Finding neural correlates of depersonalisation/derealisation disorder via explainable CNN-based analysis guided by clinical assessment scores

Mental health disorders are typically diagnosed based on subjective reports (e.g., through questionnaires) followed by clinical interviews to evaluate the self-reported symptoms. Therefore, considering the interconnected nature of psychiatric disorders, their accurate diagnosis is a real challenge without indicators of underlying physiological dysfunction. Depersonalisation/derealisation disorder (DPD) is an example of dissociative disorder affecting 1–2 % of the population. DPD is characterised mainly by persistent disembodiment, detachment from surroundings, and feelings of emotional numbness, which can significantly impact patients' quality of life. The underlying neural correlates of DPD have been investigated for years to understand and help with a more accurate and in-time diagnosis of the disorder. However, in terms of EEG studies, which hold great importance due to their convenient and inexpensive nature, the literature has often been based on hypotheses proposed by experts in the field, which require prior knowledge of the disorder. In addition, participants' labelling in research experiments is often derived from the outcome of the Cambridge Depersonalisation Scale (CDS), a subjective assessment to quantify the level of depersonalisation/derealisation, the threshold and reliability of which might be challenged. As a result, we aimed to propose a novel end-to-end EEG processing pipeline based on deep neural networks for DPD biomarker discovery, which requires no prior hand-crafted labelled data. Alternatively, it can assimilate knowledge from clinical outcomes like CDS as well as data-driven patterns that differentiate individual brain responses. In addition, the structure of the proposed model targets the uncertainty in CDS scores by using them as prior information only to guide the unsupervised learning task in a multi-task learning scenario. A comprehensive evaluation has been done to confirm the significance of the proposed deep structure, including new ways of network visualisation to investigate spectral, spatial, and temporal information derived in the learning process. We argued that the proposed EEG analytics could also be applied to investigate other psychological and mental disorders currently indicated on the basis of clinical assessment scores. The code to reproduce the results presented in this paper is openly accessible at https://github.com/AbbasSalami/DPD_Analysis