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HiMA-MDD introduces a hierarchical multi-agent architecture specifically designed to improve the interpretability and auditability of depression detection in clinical interviews by structuring evidence flow across three distinct agent layers. By leveraging Qwen2.5-72B-Instruct, this system outperforms existing holistic or generic agent-based approaches while generating a verifiable trace of intermediate judgments for each symptom. The work addresses a critical gap in current LLM applications where black-box scoring lacks the necessary transparency for clinical validation and regulatory compliance.
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HiMA-MDD: A Hierarchical Multi-Agent Harness for Interpretable Multimodal Depression Detection in Clinical Interviews

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arXiv:2608.21868v1 Announce Type: new Abstract: Depression assessment from multimodal clinical interviews requires integrating dispersed evidence from multiple symptoms into a coherent PHQ-8 profile. This process is hierarchical: relevant evidence is often sparse and context-dependent within local question-answer exchanges, multiple exchanges jointly support symptom-level judgments, and the final assessment depends on the coherence of the complete symptom profile. Existing LLM systems either process interviews holistically or distribute work across generic agent roles; neither design necessarily provides an explicit orchestration mechanism that coordinates evidence access, item-score authority, bounded feedback, and state recording across these levels. To address this gap, we introduce HiMA-MDD, a hierarchical multi-agent harness that aligns this assessment hierarchy with three agent layers. After non-agentic preprocessing constructs context-preserving multimodal QA units, Layer 1 identifies candidate QA-to-item relations and supports bounded item-grounded evidence routing. Layer 2 assigns symptom groups to operational factor specialists, with one specialist responsible for each provisional item score. Layer 3 audits the complete provisional profile, requests at most one round of targeted revision, and reconstructs the verified PHQ-8 profile. This layered design naturally yields a Hierarchical Evidence Trace, preserves all intermediate evidence, judgments, and revisions for auditability. The final item scores then deterministically produce the total score and screening decision. Using Qwen2.5-72B-Instruct as the harness backbone, our experiments on E-DAIC demonstrate that HiMA-MDD outperforms the compared state-of-the-art methods.

Abstract:Depression assessment from multimodal clinical interviews requires integrating dispersed evidence from multiple symptoms into a coherent PHQ-8 profile. This process is hierarchical: relevant evidence is often sparse and context-dependent within local question-answer exchanges, multiple exchanges jointly support symptom-level judgments, and the final assessment depends on the coherence of the complete symptom profile. Existing LLM systems either process interviews holistically or distribute work across generic agent roles; neither design necessarily provides an explicit orchestration mechanism that coordinates evidence access, item-score authority, bounded feedback, and state recording across these levels. To address this gap, we introduce HiMA-MDD, a hierarchical multi-agent harness that aligns this assessment hierarchy with three agent layers. After non-agentic preprocessing constructs context-preserving multimodal QA units, Layer 1 identifies candidate QA-to-item relations and supports bounded item-grounded evidence routing. Layer 2 assigns symptom groups to operational factor specialists, with one specialist responsible for each provisional item score. Layer 3 audits the complete provisional profile, requests at most one round of targeted revision, and reconstructs the verified PHQ-8 profile. This layered design naturally yields a Hierarchical Evidence Trace, preserves all intermediate evidence, judgments, and revisions for auditability. The final item scores then deterministically produce the total score and screening decision. Using Qwen2.5-72B-Instruct as the harness backbone, our experiments on E-DAIC demonstrate that HiMA-MDD outperforms the compared state-of-the-art methods.

Artificial Intelligence (cs.AI)

arXiv:2608.21868 [cs.AI]

(or arXiv:2608.21868v1 [cs.AI] for this version)

https://doi.org/10.48550/arXiv.2608.21868 Focus to learn more arXiv-issued DOI via DataCite (pending registration)

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