Correlation analysis between facial feature-based traditional Chinese medicine inspection of spirit classification and Beck Depression Inventory score

Objective: To determine the correlation between traditional Chinese medicine (TCM) inspection of spirit classification and the severity grade of depression based on facial features, offering insights for intelligent intergrated TCM and western medicine diagnosis of depression. Methods: Using the Aud...

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Main Authors: Shan Lu, Xubo Shang, Dong Yang, Junfeng Yan, Xiaoye Wang
Format: Article
Language:English
Published: KeAi Communications Co., Ltd. 2025-06-01
Series:Digital Chinese Medicine
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Online Access:http://www.sciencedirect.com/science/article/pii/S2589377725000758
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author Shan Lu
Xubo Shang
Dong Yang
Junfeng Yan
Xiaoye Wang
author_facet Shan Lu
Xubo Shang
Dong Yang
Junfeng Yan
Xiaoye Wang
author_sort Shan Lu
collection DOAJ
description Objective: To determine the correlation between traditional Chinese medicine (TCM) inspection of spirit classification and the severity grade of depression based on facial features, offering insights for intelligent intergrated TCM and western medicine diagnosis of depression. Methods: Using the Audio-Visual Emotion Challenge and Workshop (AVEC 2014) public dataset on depression, which conclude 150 interview videos, the samples were classified according to the TCM inspection of spirit classification: Deshen (得神, presence of spirit), Shaoshen (少神, insufficiency of spirit), and Shenluan (神乱, confusion of spirit). Meanwhile, based on Beck Depression Inventory-II (BDI-II) score for the severity grade of depression, the samples were divided into minimal (0 – 13, Q1), mild (14 – 19, Q2), moderate (20 – 28, Q3), and severe (29 – 63, Q4). Sixty-eight landmarks were extracted with a ResNet-50 network, and the feature extracion mode was stadardized. Random forest and support vectior machine (SVM) classifiers were used to predict TCM inspection of spirit classification and the severity grade of depression, respectively. A Chi-square test and Apriori association rule mining were then applied to quantify and explore the relationships. Results: The analysis revealed a statistically significant and moderately strong association between TCM spirit classification and the severity grade of depression, as confirmed by a Chi-square test (χ2 = 14.04, P = 0.029) with a Cramer’s V effect size of 0.243. Further exploration using association rule mining identified the most compelling rule: “moderate depression (Q3) → Shenluan”. This rule demonstrated a support level of 5%, indicating this specific co-occurrence was present in 5% of the cohort. Crucially, it achieved a high Confidence of 86%, meaning that among patients diagnosed with Q3, 86% exhibited the Shenluan pattern according to TCM assessment. The substantial Lift of 2.37 signifies that the observed likelihood of Shenluan manifesting in Q3 patients is 2.37 times higher than would be expected by chance if these states were independent—compelling evidence of a highly non-random association. Consequently, Shenluan emerges as a distinct and core TCM diagnostic manifestation strongly linked to Q3, forming a clinically significant phenotype within this patient subgroup. Conclusion: Automated facial analysis can serve as a common lens for TCM and western psychological assessments align in the diagnosis of depression. The inspection of spirit decline trajectory parallels worsening depression, supporting early screening and stratified intervention, and providing a reference for the intelligent assistance of integrated TCM and western medicine in the diagnosis of depression.
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spelling doaj-art-3f4e64ece79740be9f5443772a39c38f2025-08-20T03:58:10ZengKeAi Communications Co., Ltd.Digital Chinese Medicine2589-37772025-06-018214716210.1016/j.dcmed.2025.06.002Correlation analysis between facial feature-based traditional Chinese medicine inspection of spirit classification and Beck Depression Inventory scoreShan Lu0Xubo Shang1Dong Yang2Junfeng Yan3Xiaoye Wang4School of Informatics, Hunan University of Chinese Medicine, Changsha, Hunan 410208, China; Ministry of Research, The Second People’s Hospital of Hunan Province (Brain Hospital of Hunan Province), Changsha, Hunan 410007, China; Digital Chinese Medicine Editorial Office, Changsha, Hunan 410208, ChinaSchool of Intelligence Science and Technology, Beijing University of Civil Engineering and Architecture, Beijing 102616, ChinaDepartment of Psychosomatic Medicine, The Second People’s Hospital of Hunan Province (Brain Hospital of Hunan Province) , Changsha, Hunan 410007, ChinaSchool of Informatics, Hunan University of Chinese Medicine, Changsha, Hunan 410208, China; Hunan AI TCM Lab, Changsha, Hunan 410208, China; Corresponding author:Ministry of Research, The Second People’s Hospital of Hunan Province (Brain Hospital of Hunan Province), Changsha, Hunan 410007, China; Department of Science and Education, Hunna Chest Hospital, Changsha, Hunan 410013, China; Corresponding author:Objective: To determine the correlation between traditional Chinese medicine (TCM) inspection of spirit classification and the severity grade of depression based on facial features, offering insights for intelligent intergrated TCM and western medicine diagnosis of depression. Methods: Using the Audio-Visual Emotion Challenge and Workshop (AVEC 2014) public dataset on depression, which conclude 150 interview videos, the samples were classified according to the TCM inspection of spirit classification: Deshen (得神, presence of spirit), Shaoshen (少神, insufficiency of spirit), and Shenluan (神乱, confusion of spirit). Meanwhile, based on Beck Depression Inventory-II (BDI-II) score for the severity grade of depression, the samples were divided into minimal (0 – 13, Q1), mild (14 – 19, Q2), moderate (20 – 28, Q3), and severe (29 – 63, Q4). Sixty-eight landmarks were extracted with a ResNet-50 network, and the feature extracion mode was stadardized. Random forest and support vectior machine (SVM) classifiers were used to predict TCM inspection of spirit classification and the severity grade of depression, respectively. A Chi-square test and Apriori association rule mining were then applied to quantify and explore the relationships. Results: The analysis revealed a statistically significant and moderately strong association between TCM spirit classification and the severity grade of depression, as confirmed by a Chi-square test (χ2 = 14.04, P = 0.029) with a Cramer’s V effect size of 0.243. Further exploration using association rule mining identified the most compelling rule: “moderate depression (Q3) → Shenluan”. This rule demonstrated a support level of 5%, indicating this specific co-occurrence was present in 5% of the cohort. Crucially, it achieved a high Confidence of 86%, meaning that among patients diagnosed with Q3, 86% exhibited the Shenluan pattern according to TCM assessment. The substantial Lift of 2.37 signifies that the observed likelihood of Shenluan manifesting in Q3 patients is 2.37 times higher than would be expected by chance if these states were independent—compelling evidence of a highly non-random association. Consequently, Shenluan emerges as a distinct and core TCM diagnostic manifestation strongly linked to Q3, forming a clinically significant phenotype within this patient subgroup. Conclusion: Automated facial analysis can serve as a common lens for TCM and western psychological assessments align in the diagnosis of depression. The inspection of spirit decline trajectory parallels worsening depression, supporting early screening and stratified intervention, and providing a reference for the intelligent assistance of integrated TCM and western medicine in the diagnosis of depression.http://www.sciencedirect.com/science/article/pii/S2589377725000758Traditional Chinese medicine inspection of spirit classificationSeverity grade of depressionFacial feature analysisResNet landmark extractionAssociation rule miningClinical intelligent diagnosis
spellingShingle Shan Lu
Xubo Shang
Dong Yang
Junfeng Yan
Xiaoye Wang
Correlation analysis between facial feature-based traditional Chinese medicine inspection of spirit classification and Beck Depression Inventory score
Digital Chinese Medicine
Traditional Chinese medicine inspection of spirit classification
Severity grade of depression
Facial feature analysis
ResNet landmark extraction
Association rule mining
Clinical intelligent diagnosis
title Correlation analysis between facial feature-based traditional Chinese medicine inspection of spirit classification and Beck Depression Inventory score
title_full Correlation analysis between facial feature-based traditional Chinese medicine inspection of spirit classification and Beck Depression Inventory score
title_fullStr Correlation analysis between facial feature-based traditional Chinese medicine inspection of spirit classification and Beck Depression Inventory score
title_full_unstemmed Correlation analysis between facial feature-based traditional Chinese medicine inspection of spirit classification and Beck Depression Inventory score
title_short Correlation analysis between facial feature-based traditional Chinese medicine inspection of spirit classification and Beck Depression Inventory score
title_sort correlation analysis between facial feature based traditional chinese medicine inspection of spirit classification and beck depression inventory score
topic Traditional Chinese medicine inspection of spirit classification
Severity grade of depression
Facial feature analysis
ResNet landmark extraction
Association rule mining
Clinical intelligent diagnosis
url http://www.sciencedirect.com/science/article/pii/S2589377725000758
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