Background/Objectives:Psychiatry lacks the objective clinical tests routinely used in other specializations. Novel computerized methods to characterize complex behaviors such as speech could be used to identify and predict psychiatric illness in individuals.AIMS:In this proof-of-principle study, our aim was to test automated speech analyses combined with Machine Learning to predict later psychosis onset in youths at clinical high-risk (CHR) for psychosis.Methods:Thirty-four CHR youths (11 females) had baseline interviews and were assessed quarterly for up to 2.5 years; five transitioned to psychosis. Using automated analysis, transcripts of interviews were evaluated for semantic and syntactic features predicting later psychosis onset. Speech features were fed into a convex hull classification algorithm with leave-one-subject-out cross-validation to assess their predictive value for psychosis outcome. The canonical correlation between the speech features and prodromal symptom ratings was computed.Results:Derived speech features included a Latent Semantic Analysis measure of semantic coherence and two syntactic markers of speech complexity: maximum phrase length and use of determiners (e.g., which). These speech features predicted later psychosis development with 100% accuracy, outperforming classification from clinical interviews. Speech features were significantly correlated with prodromal symptoms.Conclusions:Findings support the utility of automated speech analysis to measure subtle, clinically relevant mental state changes in emergent psychosis. Recent developments in computer science, including natural language processing, could provide the foundation for future development of objective clinical tests for psychiatry.

Language and speech are the primary source of data for psychiatrists to diagnose and treat mental disorders. In psychosis, the very structure of language can be disturbed, including semantic coherence (e.g., derailment and tangentiality) and syntactic complexity (e.g., concreteness). Subtle disturbances in language are evident in schizophrenia even prior to first psychosis onset, during prodromal stages. Using computer-based natural language processing analyses, we previously showed that, among English-speaking clinical (e.g., ultra) high-risk youths, baseline reduction in semantic coherence (the flow of meaning in speech) and in syntactic complexity could predict subsequent psychosis onset with high accuracy. Herein, we aimed to cross-validate these automated linguistic analytic methods in a second larger risk cohort, also English-speaking, and to discriminate speech in psychosis from normal speech. We identified an automated machine-learning speech classifier -comprising decreased semantic coherence, greater variance in that coherence, and reduced usage of possessive pronouns -that had an 83% accuracy in predicting psychosis onset (intra-protocol), a cross-validated accuracy of 79% of psychosis onset prediction in the original risk cohort (cross-protocol), and a 72% accuracy in discriminating the speech of recent-onset psychosis patients from that of healthy individuals. The classifier was highly correlated with previously identified manual linguistic predictors. Our findings support the utility and validity of automated natural language processing methods to characterize disturbances in semantics and syntax across stages of psychotic disorder. The next steps will be to apply these methods in larger risk cohorts to further test reproducibility, also in languages other than English, and identify sources of variability. This technology has the potential to improve prediction of psychosis outcome among at-risk youths and identify linguistic targets for remediation and preventive intervention. More broadly, automated linguistic analysis can be a powerful tool for diagnosis and treatment across neuropsychiatry.Key words: Automated language analysis, prediction of psychosis, semantic coherence, syntactic complexity, high-risk youths, machine learning (World Psychiatry 2018;17:67-75) Language offers a privileged view into the mind: it is the basis by which we infer others' thought processes, such that disorganized language is considered to reflect disorder in thought. Language disturbance is prevalent in schizophrenia and is related to functional disability, given that an individual needs to think and speak clearly in order to maintain friends and a job 1 . In schizophrenia, the speaker "violates the syntactical and semantic conventions which govern language usage", yielding reduction in syntactic complexity (concrete speech, poverty of content) and loss of semantic coherence, e.g. the disruption in flow of meaning in language (derailment, tangentiality) 2. This language disturbance is an early core feature of sch...

Abused drugs can profoundly alter mental states in ways that may motivate drug use. These effects are usually assessed with self-report, an approach that is vulnerable to biases. Analyzing speech during intoxication may present a more direct, objective measure, offering a unique 'window' into the mind. Here, we employed computational analyses of speech semantic and topological structure after ± 3,4-methylenedioxymethamphetamine (MDMA; 'ecstasy') and methamphetamine in 13 ecstasy users. In 4 sessions, participants completed a 10-min speech task after MDMA (0.75 and 1.5 mg/kg), methamphetamine (20 mg), or placebo. Latent Semantic Analyses identified the semantic proximity between speech content and concepts relevant to drug effects. Graph-based analyses identified topological speech characteristics. Group-level drug effects on semantic distances and topology were assessed. Machine-learning analyses (with leave-one-out cross-validation) assessed whether speech characteristics could predict drug condition in the individual subject. Speech after MDMA (1.5 mg/kg) had greater semantic proximity than placebo to the concepts friend, support, intimacy, and rapport. Speech on MDMA (0.75 mg/kg) had greater proximity to empathy than placebo. Conversely, speech on methamphetamine was further from compassion than placebo. Classifiers discriminated between MDMA (1.5 mg/kg) and placebo with 88% accuracy, and MDMA (1.5 mg/kg) and methamphetamine with 84% accuracy. For the two MDMA doses, the classifier performed at chance. These data suggest that automated semantic speech analyses can capture subtle alterations in mental state, accurately discriminating between drugs. The findings also illustrate the potential for automated speech-based approaches to characterize clinically relevant alterations to mental state, including those occurring in psychiatric illness.

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Background: Widespread commercialization of cannabis has led to the introduction of brand names based on users' subjective experience of psychological effects and flavors, but this process has occurred in the absence of agreed standards. The objective of this work was to leverage information extracted from large databases to evaluate the consistency and validity of these subjective reports, and to determine their correlation with the reported cultivars and with estimates of their chemical composition (delta-9-THC, CBD, terpenes). Methods: We analyzed a large publicly available dataset extracted from Leafly.com where users freely reported their experiences with cannabis cultivars, including different subjective effects and flavour associations. This analysis was complemented with information on the chemical composition of a subset of the cultivars extracted from Psilabs.org. The structure of this dataset was investigated using network analysis applied to the pairwise similarities between reported subjective effects and/or chemical compositions. Random forest classifiers were used to evaluate whether reports of flavours and subjective effects could identify the labelled species cultivar. We applied Natural Language Processing (NLP) tools to free narratives written by the users to validate the subjective effect and flavour tags. Finally, we explored the relationship between terpenoid content, cannabinoid composition and subjective reports in a subset of the cultivars. Results: Machine learning classifiers distinguished between species tags given by "Cannabis sativa" and "Cannabis indica" based on the reported flavours: = 0.828 ± 0.002 (p < 0.001); and effects: = 0.9965 ± 0.0002 (p < 0.001). A significant relationship between terpene and cannabinoid content was suggested by positive correlations between subjective effect and flavour tags (p < 0.05, False-Discovery-rate (FDR)-corrected); these correlations clustered the reported effects into three groups that represented unpleasant, stimulant and soothing effects. The use of predefined tags was validated by applying latent semantic analysis tools to unstructured written reviews, also providing breed-specific topics consistent with their purported subjective effects. Terpene profiles matched the perceptual characterizations made by the users, particularly for the terpene-flavours graph (Q = 0.324).

Introduction Automated speech analysis has emerged as a scalable, cost‐effective tool to identify persons with Alzheimer's disease dementia (ADD). Yet, most research is undermined by low interpretability and specificity. Methods Combining statistical and machine learning analyses of natural speech data, we aimed to discriminate ADD patients from healthy controls (HCs) based on automated measures of domains typically affected in ADD: semantic granularity (coarseness of concepts) and ongoing semantic variability (conceptual closeness of successive words). To test for specificity, we replicated the analyses on Parkinson's disease (PD) patients. Results Relative to controls, ADD (but not PD) patients exhibited significant differences in both measures. Also, these features robustly discriminated between ADD patients and HC, while yielding near‐chance classification between PD patients and HCs. Discussion Automated discourse‐level semantic analyses can reveal objective, interpretable, and specific markers of ADD, bridging well‐established neuropsychological targets with digital assessment tools.