title: Psychologist in a Pocket: Lexicon Development and Content Validation of a Mobile-Based App for Depression Screening.
abstract: BACKGROUND
  Language reflects the state of one's mental health and personal characteristics. It also reveals preoccupations with a particular schema, thus possibly providing insights into psychological conditions. Using text or lexical analysis in exploring depression, negative schemas and self-focusing tendencies may be depicted. As mobile technology has become highly integrated in daily routine, mobile devices have the capacity for ecological momentary assessment (EMA), specifically the experience sampling method (ESM), where behavior is captured in real-time or closer in time to experience in one's natural environment. Extending mobile technology to psychological health could augment initial clinical assessment, particularly of mood disturbances, such as depression and analyze daily activities, such as language use in communication. Here, we present the process of lexicon generation and development and the initial validation of Psychologist in a Pocket (PiaP), a mobile app designed to screen signs of depression through text analysis.
  
  
  OBJECTIVE
  The main objectives of the study are (1) to generate and develop a depressive lexicon that can be used for screening text-input in mobile apps to be used in the PiaP; and (2) to conduct content validation as initial validation.
  
  
  METHODS
  The first phase of our research focused on lexicon development. Words related to depression and its symptoms based on the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) and in the ICD-10 Classification of Mental and Behavioural Disorders: Clinical Descriptions and Diagnostic Guidelines classification systems were gathered from focus group discussions with Filipino college students, interviews with mental health professionals, and the review of established scales for depression and other related constructs.
  
  
  RESULTS
  The lexicon development phase yielded a database consisting of 13 categories based on the criteria depressive symptoms in the DSM-5 and ICD-10. For the draft of the depression lexicon for PiaP, we were able to gather 1762 main keywords and 9655 derivatives of main keywords. In addition, we compiled 823,869 spelling variations. Keywords included negatively-valenced words like "sad", "unworthy", or "tired" which are almost always accompanied by personal pronouns, such as "I", "I'm" or "my" and in Filipino, "ako" or "ko". For the content validation, only keywords with CVR equal to or more than 0.75 were included in the depression lexicon test-run version. The mean of all CVRs yielded a high overall CVI of 0.90. A total of 1498 main keywords, 8911 derivatives of main keywords, and 783,140 spelling variations, with a total of 793, 553 keywords now comprise the test-run version.
  
  
  CONCLUSIONS
  The generation of the depression lexicon is relatively exhaustive. The breadth of keywords used in text analysis incorporates the characteristic expressions of depression and its related constructs by a particular culture and age group. A content-validated mobile health app, PiaP may help augment a more effective and early detection of depressive symptoms.
authors.affiliation: The Graduate School, University of Santo Tomas, Manila, Philippines. chengpaulaferrer@gmail.com.
authors.forename: Paula Glenda Ferrer
authors.identifier: http://orcid.org/0000-0003-0392-4324
authors.initials: PG
authors.lastname: Cheng
authors.forename: Roann Munoz
authors.identifier: http://orcid.org/0000-0001-8849-9210
authors.initials: RM
authors.lastname: Ramos
authors.forename: Jó Ágila
authors.identifier: http://orcid.org/0000-0002-9895-291X
authors.initials: JÁ
authors.lastname: Bitsch
authors.forename: Stephan Michael
authors.identifier: http://orcid.org/0000-0002-3687-6165
authors.initials: SM
authors.lastname: Jonas
authors.forename: Tim
authors.identifier: http://orcid.org/0000-0002-6335-3351
authors.initials: T
authors.lastname: Ix
authors.forename: Portia Lynn Quetulio
authors.identifier: http://orcid.org/0000-0001-7497-8165
authors.initials: PL
authors.lastname: See
authors.forename: Klaus
authors.identifier: http://orcid.org/0000-0001-7252-4186
authors.initials: K
authors.lastname: Wehrle
keywords: Psychologist in a Pocket; depression; lexicon development; text analysis