Natural Language Processing-Based Quantification of the Mental State of Psychiatric Patients

Abstract

Psychiatric practice routinely uses semistructured and/or unstructured free text to record the behavior and mental state of patients. Many of these data are unstructured, lack standardization, and are difficult to use for analysis. Thus, it is difficult to quantitatively analyze a patient’s illness trajectory over time and his or her responsiveness to treatment, and it is also difficult to compare different patients quantitatively. In this article, experts in the field of psychiatry, along with machine learning models, have collaboratively transformed patient data available in status assessments generated by physicians into binary vector representations. Data from patients with mental health disorders collected within a real-world clinical setting from one of the largest behavioral electronic health record (EHR) systems in the United States have been used for generating these representations. The binary vector representation of these health records is shown to be useful in various clinical tasks, such as disease phenotyping, characterizing the suicidality of patients, and inferring diagnoses. To summarize, this approach can transform semistructured free-text summaries of patients’ status assessments into a structured, quantifiable format, which enriches the data that reside within EHR systems. This allows for effective intra- and interpatient quantifications and comparisons, which are much needed in the field of mental health. With the aid of these binary representations, patients’ mental states can be systematically tracked over time, as can their responses to medications at the individual and population levels.