Patients with diabetes are at increased risk of comorbid depression or anxiety, complicating their management. This study evaluated the performance of large language models (LLMs) in detecting these symptoms from secure patient messages. We applied multiple approaches, including engineered prompts, systemic persona, temperature adjustments, and zero-shot and few-shot learning, to identify the best-performing model and enhance performance. Three out of five LLMs demonstrated excellent performance (over 90% of F-1 and accuracy), with Llama 3.1 405B achieving 93% in both F-1 and accuracy using a zero-shot approach. While LLMs showed promise in binary classification and handling complex metrics like Patient Health Questionnaire-4, inconsistencies in challenging cases warrant further real-life assessment. The findings highlight the potential of LLMs to assist in timely screening and referrals, providing valuable empirical knowledge for real-world triage systems that could improve mental health care for patients with chronic diseases.

Mental health remains a critical global challenge, with increasing demand for accessible, effective interventions. Large language models (LLMs) offer promising solutions in psychotherapy by enhancing the assessment, diagnosis, and treatment of mental health conditions through dynamic, context-aware interactions. This survey provides a comprehensive overview of the current landscape of LLM applications in psychotherapy, highlighting the roles of LLMs in symptom detection, severity estimation, cognitive assessment, and therapeutic interventions. We present a novel conceptual taxonomy to organize the psychotherapy process into three core components: assessment, diagnosis, and treatment, and examine the challenges and advancements in each area. The survey also addresses key research gaps, including linguistic biases, limited disorder coverage, and underrepresented therapeutic models. Finally, we discuss future directions to integrate LLMs into a holistic, end-to-end psychotherapy framework, addressing the evolving nature of mental health conditions and fostering more inclusive, personalized care.