Multimodal digital assessment of depression with actigraphy and app in Hong Kong Chinese

Abstract There is an emerging potential for digital assessment of depression. In this study, Chinese patients with major depressive disorder (MDD) and controls underwent a week of multimodal measurement including actigraphy and app-based measures (D-MOMO) to record rest-activity, facial expression, voice, and mood states. Seven machine-learning models (Random Forest RF, Logistic regression LR, Support vector machine SVM, K-Nearest Neighbors KNN, Decision tree DT, Naive Bayes NB, and Artificial Neural Networks ANN) with leave-one-out cross-validation were applied to detect lifetime diagnosis of MDD and non-remission status. Eighty MDD subjects and 76 age- and sex-matched controls completed the actigraphy, while 61 MDD subjects and 47 controls completed the app-based assessment. MDD subjects had lower mobile time ( P = 0.006), later sleep midpoint ( P = 0.047) and Acrophase ( P = 0.024) than controls. For app measurement, MDD subjects had more frequent brow lowering ( P = 0.023), less lip corner pulling ( P = 0.007), higher pause variability ( P = 0.046), more frequent self-reference ( P = 0.024) and negative emotion words ( P = 0.002), lower articulation rate ( P < 0.001) and happiness level ( P < 0.001) than controls. With the fusion of all digital modalities, the predictive performance (F1-score) of ANN for a lifetime diagnosis of MDD was 0.81 and 0.70 for non-remission status when combined with the HADS-D item score, respectively. Multimodal digital measurement is a feasible diagnostic tool for depression in Chinese. A combination of multimodal measurement and machine-learning approach has enhanced the performance of digital markers in phenotyping and diagnosis of MDD.