Using Large Language Models to Measure Symptom Severity in Patients At Risk for Schizophrenia

Fuente: arXiv
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Auteurs principaux: Chen, Andrew X., Horga, Guillermo, Escola, Sean
Format: Preprint
Publié: 2025
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author Chen, Andrew X.
Horga, Guillermo
Escola, Sean
author_facet Chen, Andrew X.
Horga, Guillermo
Escola, Sean
contents Patients who are at clinical high risk (CHR) for schizophrenia need close monitoring of their symptoms to inform appropriate treatments. The Brief Psychiatric Rating Scale (BPRS) is a validated, commonly used research tool for measuring symptoms in patients with schizophrenia and other psychotic disorders; however, it is not commonly used in clinical practice as it requires a lengthy structured interview. Here, we utilize large language models (LLMs) to predict BPRS scores from clinical interview transcripts in 409 CHR patients from the Accelerating Medicines Partnership Schizophrenia (AMP-SCZ) cohort. Despite the interviews not being specifically structured to measure the BPRS, the zero-shot performance of the LLM predictions compared to the true assessment (median concordance: 0.84, ICC: 0.73) approaches human inter- and intra-rater reliability. We further demonstrate that LLMs have substantial potential to improve and standardize the assessment of CHR patients via their accuracy in assessing the BPRS in foreign languages (median concordance: 0.88, ICC: 0.70), and integrating longitudinal information in a one-shot or few-shot learning approach.
format Preprint
id arxiv_https___arxiv_org_abs_2508_10226
institution arXiv
publishDate 2025
record_format arxiv
spellingShingle Using Large Language Models to Measure Symptom Severity in Patients At Risk for Schizophrenia
Chen, Andrew X.
Horga, Guillermo
Escola, Sean
Computation and Language
Artificial Intelligence
Patients who are at clinical high risk (CHR) for schizophrenia need close monitoring of their symptoms to inform appropriate treatments. The Brief Psychiatric Rating Scale (BPRS) is a validated, commonly used research tool for measuring symptoms in patients with schizophrenia and other psychotic disorders; however, it is not commonly used in clinical practice as it requires a lengthy structured interview. Here, we utilize large language models (LLMs) to predict BPRS scores from clinical interview transcripts in 409 CHR patients from the Accelerating Medicines Partnership Schizophrenia (AMP-SCZ) cohort. Despite the interviews not being specifically structured to measure the BPRS, the zero-shot performance of the LLM predictions compared to the true assessment (median concordance: 0.84, ICC: 0.73) approaches human inter- and intra-rater reliability. We further demonstrate that LLMs have substantial potential to improve and standardize the assessment of CHR patients via their accuracy in assessing the BPRS in foreign languages (median concordance: 0.88, ICC: 0.70), and integrating longitudinal information in a one-shot or few-shot learning approach.
title Using Large Language Models to Measure Symptom Severity in Patients At Risk for Schizophrenia
topic Computation and Language
Artificial Intelligence
url https://arxiv.org/abs/2508.10226