TRUST: An LLM-Based Dialogue System for Trauma Understanding and Structured Assessments

Objectives: While Large Language Models (LLMs) have been widely used to assist clinicians and support patients, no existing work has explored dialogue systems for standard diagnostic interviews and assessments. This study aims to bridge the gap in mental healthcare accessibility by developing an LLM-powered dialogue system that replicates clinician behavior. Materials and Methods: We introduce TRUST, a framework of cooperative LLM modules capable of conducting formal diagnostic interviews and assessments for Post-Traumatic Stress Disorder (PTSD). To guide the generation of appropriate clinical responses, we propose a Dialogue Acts schema specifically designed for clinical interviews. Additionally, we develop a patient simulation approach based on real-life interview transcripts to replace time-consuming and costly manual testing by clinicians. Results: A comprehensive set of evaluation metrics is designed to assess the dialogue system from both the agent and patient simulation perspectives. Expert evaluations by conversation and clinical specialists show that TRUST performs comparably to real-life clinical interviews. Discussion: Our system performs at the level of average clinicians, with room for future enhancements in communication styles and response appropriateness. Conclusions: Our TRUST framework shows its potential to facilitate mental healthcare availability.

Automating PTSD Diagnostics in Clinical Interviews: Leveraging Large Language Models for Trauma Assessments

The shortage of clinical workforce presents significant challenges in mental healthcare, limiting access to formal diagnostics and services. We aim to tackle this shortage by integrating a customized large language model (LLM) into the workflow, thus promoting equity in mental healthcare for the general population. Although LLMs have showcased their capability in clinical decision-making, their adaptation to severe conditions like Post-traumatic Stress Disorder (PTSD) remains largely unexplored. Therefore, we collect 411 clinician-administered diagnostic interviews and devise a novel approach to obtain high-quality data. Moreover, we build a comprehensive framework to automate PTSD diagnostic assessments based on interview contents by leveraging two state-of-the-art LLMs, GPT-4 and Llama-2, with potential for broader clinical diagnoses. Our results illustrate strong promise for LLMs, tested on our dataset, to aid clinicians in diagnostic validation. To the best of our knowledge, this is the first AI system that fully automates assessments for mental illness based on clinician-administered interviews.