Dynamic topic language model on heterogeneous children’s mental health clinical notes

Abstract

Mental health diseases which affect children’s lives and well-beings have received increased attention since the COVID-19 pandemic. Analyzing psychiatric clinical notes with topic models is critical to evaluating children’s mental status over time. However, few topic models are built for longitudinal settings, and most existing approaches fail to capture temporal trajectories for each document. To address these challenges, we develop a dynamic topic model with consistent topics and individualized temporal dependencies on the evolving document metadata. Our model preserves the semantic meaning of discovered topics over time and incorporates heterogeneity among documents. In particular, when documents can be categorized, we propose a classifier-free approach to maximize topic heterogeneity across different document groups. We also present an efficient variational optimization procedure adapted for the multistage longitudinal setting. In this case study, we apply our method to the psychiatric clinical notes from a large tertiary pediatric hospital in Southern California and achieve a 38% increase in the overall coherence of extracted topics. Our real data analysis reveals that children tend to express more negative emotions during state shutdowns and more positive when schools reopen. Furthermore, it suggests that sexual and gender minority (SGM) children display more pronounced reactions to major COVID-19 events and a greater sensitivity to vaccine-related news than non-SGM children. This study examines children’s mental health progression during the pandemic and offers clinicians valuable insights to recognize disparities in children’s mental health related to their sexual and gender identities.