{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T13:11:28Z","timestamp":1789132288103,"version":"build-2803163510"},"reference-count":47,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T00:00:00Z","timestamp":1789084800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T00:00:00Z","timestamp":1789084800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100009619","name":"Japan Agency for Medical Research and Development","doi-asserted-by":"publisher","award":["23dk0307110h0002"],"award-info":[{"award-number":["23dk0307110h0002"]}],"id":[{"id":"10.13039\/100009619","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Psychiatry Clin Neurosci"],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Given their differing pathophysiology and treatment approaches, the primary aim of the current study was to develop a methodology accurately distinguishing bipolar from unipolar depression.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      Adults with bipolar disorder or major depressive disorder were recruited nationwide in Japan and assessed\n                      <jats:italic>via<\/jats:italic>\n                      recorded interviews. During the interview, diagnoses were established using the Structured Clinical Interview for DSM\u20105\u2010Research Version. Depressive and manic symptom severity was assessed using the Hamilton Depression Rating Scale (HDRS) and Young Mania Rating Scale (YMRS), respectively. Artificial intelligence (AI)\u2010based integrative, quantitative analyses of behavioral characteristics, including facial expressions, eye gaze, and voice prosody, were conducted on the recorded video.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Between August 2022 and March 2024, 379 participants completed interviews, of whom 366 were analyzed (120 bipolar I, 93 bipolar II, 122 major depressive, and 74 persistent depressive disorder). AI\u2010based diagnostic differentiation between bipolar and unipolar depression using four\u2010fold, three\u2010times repeated cross\u2010validation achieved an overall accuracy of 78%, with an area under the curve of 0.76. Key features contributing to bipolar diagnosis included greater temporal instabilities in neutral facial expression, eye gaze, sad facial expression, and root mean square amplitude of speech. HDRS could be predicted in unipolar and bipolar depression, with influential predictors of depression including sleep inefficiency, autistic traits, variability in sad facial expression, and comorbid anxiety disorder. YMRS could be predicted with major predictors including comorbid anxiety disorder, sleep inefficiency, and variabilities in sad facial expression and eye movement.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Integrating multimodal behavioral indicators with AI\u2010based modeling enables clinically meaningful differentiation between bipolar and unipolar depression.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/pcn.70124","type":"journal-article","created":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T13:00:51Z","timestamp":1789131651000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Differentiation between bipolar versus unipolar depression by AI\u2010based multimodal behavioral analysis"],"prefix":"10.1111","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2748-6317","authenticated-orcid":false,"given":"Hidenori","family":"Yamasue","sequence":"first","affiliation":[{"name":"Department of Psychiatry Hamamatsu University School of Medicine  Hamamatsu Japan"},{"name":"United Graduate School of Child Development Osaka University, Kanazawa University, Hamamatsu University School of Medicine, Chiba University and University of Fukui  Suita Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sanskar Rahul","family":"Nanegaonkar","sequence":"additional","affiliation":[{"name":"I'mbesideyou  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yumi","family":"Kiyama","sequence":"additional","affiliation":[{"name":"Center for Clinical Research Hamamatsu University Hospital  Hamamatsu Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mamindla Vishwa Raghava","family":"Reddy","sequence":"additional","affiliation":[{"name":"I'mbesideyou  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kotaro","family":"Ando","sequence":"additional","affiliation":[{"name":"I'mbesideyou  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shozo","family":"Kamiya","sequence":"additional","affiliation":[{"name":"I'mbesideyou  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jun","family":"Inoue","sequence":"additional","affiliation":[{"name":"Department of Psychiatry Hamamatsu University School of Medicine  Hamamatsu Japan"},{"name":"Department of Child and Adolescent Psychiatry Hamamatsu University School of Medicine  Hamamatsu Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Asuka","family":"Sakurai","sequence":"additional","affiliation":[{"name":"Department of Psychiatry Hamamatsu University School of Medicine  Hamamatsu Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tahichi","family":"Nakano","sequence":"additional","affiliation":[{"name":"Hamamatsu University School of Medicine  Hamamatsu Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amane","family":"Sato","sequence":"additional","affiliation":[{"name":"Hamamatsu University School of Medicine  Hamamatsu Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5164-5963","authenticated-orcid":false,"given":"Yosuke","family":"Kameno","sequence":"additional","affiliation":[{"name":"Department of Psychiatry Hamamatsu University School of Medicine  Hamamatsu Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1924-8167","authenticated-orcid":false,"given":"Tomoyasu","family":"Wakuda","sequence":"additional","affiliation":[{"name":"Department of Psychiatry Hamamatsu University School of Medicine  Hamamatsu Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Keiichi","family":"Odagiri","sequence":"additional","affiliation":[{"name":"Center for Clinical Research Hamamatsu University Hospital  Hamamatsu Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7856-3952","authenticated-orcid":false,"given":"Tadafumi","family":"Kato","sequence":"additional","affiliation":[{"name":"Department of Psychiatry and Behavioral Science Juntendo University Graduate School of Medicine  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,9,11]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/acps.13490"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/bdi.12513"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jad.2021.02.060"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/bdi.12612"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.4088\/JCP.14016tx2c"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1177\/070674370605100102"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1186\/s40345-015-0039-8"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1001\/archpsyc.1995.03950140032004"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0165-0327(03)00194-0"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jad.2004.01.017"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.eurpsy.2014.06.005"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/0165-0327(92)90072-E"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jad.2025.120889"},{"key":"e_1_2_11_15_1","doi-asserted-by":"publisher","DOI":"10.2196\/72229"},{"key":"e_1_2_11_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jad.2022.03.054"},{"key":"e_1_2_11_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.euroneuro.2024.01.003"},{"key":"e_1_2_11_18_1","doi-asserted-by":"publisher","DOI":"10.3390\/diagnostics13142323"},{"key":"e_1_2_11_19_1","volume-title":"Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision (DSM\u20105\u2010TR)","year":"2022"},{"key":"e_1_2_11_20_1","volume-title":"International Classification of Diseases 11th Revision (ICD\u201011)","year":"2024"},{"key":"e_1_2_11_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(25)01140-7"},{"key":"e_1_2_11_22_1","volume-title":"User's Guide for the Structured Clinical Interview for DSM\u2010IV Axis I Disorders SCID\u2010I: Clinician Version","author":"First M","year":"1997"},{"key":"e_1_2_11_23_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.2044-8341.1959.tb00467.x"},{"key":"e_1_2_11_24_1","doi-asserted-by":"publisher","DOI":"10.1192\/bjp.133.5.429"},{"key":"e_1_2_11_25_1","doi-asserted-by":"publisher","DOI":"10.1017\/S0033291718002283"},{"key":"e_1_2_11_26_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jad.2014.06.042"},{"key":"e_1_2_11_27_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0190442"},{"key":"e_1_2_11_28_1","article-title":"Quantitative facial expression analysis revealed the efficacy and time course of oxytocin in autism","volume":"10","author":"Owada K","year":"2019","journal-title":"Brain"},{"key":"e_1_2_11_29_1","doi-asserted-by":"publisher","DOI":"10.3389\/fpsyt.2021.634756"},{"key":"e_1_2_11_30_1","doi-asserted-by":"publisher","DOI":"10.1002\/aur.1678"},{"key":"e_1_2_11_31_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0225377"},{"key":"e_1_2_11_32_1","doi-asserted-by":"publisher","DOI":"10.1002\/aur.3080"},{"key":"e_1_2_11_33_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13229-016-0083-y"},{"key":"e_1_2_11_34_1","doi-asserted-by":"publisher","DOI":"10.1023\/A:1005653411471"},{"key":"e_1_2_11_35_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF02211841"},{"key":"e_1_2_11_36_1","unstructured":"DengJ GuoJ ZhouY YuJ KotsiaI ZafeiriouS.RetinaFace: Single\u2010stage dense face localisation in the wild. Arxiv.2019."},{"key":"e_1_2_11_37_1","doi-asserted-by":"publisher","DOI":"10.1109\/TVCG.2019.2938165"},{"key":"e_1_2_11_38_1","doi-asserted-by":"publisher","DOI":"10.1109\/LSP.2016.2603342"},{"key":"e_1_2_11_39_1","first-page":"1","volume-title":"HyperExtended LightFace: A Facial Attribute Analysis Framework","author":"Serengil SI","year":"2021"},{"key":"e_1_2_11_40_1","doi-asserted-by":"crossref","unstructured":"McFeeB RaffelC LiangDet al.librosa: Audio and music signal analysis in Python.2015. Proc 14th Python Sci Conf: 18\u201324.","DOI":"10.25080\/Majora-7b98e3ed-003"},{"key":"e_1_2_11_41_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.wocn.2018.07.001"},{"key":"e_1_2_11_42_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41746-023-00977-7"},{"key":"e_1_2_11_43_1","doi-asserted-by":"publisher","DOI":"10.3389\/fpsyt.2023.1079448"},{"key":"e_1_2_11_44_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jad.2025.04.159"},{"key":"e_1_2_11_45_1","doi-asserted-by":"publisher","DOI":"10.1176\/appi.books.9780890425596"},{"key":"e_1_2_11_46_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2215-0366(19)30289-5"},{"key":"e_1_2_11_47_1","doi-asserted-by":"publisher","DOI":"10.3389\/fpsyg.2019.00259"},{"key":"e_1_2_11_48_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.neubiorev.2025.106070"}],"container-title":["Psychiatry and Clinical Neurosciences"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/pcn.70124","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/pcn.70124","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/pcn.70124","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T13:00:55Z","timestamp":1789131655000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/pcn.70124"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,11]]},"references-count":47,"alternative-id":["10.1111\/pcn.70124"],"URL":"https:\/\/doi.org\/10.1111\/pcn.70124","archive":["Portico"],"relation":{},"ISSN":["1323-1316","1440-1819"],"issn-type":[{"value":"1323-1316","type":"print"},{"value":"1440-1819","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,11]]},"assertion":[{"value":"2026-03-09","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-08-19","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-09-11","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"pcn.70124"}}