Detecting schizophrenia, bipolar disorder, psychosis vulnerability and major depressive disorder from 5 minutes of online-collected speech

Background Psychosis poses substantial social and healthcare burdens. The analysis of speech is a promising approach for the diagnosis and monitoring of psychosis, capturing symptoms like thought disorder and flattened affect. Recent advancements in Natural Language Processing (NLP) methodologies enable the automated extraction of informative speech features, which has been leveraged for early psychosis detection and assessment of symptomology. However, critical gaps persist, including the absence of standardized sample collection protocols, small sample sizes, and a lack of multi-illness classification, limiting clinical applicability. Our study aimed to (1) identify an optimal assessment approach for the online and remote collection of speech, in the context of assessing the psychosis spectrum and evaluate whether a fully automated, speech-based machine learning (ML) pipeline can discriminate among different conditions on the schizophrenia-bipolar spectrum (SSD-BD-SPE), help-seeking comparison subjects (MDD), and healthy controls (HC) at varying layers of analysis and diagnostic complexity.