Performance of Automatic Speech Analysis in Detecting Depression: Systematic Review and Meta-Analysis
Bibliographic record
Abstract
BACKGROUND: Despite the high prevalence and significant burden of depression, underdiagnosis remains a persistent challenge. Automatic speech analysis (ASA) has emerged as a promising method for depression assessment. However, a comprehensive quantitative synthesis evaluating its diagnostic accuracy is still lacking. OBJECTIVE: This systematic review and meta-analysis aimed to assess the diagnostic performance of ASA in detecting depression, considering both machine learning and deep learning approaches. METHODS: We conducted a systematic search across 8 databases, including MEDLINE, PsycInfo, Embase, CINAHL, IEEE Xplore, ACM Digital Library, Scopus, and Google Scholar from January 2013 to April 1, 2025. We included studies published in English that evaluated the accuracy of ASA for detecting depression, and reported performance metrics such as accuracy, sensitivity, specificity, precision, or confusion matrices. Study quality was assessed using a modified version of the Quality Assessment of Studies of Diagnostic Accuracy-Revised. A 3-level meta-analysis was performed to estimate the pooled highest and lowest accuracy, sensitivity, specificity, and precision. Meta-regressions and subgroup analyses were performed to explore heterogeneity across various factors, including type of publication, artificial intelligence algorithms, speech features, speech-eliciting tasks, ground truth assessment, validation approach, dataset, dataset language, participants' mean age, and sample size. RESULTS: Of the 1345 records identified, 105 studies met the inclusion criteria. The pooled mean of the highest accuracy, sensitivity, specificity, and precision were 0.81 (95% CI 0.79 to 0.83), 0.84 (95% CI 0.81 to 0.86), 0.83 (95% CI 0.79 to 0.86), and 0.81 (95% CI 0.77 to 0.84), respectively, whereas the pooled mean of the lowest accuracy, sensitivity, specificity, and precision were 0.66 (95% CI 0.63 to 0.69), 0.63 (95% CI 0.58 to 0.68), 0.60 (95% CI 0.55 to 0.66), and 0.64 (95% CI 0.58 to 0.70), respectively. CONCLUSIONS: ASA shows promise as a method for detecting depression, though its readiness for clinical application as a standalone tool remains limited. At present, it should be regarded as a complementary method, with potential applications across diverse contexts. Further high-quality, peer-reviewed studies are needed to support the development of robust, generalizable models and to advance this emerging field. TRIAL REGISTRATION: PROSPERO CRD42023444431; https://www.crd.york.ac.uk/PROSPERO/view/CRD42023444431.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.029 | 0.100 |
| Meta-epidemiology (narrow) | 0.003 | 0.001 |
| Meta-epidemiology (broad) | 0.016 | 0.033 |
| Bibliometrics | 0.007 | 0.006 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.004 | 0.003 |
| Open science | 0.003 | 0.002 |
| Research integrity | 0.002 | 0.002 |
| Insufficient payload (model declined to judge) | 0.003 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".