Scalable, context-sensitive psychiatric assessment with large language models and brief diaries.

backgroundAccurate psychiatric assessment requires understanding a person's unique experience within their psychosocial context. Clinical interviews have been the gold standard for assessment as the only methods capable of this complex task, but they are time and resource-intensive. Consequently, psychiatric assessment typically relies on patient report surveys that are decontextualized and narrow in scope. This comprehensiveness-scalability tradeoff is a major bottleneck in studying and treating psychopathology. We propose using large language models (LLMs) to score psychopathology from brief personal narratives as a low-burden, context-sensitive solution.

methodsParticipants (

resultsSupporting convergent and discriminant validity, LLM ratings correlated most strongly with corresponding self-report domains at the between (average convergent

conclusionsAcross multiple forms of validity, we showed that LLMs can assess most major forms of psychopathology from mere minutes of audio. These results support scoring open-ended narratives with LLMs as a scalable, portable method to translate idiographic diagnostic data into standardized psychiatric assessments.