Perla: A Conversational Agent for Depression Screening in Digital Ecosystems. Design, Implementation and Validation

Abstract

Most depression assessment tools are based on self-report questionnaires, such as the Patient Health Questionnaire (PHQ-9). These psychometric instruments can be easily adapted to an online setting by means of electronic forms. However, this approach lacks the interacting and engaging features of modern digital environments. With the aim of making depression screening more available, attractive and effective, we developed Perla, a conversational agent able to perform an interview based on the PHQ-9. We also conducted a validation study in which we compared the results obtained by the traditional self-report questionnaire with Perla’s automated interview. Analyzing the results from this study we draw two significant conclusions: firstly, Perla is much preferred by Internet users, achieving more than 2.5 times more reach than a traditional form-based questionnaire; secondly, her psychometric properties (Cronbach's alpha of 0.81, sensitivity of 96% and specificity of 90%) are excellent and comparable to the traditional well-established depression screening questionnaires.

Psychometric Properties of a Chatbot Version of the PHQ-9 With Adults and Older Adults

“…To our knowledge, only two studies reported psychometric properties of chatbot assessments. One study on the PHQ-9 delivered in Spanish by a chatbot found that the psychometric properties are comparable to the paper and pencil version ( 24 ). Another study of a loneliness scale that found quantitative equivalence between the chatbot and paper and pencil version ( 20 ).…”

Chatbot features for anxiety and depression: A scoping review

“…Our study also revealed three unique chatbots, “Vincent”, 42 “Gloomy” 43 and “Perla” 31 where they acted as the care-receiver. These chatbots serve as the one having a mental illness and are looking for help.…”

“…Despite the focus of chatbots primarily as a virtual assistance type character to provide therapy or “friend” character to the user, three bots “Vincent” 42 “Gloomy” 43 and “Perla” 31 particularly stood out more for their concept and not only due to the technological or AI they used. Rather than the chatbot being the care-provider these chatbots contained an interesting feature where they acted as the care-receiver.…”

Conversational Analysis Agents for Depression Detection: A Systematic Review

“…The study in [33] explains why there has recently been a considerable need for early biomarkers of mild mental decline in the context of Alzheimer's Disease (AD) and dementia research. The focus of the study in [34] is on developing a chatbot that can lead a meeting based on the Patient Health Questionnaire (PHQ) -9 exam to increase screening for openness, allure, and the possibility of melancholy. Particularly linguistic patterns were discovered to be linked to depression [35].…”

“…Also, the technologies used is shown in Table 5. [46,48,49,50,51,34,57,67,68] Summarily, with regards to technology platforms, cell phones, regularly Android-based, are utilized in most of the surveyed works because of their convenience and moderateness. Interestingly, demanding innovations are huge, and the evaluated works adopted dissimilar ones.…”