Estimating Symptoms and Clinical Signs Instead of Disorders: The Path Toward The Clinical Use of Voice and Speech Biomarkers In Psychiatry

Despite the continuous innovation in voice biomarkers domain for more than a decade and the apparent need for clinicians to have objective diagnostic tools, no device has yet been implemented in real clinical settings or widely adopted by clinicians. After giving a short overview of the literature, we argue that in addition to the factors usually mentioned in the literature (low performance, database sizes, transparency, etc.), an underestimated but crucial factor preventing the use of such systems is the therapeutic relationship. We also discuss the "objectivity" of such systems, and the place of diagnosis in clinical practice and its conceptual limitations. In order to shape useful and relevant voice biomarkers, we propose to estimate symptoms instead of diagnosis, and draw perspectives related to this paradigm, which will require databases annotated with patients’ symptoms rather than only their pathological status.