A multisource clinical deep learning model for early identification of mental disorders in first-visit psychiatric patients

Introduction Mental disorders often present with overlapping symptoms at the first psychiatric visit, making early identification difficult. This study included 5802 first-visit psychiatric patients and developed a TUCH-FT for multi-label classification of mental disorders using demographic information, clinical history, and item-level Symptom Checklist-90 data. Final diagnostic labels were determined through longitudinal follow-up, treatment response, and psychiatric expert evaluation. The original FT-Transformer places heterogeneous clinical variables in a single sequence, which may weaken source-specific structures, inadequately represent unclear clinical histories, and fail to model directional cross-source interactions and hierarchical comorbidity relationships. Methods To overcome these limitations, this study proposes a three-branch clinical feature encoding method, an uncertainty-aware embedding method, a cross-group multi-head attention fusion mechanism, and a hierarchical multi-label classification method to address the challenges of heterogeneous clinical information, ambiguous clinical histories, the interaction of information from multiple sources, and the modelling of comorbidity relationships. Results TUCH-FT achieved a Macro-F1 of 0.803, Micro-F1 of 0.842, Macro-average precision of 0.838, Hamming loss of 0.095, and label ranking average precision of 0.876. In a temporally separated, same-centre validation cohort of 1, 272 patients, TUCH-FT demonstrated good calibration performance, with the lowest Brier score observed for psychotic disorders (0.072) and the highest for anxiety disorders (0.134), while expected calibration errors ranged from 0.031 to 0.067. Discussion Although the exact-match accuracy for complete diagnostic combinations was 60.8%, indicating some limitations in predicting co-occurring disorders, TUCH-FT may still provide a useful reference for differential assessment among first-visit psychiatric patients presenting with mood-related symptoms.