Background: Most previous studies make psychiatric diagnoses based on diagnostic terms. In this study we sought to augment Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5) diagnostic criteria with deep neural network models to make psychiatric diagnoses based on psychiatric notes. Methods: We augmented DSM-5 diagnostic criteria with self-attention-based bidirectional long short-term memory (BiLSTM) models to identify schizophrenia, bipolar, and unipolar depressive disorders. Given that the diagnostic criteria for psychiatric diagnosis include a certain symptom profile and functional impairment, we first extracted psychiatric symptoms and functional features with two approaches, including a lexicon-based approach and a dependency parsing approach. Then, we incorporated free-text discharge notes and extracted features for psychiatric diagnoses with the proposed models. Results: The micro-averaged F1 scores of the two automatic annotation approaches were greater than 0.8. BiLSTM models with self-attention outperformed the rule-based models with DSM-5 criteria in the prediction of schizophrenia and bipolar disorder, while the latter outperformed the former in predicting unipolar depressive disorder. Approaches for augmenting DSM-5 criteria with a self-attention-based BiLSTM outperformed both pure rule-based and pure deep neural network models. In terms of classification of psychiatric diagnoses, we observed that the performance for schizophrenia and bipolar disorder was acceptable. Conclusion: This DSM-5-augmented deep neural network models showed good performance in identifying psychiatric diagnoses from psychiatric notes. We conclude that it is possible to establish a model that consults clinical notes to make psychiatric diagnoses comparably to physicians. Further research will be extended to outpatient notes and other psychiatric disorders.
Date:
2023-02
Relation:
Artificial Intelligence in Medicine. 2023 Feb;136:Article number 102488.
