Contactless gait-derived features as candidate digital biomarkers of depression severity in adolescents

Abstract: Timely assessment of depression severity in adolescents is essential for guiding clinical care, yet conventional evaluations rely on episodic clinical assessments and symptom rating scales. Contactless gait analysis offers a potentially scalable approach to capturing objective behavioral features associated with depression. Here, we introduce the Long-Distance 3D Adolescent Depression Gait Dataset (LD3D-ADG), comprising depth-sensor gait recordings from 119 adolescents at a single center, including 39 healthy controls, 41 with mild depression, and 39 with moderate-to-severe depression. We developed UMLPA-GCN, a graph convolutional network that models spatiotemporal gait dynamics across three anatomically defined skeletal partitions. In participant-independent five-fold cross-validation, UMLPA-GCN achieved 75.63% classification accuracy, a macro-F1 score of 75.52%, and a macro-area under the receiver operating characteristic curve of 0.839 (95% confidence interval, 0.779--0.899). Class-specific recall was 87.18%, 63.41%, and 76.92% for healthy controls, mild depression, and moderate-to-severe depression, respectively. At the participant level, reduced arm swing, slower pelvic movement, restricted joint range of motion, and greater arm-swing asymmetry were identified as leading potential digital biomarkers contributing to depression severity assessment, associated with higher 17-item Hamilton Depression Rating Scale scores. These findings provide proof-of-concept evidence for contactless digital depression severity stratification in adolescents. Further external and prospective validation is needed to establish their utility for longitudinal monitoring and timely clinical assessment.