to 5,524 users with more balanced scores. On 422 held-out users, the model achieved MAE $= 3.98$, Pearson $r = 0.67$, and AUC $= 0.88$ at the clinical threshold (PHQ-9 $\geq 10$); AUC was $> 0.80$ across severity thresholds from PHQ-9 $\geq 3$ to PHQ-9 $\geq 24$, demonstrating that the model captures depression severity across the full clinical spectrum. These results support passive depression monitoring without self-report.

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