Task-evoked eye movements as candidate digital biomarkers of depression severity in adolescents and young adults

Youxiang Sun, Yujie Nie, Zhuoru Wu, Mengyuan Yu, Wenkong Wang +4

Objective digital measures of depression severity could complement conventional symptom assessments and facilitate more timely clinical evaluation. Here, we investigated whether task-evoked eye movements provide interpretable behavioral markers of depression severity in adolescents and young adults. In this single-center, cross-sectional study, 155 participants aged 14--20 years completed emotional-spatial free-viewing and memory-guided recall tasks and were stratified by 17-item Hamilton Depression Rating Scale scores. We examined 19 prespecified eye-movement features across six task-informed domains using covariate-adjusted ordinal-trend models. Greater depression severity was associated with lower gaze-allocation entropy (standardized $β=-0.599$), fewer inter-area switches ($β=-0.526$), longer first target-entry latency ($β=0.572$), and lower target dwell proportion ($β=-0.678$; all false-discovery-rate-adjusted $q<0.001$). Emotion-specific attentional-bias measures were not associated with severity, whereas associations involving fixation dispersion weakened after adjustment for anxiety symptoms. In a complementary machine-learning analysis incorporating 44 candidate…