Physical and Engineering Sciences in Medicine

https://doi.org/10.1007/s13246-020-00938-4

SCIENTIFIC PAPER

EEG‑based deep learning model for the automatic detection of clinical

depression
Pristy Paul Thoduparambil1 · Anna Dominic1 · Surekha Mariam Varghese1

Received: 13 May 2020 / Accepted: 10 October 2020

© Australasian College of Physical Scientists and Engineers in Medicine 2020

Abstract
Clinical depression is a neurological disorder that can be identified by analyzing the Electroencephalography (EEG) signals.
However, the major drawback in using EEG to accurately identify depression is the complexity and variation that exist in
the EEG of a depressed individual. There are several strategies for automated depression diagnosis, but they all have flaws,
which make the diagnostic task inaccurate. In this paper, a deep model is designed in which an integration of Convolution
Neural Network (CNN) and Long Short Term Memory (LSTM) is implemented for the detection of depression. CNN and
LSTM are used to learn the local characteristics and the EEG signal sequence, respectively. In the deep learning model, filters
in the convolution layer are convolved with the input signal to generate feature maps. All the extracted features are given to
the LSTM for it to learn the different patterns in the signal, after which the classification is performed using fully connected
layers. LSTM has memory cells to remember the essential features for a long time. It also has different functions to update
the weights during training. Testing of the model was done by random splitting technique and obtained 99.07% and 98.84%
accuracies for the right and left hemispheres EEG signals, respectively.

Keywords  CD · EEG · CNN · LSTM

Introduction comparatively hypoactive Left Hemisphere (LH). Negative

Clinical depression (CD) or simply depression, is one of the
most common psychological conditions that has an adverse
impact on many lives [1]. Feeling of sadness, guilt, loss of
interest, difficulty in concentrating, trouble in making deci-
sions, sleep disturbances are some of the main symptoms
of clinical depression. Such conditions may also become
chronic, which in turn might hinder a person from carrying
out everyday responsibilities. This can lead to various dis-
turbing thoughts and self-harm attempts in the worst cases
[2]. It can affect any individual, regardless of age and social
position [3].
The three levels of depression are mild, medium, and
extreme, depending upon the severity of the symptoms [2].
Depression is attributed primarily to the inter-hemisphere
imbalance, a hyper-active Right Hemisphere (RH), and a
* Pristy Paul Thoduparambil
pristypault@gmail.com
1
Department of Computer Science and Engineering, Mar
Athanasius College of Engineering, Kothamangalam,
Kerala, India
thinking and depression are related to more prominent acti-
vation within the frontal area of the RH. The intensity of
depression is completely associated with the hyperactivity
of RH [4].
Studies indicate that women are the foremost victims
of depression [5]. To help depressed individuals return to
a healthy life, early identification of depression is neces-
sary. Clinicians recommend a reliable and early diagnosis
to increase the chances of successful recovery. Additionally,
early diagnosis can aid throughout the recovery period and
further enhance the quality of life for patients.
A person’s neurological condition is embodied within the
brain’s electrical activity. Electroencephalography (EEG) is
a diagnostic examination that can be administered to assess
the electrical activity of the brain over a certain unspeci-
fied period and is helpful in diagnosing various neurological
conditions such as depression or epilepsy. EEG recording is
a simple process and is achieved by positioning metal elec-
trodes on the scalp at different positions, which measures the
tiny electrical potentials that occur on the head as a result
of neuronal brain behaviour. Compared to other brain imag-
ing methods, this has an extremely high time resolution to

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monitor the millisecond precision of events inside the brain
[6]. Thus, depression can be diagnosed by comparing the
EEG of the left and right hemispheres of the brain.
A sample EEG signal in the time domain and frequency
domain is shown in Figs. 1 and 2, respectively. The EEG
signal is primarily divided into four frequency bands like:
delta (< 4 Hz), theta (4–8 Hz), alpha (8–15 Hz) and beta
(> 15 Hz) as seen in Fig. 2
– Delta This band has a frequency of 4 Hz or less, which
can be observed in babies and adults when they are
Fig. 1  Sample EEG signal in time domain
Fig. 2  EEG signal in frequency domain
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Physical and Engineering Sciences in Medicine
asleep. It appears to be the most amplitudinal and the
slowest waves. This is normal as the dominant pattern in
children up to 1 year and in sleep stages 3 and 4.
– Theta This band has a frequency of 4 to 8 Hz and is
labelled as a slow activity. It is detected in children and
adults when asleep. It is normal in children up to the age
of 13 years and in sleep, but it is considered abnormal
in the case of awake adults. This can be seen in diffuse
abnormalities like metabolic encephalopathy or some
instances of hydrocephalus.
Physical and Engineering Sciences in Medicine
– Alpha This band has a frequency of 8 to 15 Hz. It is typi-
cally better seen on either side in the posterior areas of
the brain. It is observed when the eyes are shut, relaxed,
and fades when the eyes are open or when one thinks,
calculates, etc. This is a typical pattern seen in relaxed
adults and occurs the most during a lifetime, particularly
after the age of thirteen.
– Beta This band has a frequency greater than 15 Hz and
is labelled as a fast activity. This is observable across the
parietal lobes and frontal lobes. In the regions of cortical
injury, it may be missing or with a decreased intensity. It
is found to be dominant pattern for adults with high alert-
ness, nervous behaviour or have their eyes wide open. It
is commonly called natural rhythm [7].
EEG is non-linear and non-stationary in nature [8]. Manu-
ally reading and understanding EEG signals is time consum-
ing, tedious, and troublesome; significantly with the large
quantity of EEG information that must be studied [9]. Due
to this, many EEG analysis packages have been developed
for computerized abnormality detection. Subha et al. [10]
used an eight-level multiresolution decomposition method
of discrete wavelet transformation for classifying the EEG
frequency band into approximation stages. Using the tech-
nique of total variation filtering, the high-frequency noise
components in the EEG were eliminated. Relative wavelet
energy and entropy characteristics of each stage were meas-
ured and provided to the Artificial Neural Network (ANN)
as input for identifying normal and depressed subjects. Hos-
seinifard et al. [11] concentrated on the classification of the
depressed and normal subjects by nonlinear EEG signal
analysis. The four non-linear characteristics extracted from
the signal were detrended fluctuation analysis (DFA), cor-
relation dimension, Higuchi fractal, and Lyapunov exponent.
The most appropriate characteristics were selected using a
genetic algorithm. K-nearest neighbour, linear discriminant
analysis, and logistic regression were used for classification,
and logistic regression classifier was found to be better with
90% accuracy.
Faust et al. [12] used the wavelet packet decomposition
method and nonlinear algorithms together for the classifica-
tion purpose. Non-linear measures were used for the pro-
cessing of EEG frequency bands retrieved by decomposition,
and only the selected features by t-test [13] were provided
to different classifiers. Probabilistic Neural Network (PNN)
showed better performance than the other classifiers. Acha-
rya et al. [14] has investigated several other non-linear fea-
tures: fractal dimension, largest Lyapunov exponent, sample
entropy, DFA, Hurst’s exponent, higher-order spectra, and
recurrence quantification analysis. After calculating the
t-value [15], all the extracted features were ranked accord-
ing to their importance and given to five separate classifiers:
Support Vector Machine (SVM), k-nearest neighbour, Naive
Bayes, PNN, and decision tree. With 98% precision, SVM
achieved better classification. Besides, they suggested an
index for the diagnosis of depression by incorporating above
features. ANN are mathematical models inspired explicitly
by biological neural networks and can learn various patterns
and make predictions [16]. Many studies [17–19] used clas-
sifiers based on ANN for the automatic detection of pancre-
atic cancer, depression, and epilepsy, respectively.
In all traditional machine learning approaches [10–12,
14, 17–19], it is required to extract relevant features through
some non-linear inspection, and then apply a machine learn-
ing categorization algorithm like SVM, PNN, Enhanced
PNN or ANN. Typically, features are selected for accurate
results by performing trial and error, but this can be time
consuming. There is also a possibility that significant fea-
tures get omitted, and insignificant features get extracted.
All this makes the classification a complex activity and these
methods are rarely used in medical practice due to its low
precision, sensitivity, and inaccuracy.
Recently, deep learning has become more popular in the
medical field for accurate and automatic decision making.
Deep learning, a subfield of ANN, is a learning mechanism
that lets computers automatically learn from examples and
make recognitions/predictions that imitate the way humans
do it. It often achieves greater accuracy and captures high
priority in areas such as medical diagnosis, recognition of
images, prediction making, recognition of speech, and so
on [9].
In recent years, Convolutional Neural Network (CNN)
is found to be a significant and robust methodology in deep
learning. It has achieved considerable success in computer
vision and has recently become widely used in biomedical
signal and image processing tasks [20]. Moreover, various
researchers focused on developing a computer-aided diag-
nosis system using CNN in the medical field. Acharya et al.
[21] constructed a CNN model with an average accuracy
of 88.7%, for extracting EEG features and classifying the
signal as normal, preictal, and seizure. Yildirim et al. [22]
proposed a one-dimensional CNN to classify normal and
abnormal EEG signals automatically and obtained a 20.66%
percent classification error. Recently, Anna et al. [9] and
Acharya et al. [23] developed CNN models with 11 and 13
layers, respectively, for identifying patients having depres-
sion using the EEG signal. Yildirim et al. [24] developed a
one-dimensional CNN based model with a 91.33% accuracy
to efficiently distinguish cardiac arrhythmia from long-term
ECG signal segments. Aswathy et al. [25] conducted a com-
parative analysis of the performance of three different neural
networks: feed-forward neural network, block-based neural
network, and CNN in the diagnosis of Alzheimer’s disease,
from which CNN was observed to be the best classifier.
Another type of deep learning algorithm that was pro-
posed by German researchers Hochreiter and Schmidhuber
13

in 1997 is Long Short Term Memory (LSTM) [26]. It is
widely used for analyzing time-series data [27] and is the
primary technique used in the processing of natural lan-
guages, image identification, speech recognition [28]. It is
the evolution over the Recurrent Neural Network (RNN) to
deal with the vanishing gradient problem in the traditional
one. The LSTM units are connected in such a way that infor-
mation cycles through the loop and enables the network to
learn about the temporal dynamics present in the data. It
has the capability to retain the important/relevant informa-
tion and removing/ignoring the irrelevant ones [27]. For
the prediction of seizure, Petrosian et al. [29] used RNN to
extract features from wavelet decomposed sub-bands of the
EEG time series data. In another analysis [30], the wave-
let sequences based on deep bidirectional LSTM was used
for grouping ECG signals into various categories. Tsiouris
et al. [31] used LSTM for the prediction of epileptic seizures
using both time and frequency domain features extracted
from the EEG signal.
Oh et al. [27] proposed a system that automatically diag-
nosis arrhythmia from noisy ECG signals by integrating
LSTM with CNN. Supratak et al. [32] implemented a model
called DeepSleepNet combining CNN and bidirectional
LSTM for the automatic classification of stages in the sleep
cycle. Swapna et al. [33] presented an automated diabetes
detection system with 95.1% accuracy using a CNN-LSTM
framework and cardiac signals. For the prediction of mortal-
ity in the ICU, Mohammad [34] used a CNN-LSTM model.
Shahzadi et al. [35] implemented a categorization model for
3D brain tumor MR images by cascading CNN with LSTM.
Shahbazi et al. [36] presented a CNN and LSTM integrated
network that uses multichannel EEG for predicting epileptic
seizures with 98.21% sensitivity. Wahyuningrum et al. [37]
developed a new method using the CNN-LSTM method for
classifying knee osteoarthritis seriousness from radiographic
Fig. 3  Automatic depression
detection system using EEG
signal
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images. Jianfeng et al. [38] used two networks, one using
one dimensional CNN and LSTM and another with two
dimensional CNN and LSTM, to know the local and global
emotion associated characteristics from speech. Both mod-
els achieved excellence on the task of understanding speech
emotion, particularly the two-dimensional CNN-LSTM
framework that outperforms conventional methods with
95.89% accuracy.
Most of the current depression diagnosis studies have
generally been based on the extraction of hand-crafted fea-
tures accompanied by a shallow classifier that is trained on
these selected features. This study aims to develop a fully
automatic system for depression detection without the need
for extraction and selection of features, thereby eliminating
all obstacles for achieving the best accuracy in the classifica-
tion. CNN-LSTM, a combined model, is considered in this
study to automatically extract local characteristics and learn
the long-term relations embedded in the EEG data.
Method and materials
The different modules in the CNN-LSTM combined auto-
matic diagnostic system are signal preprocessing, local fea-
ture extraction, sequence learning, and classification.
Figure 3 shows the overall architecture of the automatic
depression diagnostic system.
EEG dataset
The EEG signals were obtained from “PATIENT REPOSI-
TORY FOR EEG DATA + COMPUTATIONAL TOOLS”
(University of New Mexico) [39]. The collected data-
set includes EEG recordings captured using 64Ag/AgCl
Physical and Engineering Sciences in Medicine
electrodes with the help of Synamps2 system voltage from
the scalp of the brain (500 Hz sampling rate, band pass filter
0.5–100, impedance less than 10 kΩ).
Preprocessing
For EEG data, preprocessing is vital to transform the raw
signal into a format similar to the original neural signal,
making it appropriate for further processing. Due to the lack
of spatial information, the signal received from the scalp
may not be the same as the signal from the brain. Various
artifacts such as muscle movement or eye blinking may cor-
rupt the data resulting in distorted signals. Furthermore,
the signal can contain unwanted noises. All of these are
impediments to getting the correct result after EEG analy-
sis. Finally, the relevant signals need to be separated from
randomly occurring neural activity in EEG recordings.
Bad channels that can tamper the accuracy of data may
be present in the EEG data. Inappropriate placing of elec-
trode or loosing contact with the scalp, bridging of multiple
channels as well as over saturation of electrode in case of
using wet electrodes can lead to bad channel [9]. It is nec-
essary to eliminate these in the early stages since they can
have adverse effects on further procedures and analysis. In
the collected EEG data, bad channels and eye blinks were
already identified and removed using the FASTER algorithm
[40] and independent component analysis.
Before passing the signal to the model, Z-score normali-
zation [27] was applied to eliminate the amplitude scaling
problem and to remove the offset effect in the EEG data,
thereby standardizing the signal.
Feature extraction and sequence learning
From previous work [23], it has been observed that CNN
is highly efficient for automatically extracting time-domain
features but very weak in learning sequential data. In the
case of LSTM, it is widely used for learning long-term
dependencies in a time-series signal [27]. It is essential to
make both temporal and sequential learning for efficiently
and automatically analyzing EEG signals and both the CNN
and LSTM have performed relatively well on EEG signals.
For this reason, a deep learning model that combines CNN
and LSTM was developed for the automatic diagnosis of
depression.
The main layers in ANN are input layer, output layer, and
the hidden layers [9]. Deep learning is completely based
on ANN and has a more significant number of hidden lay-
ers. The performance of the deep learning system is mostly
dependent on the hidden layers in the network. The devel-
oped model can achieve high accuracy by adding more hid-
den layers. However, when the number of hidden layers is
beyond a limit, the model will get over-trained and cause
the accuracy to decrease. Therefore, it is the responsibility
of the developer to decide the appropriate number of layers
in the deep learning model. The maximum number of lay-
ers can only be determined through trial and error. In this
model, the accuracy reached its maximum when the total
layer count was 13 (including the input layer). The perfor-
mance of the system has improved after adding the drop-
out layer. Therefore number of layers was chosen as 13 and
a deep model with 13 layers was developed for automatic
depression detection. The various parameters like the order
and frequency of layers, kernel size, type and frequency of
filter, strides were decided based on previous observations
[9, 21–24, 27, 33–38] and through trial and error. Architec-
ture of the model, detailing the different layers is depicted
in Fig. 4 and the detailed overview of each layer is specified
in Table 1.
Layer 0, the input layer, accepts the preprocessed EEG
signal. Layers 1 to 6 together forms the local feature extrac-
tion module consisting of mainly convolution and pool-
ing processes. Convolution is principally performed to get
the local characteristics of the input EEG signal [23]. The
convolution operation is performed by moving kernel one
at a time across the input vector and summing up product
of input and kernel value falling at the same place. This is
repeated until the kernel hits the right bottom corner of the
input vector. The output of the convolution process is the
feature map obtained per kernel. The equation of the convo-
lution operation [23] is given below.
∑N−1
cr = fx
n=0 n r−n
(1)
where x denotes the input EEG signal to the system, f is
the filter (also called kernels), c is the output/feature map
obtained as a result, N indicates the number of data ele-
ments in the input signal x. The subscript n and r show the
nth component of the filter and the rth output respectively.
For getting better results, 128, 64 and 32 specific filters with
various filter sizes of 7 × 1, 5 × 1, 3 × 1 respectively are cho-
sen. During the training period, the network itself constantly
adjusts the kernel weights to obtain the correct information
present in the input data.
After each convolution process, one of the several
activation functions is applied; here, the leaky linear unit
rectifier (LeakyRelu) [41] is applied, to improve CNN’s
non-linearity. As shown in the Eq.  (2) [23], the ReLU
function outputs zero for inputs less than zero, and the
number itself for inputs greater than zero.
f (x) = max (0, x) (2)
All the extracted feature maps are given as input to
the next layer, called the pooling layer that functions to
reduce the size of feature maps obtained from the previous
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Fig. 4  Proposed CNN-LSTM
model

Table 1  Various parameters of the proposed deep model convolution layer while retaining the essential features
Layer Type Filter size Other parameters
[23]. Min pooling, average pooling, and max pooling
are the various pooling operations available. Since the
1 Conv1D 128 × 7 Strides = 1, activation = ReLU max pooling function is used in this analysis, after each
2 MaxPooling1D 2 Strides = 2 max pooling operation, only the larger value is preserved
3 Conv1D 64 × 5 Strides = 1, activation = ReLU within the stride 2 windows of the feature map. The addi-
4 MaxPooling1D 2 Strides = 2 tion of max pooling between successive layers of convolu-
5 Conv1D 32 × 3 Strides = 1, activation = ReLU tion reduced the number of parameters and computational
6 MaxPooling1D 2 Strides = 2 overload, thereby controlling the overfitting of the model.
7 LSTM – Unit Size = 32, return In order to extract the complete features of a large, com-
sequences = true
plex, continuous, non-linear EEG signal, it is necessary to
8 LSTM – Unit size = 32, return
consider the patterns in the previous time domain in addition
sequences = true
to the current patterns. Therefore, the sequence learning,
9 Flatten – –
which aims at modelling short and long-term memory is
10 Dense – Unit size = 10, activation = ReLU
required for correctly identifying the disorder, and this is
11 Dropout – rate = 0.2
possible through some deep learning methods. From the pre-
12 Dense – Unit size = 2, activation = Soft-
Max vious study [29], RNN was used for the learning of the EEG

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signal by exploiting its short-term memory capacity. How-
ever, it was found to be unsuccessful in long-term memory
due to the issue of vanishing gradient [42] that appears dur-
ing back-propagation while training the ANN. This prevents
the correct learning of previous layers in the network during
training. It can be overcome through deciding and storing
important information over a long period and this is possible
through LSTM, a type of RNN.
In the developed model, Layers 7 and 8 are the series
of LSTM with 32 units for finding various patterns in the
signal from the feature maps produced by the CNN part.
This facilitates learning the long-term dependencies in the
signal. The stacked LSTM enables the learning of complex
information in the time series signal, thereby increasing the
accuracy in prediction. The LSTM architecture, as shown in
Fig. 5 consists of a memory cell for storing information and
three gates such as input gate, output gate, and forget gate,
which regulates the flow of data into and out of the cell. Four
different functions that are sigmoid, tanh, multiplication, and
addition [26] are present in the LSTM for making the weight
updation easier during the model training.
The flatten layer is introduced in between the LSTM and
the fully connected layer that convert matrix formed feature
into a vector form to be given as input to the fully connected
layer of the deep learning model. The fully connected layer
in layers 10 and 12 does actual classification based on the
output from the last LSTM.
Fig. 5  Overview of LSTM
model
In a fully connected layer, each neuron in one layer is
connected to all the neurons in the next layer. The equation
for it is represented as [23]
∑
xi = w y + bi
j ji j (3)
where w denotes the weight, y is the input to the neuron/
output from the previous neuron, b is the biases, x indicates
the output of the current neuron.
In the last fully connected layer, the softmax activation
function is used to enable the neural network to perform a
multi-class function. Now the network is able to determine
the probability of a particular EEG signal to be that of a
depressed or not.
The dropout layer is included as the 11th layer for pre-
venting the model from overfitting and improving generali-
zation [43]. The dropout technique randomly drops units/
neurons while forward propagating, thereby making the
system learn from a subset of features. This also trains the
system to continue working in situations where any of the
neurons are non-functional.
The network is trained in 17 epochs with a batch size of
64. Adaptive moment estimation (Adam) [44] optimization
algorithm is used to upgrade the various parameters of the
developed network. This lets the network converge at a rapid
pace and thus enhances the training phase performance.
Experiments were done with and without dropout, and the
performance was found to be more accurate in the network
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Fig. 6  Network without dropout
Fig. 7  Network with dropout
Fig. 8  Performance evaluated
by varying number of layers
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with the dropout layer. The last part of the network without
dropout is shown in Fig. 6 (total of 12 layers in the network).
The last part of the network with dropout is shown in
Fig. 7 (final network with a total of 13 layers). Here, some
of the neurons in the fully connected layers are dropped.
This prevents the network from over-training. Through this
dropout mechanism, the network learns to work without
fail, even in the cases where some neuron is not working.
Results
The proposed hybrid model was implemented using
python language with Keras and TensorFlow libraries.
The model was trained, evaluated, and it has achieved
high performance compared to the existing methods. The
performance of the system was determined by considering
correctly and incorrectly recognized EEG signal. To find
out what role the right and left hemispheres play in depres-
sion, EEG samples from both hemispheres were used.
The performance of the system, while varying the total
number of layers in the network, is shown in Fig. 8. The
maximum accuracy has obtained when the total layer
count was 13.
Some of the approaches to evaluate the system’s perfor-
mance are random splitting and tenfold cross-validation.
Random splitting was used here, and it is the method of
splitting the collected data randomly into training, valida-
tion, and testing. The performance measures such as accu-
racy, specificity, sensitivity were found to be the best when
training, validation, and testing data was 80%, 10%, and
10%, respectively, and is shown in Fig. 9.
The model was trained using both the training and vali-
dation data. The performance of the system becomes better
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or worse, depending on training, which is crucial in every
machine learning method. Data that is not used during the
training process is called testing data, and this data is not
familiar to the system. Therefore, this new/unknown data
was used for measuring the overall performance of the sys-
tem. Experiments were performed in 17 epochs, with an
average of 47 s. As shown in Figs. 10 and 11, the model
achieved the following accuracies after training for 17
epochs. Using RH data, it achieved an accuracy of 99.42%
during training and 98.84% during validation. Using the LH
data, it achieved an accuracy of 98.55% during training and
98.61% during validation.
The performance of the system was calculated using an
unused dataset after completing the training. The model
has achieved an accuracy of 99.07% and 98.84% using the
right and left hemisphere data, respectively and is shown
in Table 2.
Discussion
Over the years, several different methods for computer-aided
depression detection have been developed. All these meth-
ods used ANN and other conventional machine learning
classifiers after extracting relevant features by approaches
such as relative wavelet energy [10], signal entropy [10, 12],
non-linear [11, 14]. However, these methods have the over-
head of finding the relevant features from EEG for detecting
depression. Additionally, one needs to select an appropri-
ate method for collecting features. In some cases, there is

Fig. 9  Performance measures of
the model evaluated by chang-
ing training data percent

Fig. 10  Accuracy of the model

using right hemisphere data

13

Fig. 11  Accuracy of the model
using left hemisphere data
a chance of missing important characteristics and includ-
ing irrelevant ones. Thus, such methods are complex, time-
consuming, and requires the developer to be professionally
experienced.
There have been attempts by many researchers to remove
these challenges by developing automatic depression detec-
tion systems. Such systems mainly used CNN [9, 21–25].
These methods of diagnosis lack sequence learning, which
is necessary for learning a signal completely.
In the proposed method, all the essential features are
extracted automatically using CNN, and the sequence
learning is done using LSTM. The benefit of this system is
its high performance in the task of diagnosing depression by
studying both local characteristics and overall EEG signal
patterns. Although this model used only a small set of EEG
signals, it achieved an accuracy of 99.07% using the right
hemisphere data and 98.84% from the left hemisphere. From
the results, it is evident that the right hemisphere shows high
performance compared to the left hemisphere.
Negative emotions, bad moods, and depression were
correlated with comparatively higher activity in the frontal
cortex of RH than in the homotopic area of the LH [4]. In
depressive patients, hypometabolism and hypermetabolism
characterize LH and RH, respectively. Depression rate is
positively related to RH higher activity. Because of this,
the accuracy of RH is more than LH’s accuracy during the
diagnosis of depression using EEG. Hence, the EEG of RH
Table 2  Performance measures using test data
Accuracy (%) Sensitivity (%) Specificity (%)
Right 99.07 99.5 98.6
Left 98.84 98.61 99.06
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is more significant in the diagnosis of clinical depression
than that of LH.
In future this can be extended using more subjects. This
developed method can be implemented in clinics as a diag-
nostic tool.
Conclusions
The diagnosis of depression in its early stages is critical for
reducing its risks with proper care and anti-depression treat-
ments. An automated system will help to diagnose depres-
sion regardless of the knowledge level and experience of
neurologists. EEG can be used effectively for detecting CD.
The developed EEG based automatic system that combines
CNN and LSTM makes the detection more accurate by
learning both local characteristics and long dependencies in
the EEG signal. Thus, the system has been proved to be most
efficient for detecting clinical depression. This method can
be used effectively in clinical sites by providing sufficient
data for successful training.
Funding None.
Compliance with ethical standards 
Conflict of interest  The authors declare that they have no conflict of
interest.
Informed consent  Data used in this research is taken from the database
made available under the Public Domian Dedication and License v1.0,
as part of a Brain Initiative Seed Award supported by the University of
New Mexico. All participants provided written informed consent that
was approved by the University of Arizona.
Physical and Engineering Sciences in Medicine
Research involving human and animals participants  This paper does
not contain any studies with human participants or animals performed
by any of the authors.
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