Multilingual Lexical Feature Analysis of Spoken Language for Predicting Major Depression Symptom Severity

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arXiv:2511.07011v2 Announce Type: replace-cross Abstract: Background: Remotely captured spoken language could provide objective, regular indicators of depression symptom severity. However, research to date has largely used non-clinical, cross-sectional written language and complex machine learning (ML) approaches with limited interpretability. Methods: We used linear mixed-effect models to identify interpretable lexical features associated with symptom severity in data from the RADAR-MDD study that comprised 5,846 smartphone recordings and Patient Health Questionnaire (PHQ-8) scores from 467 participants in the UK, Netherlands and Spain. We then developed ML models and systematically assessed via nested cross-validation whether interpretable lexical features or high-dimensional vector embeddings improved the accuracy of PHQ-8 prediction over sociodemographic and confounding features. Results: Depression symptom severity was associated with five lexical features, including reductions in word count measures, use of first-person plural pronouns and positive word frequency. Associations were stable across countries, except for positive word frequency. Lexical features and vector embeddings did improve prediction accuracy beyond baseline models. Limitations: Our cohort was skewed in age (median = 53, IQR 35 to 62) and majority female (n=357), potentially affecting the generalizability of our results. A lack of natural language processing tools for non-English languages restricted our feature choices. Conclusion: Further research is required to realise the value of spoken …

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