Previously submitted to: JMIR Mental Health (no longer under consideration since Nov 03, 2025)
Date Submitted: Nov 1, 2025
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
Linguistic Markers in At-Risk Mental States using Natural Language Processing: A Systematic Review
ABSTRACT
Background:
In recent years, research on psychosis has increasingly focused on prevention, aiming to implement early interventions that mitigate or reduce its impact. Within this framework, the analysis of linguistic markers in individuals with at-risk mental states (ARMS) has proven valuable for identifying those at risk and predicting psychosis onset. Artificial intelligence tools, particularly Natural Language Processing (NLP), have emerged as effective resources for detecting these language-based indicators.
Objective:
This study aims to synthesize the existing scientific evidence on linguistic markers analyzed through NLP techniques in individuals with ARMS.
Methods:
A systematic review following the PRISMA 2020 protocol [1]was done. Three databases (PubMed, PsycInfo, and Scopus) were searched for published articles from their inception to September 2025. Rayyan software was used to manage references and article downloads.
Results:
Thirteen studies met the inclusion criteria. The findings indicated that alterations in semantic coherence, syntactic complexity, referential cohesion, and speech/content poverty differentiated ARMS individuals from healthy controls. Several of these markers, analyzed with NLP tools, predicted the onset of psychosis with accuracy levels exceeding 70%.
Conclusions:
NLP techniques offer a powerful approach for detecting language alterations that distinguish ARMS individuals and provide meaningful predictions of psychosis onset, highlighting their potential as a complement to traditional clinical assessments for early identification and prevention. Clinical Trial: PROSPERO CRD420251029527 https://www.crd.york.ac.uk/PROSPERO/view/CRD420251029527
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