Validation Of Visual And Auditory Digital Markers Of Suicidality In Acutely Suicidal Psychiatric In-Patients

Background Multiple symptoms of suicide risk are assessed based on visual and auditory information including flattened affect, reduced movement, and slowed speech. Objective quantification of such symptomatology from novel data sources can increase the sensitivity, scalability, and timeliness of suicide risk assessment. Methods In the current study we utilized video to quantify facial, vocal, and movement markers associated with mood, emotion, and motor functioning from a structured clinical conversation in 20 patients admitted to a psychiatric hospital following a suicide risk attempt. Measures were calculated using open source deep learning algorithms for processing facial expressivity, head movement, and vocal characteristics. Derived digital measures of flattened affect, reduced movement, and slowed speech were compared to suicide severity using the Beck Suicide Scale (BSS), controlling for age and gender using multiple linear regression. Results Suicide severity was associated with multiple visual and auditory markers including speech prevalence ( β = −0.68; P =.017, r 2 =.40, overall expressivity ( β = −0.46; P = 0.10, r 2 =.27), and head movement measured as head pitch variability ( β = −1.24; P =.006, r 2 =.48) and head yaw variability ( β = −0.54; p =.055, r 2 =.32). Conclusions Digital measurements of facial affect, movement, and speech prevalence demonstrated strong effect sizes and significant linear associations with severity of suicidal ideation. ### Competing Interest Statement The authors Anzar Abbas, Vijay Yadav, Vidya Koesmahargyo, and Isaac Galatzer-Levy declare that they are employed and receive stock options from AiCure, a company that sells products related to remote measurement of medication adherence. ### Funding Statement The study is funded by the Digital Lives initiative of the Swiss National Science Foundation (SNSF). ### Author Declarations I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained. Yes The details of the IRB/oversight body that provided approval or exemption for the research described are given below: University of Zurich ethical review board All necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived. Yes I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance). Yes I have followed all appropriate research reporting guidelines and uploaded the relevant EQUATOR Network research reporting checklist(s) and other pertinent material as supplementary files, if applicable. Yes Due to privacy concerns, participants of this study did not agree for their data to be shared publicly.