Explainable Multimodal Depression Recognition in Clinical Interviews via PHQ-Aligned Symptom Summarization

Abstract

Recent advances in multimodal depression recognition for clinical interviews (MDRC) have demonstrated the potential of AI systems by integrating textual, acoustic, and facial cues. However, existing methods pay limited attention to interpretability, thereby constraining reproducibility and clinician review. To address this, we introduce Explain-MDRC, an explainable MDRC framework that mirrors clinical workflows by generating structured symptom summaries from text and integrating them with nonverbal cues for recognition. Specifically, we construct Explain-DAIC, a dataset based on DAIC-WOZ and enriched with PHQ-8-aligned summary annotations, providing a foundation for developing models with built-in interpretability. We further propose PhqCML, a model that combines PHQ-8-aligned symptom summarization with PHQ-aware contrastive learning and summary-informed multimodal fusion. Automated metrics and expert evaluations show that Explain-MDRC improves recognition performance and provides more interpretable, clinician-readable intermediate evidence, suggesting a promising direction for transparent AI-assisted depression recognition research.