Acoustic and Natural Language Markers for Bipolar Disorder: A Pilot, mHealth Cross-Sectional Study

Abstract BackgroundMonitoring symptoms of bipolar disorder (BD) is a challenge faced by mental health services. Speech patterns are crucial in assessing the current experiences, emotions, and thought patterns of people with BD. Natural language processing (NLP) and acoustic si...

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Main Authors: Cristina Crocamo, Riccardo Matteo Cioni, Aurelia Canestro, Christian Nasti, Dario Palpella, Susanna Piacenti, Alessandra Bartoccetti, Martina Re, Valentina Simonetti, Chiara Barattieri di San Pietro, Maria Bulgheroni, Francesco Bartoli, Giuseppe Carrà
Format: Article
Language:English
Published: JMIR Publications 2025-04-01
Series:JMIR Formative Research
Online Access:https://formative.jmir.org/2025/1/e65555
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author Cristina Crocamo
Riccardo Matteo Cioni
Aurelia Canestro
Christian Nasti
Dario Palpella
Susanna Piacenti
Alessandra Bartoccetti
Martina Re
Valentina Simonetti
Chiara Barattieri di San Pietro
Maria Bulgheroni
Francesco Bartoli
Giuseppe Carrà
author_facet Cristina Crocamo
Riccardo Matteo Cioni
Aurelia Canestro
Christian Nasti
Dario Palpella
Susanna Piacenti
Alessandra Bartoccetti
Martina Re
Valentina Simonetti
Chiara Barattieri di San Pietro
Maria Bulgheroni
Francesco Bartoli
Giuseppe Carrà
author_sort Cristina Crocamo
collection DOAJ
description Abstract BackgroundMonitoring symptoms of bipolar disorder (BD) is a challenge faced by mental health services. Speech patterns are crucial in assessing the current experiences, emotions, and thought patterns of people with BD. Natural language processing (NLP) and acoustic signal processing may support ongoing BD assessment within a mobile health (mHealth) framework. ObjectiveUsing both acoustic and NLP-based features from the speech of people with BD, we built an app-based tool and tested its feasibility and performance to remotely assess the individual clinical status. MethodsWe carried out a pilot, observational study, sampling adults diagnosed with BD from the caseload of the Nord Milano Mental Health Trust (Italy) to explore the relationship between selected speech features and symptom severity and to test their potential to remotely assess mental health status. Symptom severity assessment was based on clinician ratings, using the Young Mania Rating Scale (YMRS) and Montgomery-Åsberg Depression Rating Scale (MADRS) for manic and depressive symptoms, respectively. Leveraging a digital health tool embedded in a mobile app, which records and processes speech, participants self-administered verbal performance tasks. Both NLP-based and acoustic features were extracted, testing associations with mood states and exploiting machine learning approaches based on random forest models. ResultsWe included 32 subjects (mean [SD] age 49.6 [14.3] years; 50% [16/32] females) with a MADRS median (IQR) score of 13 (21) and a YMRS median (IQR) score of 5 (16). Participants freely managed the digital environment of the app, without perceiving it as intrusive and reporting an acceptable system usability level (average score 73.5, SD 19.7). Small-to-moderate correlations between speech features and symptom severity were uncovered, with sex-based differences in predictive capability. Higher latency time (ρρρρR2R2R2 ConclusionsRemotely collected speech patterns, including both linguistic and acoustic features, are associated with symptom severity levels and may help differentiate clinical conditions in individuals with BD during their mood state assessments. In the future, multimodal, smartphone-integrated digital ecological momentary assessments could serve as a powerful tool for clinical purposes, remotely complementing standard, in-person mental health evaluations.
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spelling doaj-art-dfd6f75bb5354b268a28fd26be059dec2025-08-20T03:13:45ZengJMIR PublicationsJMIR Formative Research2561-326X2025-04-019e65555e6555510.2196/65555Acoustic and Natural Language Markers for Bipolar Disorder: A Pilot, mHealth Cross-Sectional StudyCristina Crocamohttp://orcid.org/0000-0002-2979-2107Riccardo Matteo Cionihttp://orcid.org/0000-0001-5718-9930Aurelia Canestrohttp://orcid.org/0000-0003-2718-4076Christian Nastihttp://orcid.org/0000-0003-2986-2125Dario Palpellahttp://orcid.org/0000-0002-3073-8407Susanna Piacentihttp://orcid.org/0000-0002-8184-2634Alessandra Bartoccettihttp://orcid.org/0000-0002-0862-8703Martina Rehttp://orcid.org/0000-0003-4385-2951Valentina Simonettihttp://orcid.org/0000-0001-7013-1338Chiara Barattieri di San Pietrohttp://orcid.org/0000-0003-4407-7037Maria Bulgheronihttp://orcid.org/0000-0001-8484-9834Francesco Bartolihttp://orcid.org/0000-0003-2612-4119Giuseppe Carràhttp://orcid.org/0000-0002-6877-6169 Abstract BackgroundMonitoring symptoms of bipolar disorder (BD) is a challenge faced by mental health services. Speech patterns are crucial in assessing the current experiences, emotions, and thought patterns of people with BD. Natural language processing (NLP) and acoustic signal processing may support ongoing BD assessment within a mobile health (mHealth) framework. ObjectiveUsing both acoustic and NLP-based features from the speech of people with BD, we built an app-based tool and tested its feasibility and performance to remotely assess the individual clinical status. MethodsWe carried out a pilot, observational study, sampling adults diagnosed with BD from the caseload of the Nord Milano Mental Health Trust (Italy) to explore the relationship between selected speech features and symptom severity and to test their potential to remotely assess mental health status. Symptom severity assessment was based on clinician ratings, using the Young Mania Rating Scale (YMRS) and Montgomery-Åsberg Depression Rating Scale (MADRS) for manic and depressive symptoms, respectively. Leveraging a digital health tool embedded in a mobile app, which records and processes speech, participants self-administered verbal performance tasks. Both NLP-based and acoustic features were extracted, testing associations with mood states and exploiting machine learning approaches based on random forest models. ResultsWe included 32 subjects (mean [SD] age 49.6 [14.3] years; 50% [16/32] females) with a MADRS median (IQR) score of 13 (21) and a YMRS median (IQR) score of 5 (16). Participants freely managed the digital environment of the app, without perceiving it as intrusive and reporting an acceptable system usability level (average score 73.5, SD 19.7). Small-to-moderate correlations between speech features and symptom severity were uncovered, with sex-based differences in predictive capability. Higher latency time (ρρρρR2R2R2 ConclusionsRemotely collected speech patterns, including both linguistic and acoustic features, are associated with symptom severity levels and may help differentiate clinical conditions in individuals with BD during their mood state assessments. In the future, multimodal, smartphone-integrated digital ecological momentary assessments could serve as a powerful tool for clinical purposes, remotely complementing standard, in-person mental health evaluations.https://formative.jmir.org/2025/1/e65555
spellingShingle Cristina Crocamo
Riccardo Matteo Cioni
Aurelia Canestro
Christian Nasti
Dario Palpella
Susanna Piacenti
Alessandra Bartoccetti
Martina Re
Valentina Simonetti
Chiara Barattieri di San Pietro
Maria Bulgheroni
Francesco Bartoli
Giuseppe Carrà
Acoustic and Natural Language Markers for Bipolar Disorder: A Pilot, mHealth Cross-Sectional Study
JMIR Formative Research
title Acoustic and Natural Language Markers for Bipolar Disorder: A Pilot, mHealth Cross-Sectional Study
title_full Acoustic and Natural Language Markers for Bipolar Disorder: A Pilot, mHealth Cross-Sectional Study
title_fullStr Acoustic and Natural Language Markers for Bipolar Disorder: A Pilot, mHealth Cross-Sectional Study
title_full_unstemmed Acoustic and Natural Language Markers for Bipolar Disorder: A Pilot, mHealth Cross-Sectional Study
title_short Acoustic and Natural Language Markers for Bipolar Disorder: A Pilot, mHealth Cross-Sectional Study
title_sort acoustic and natural language markers for bipolar disorder a pilot mhealth cross sectional study
url https://formative.jmir.org/2025/1/e65555
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