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Chatbot psychosis

From Wikipedia, the free encyclopedia

This article is about the appearance of AI-induced psychosis in humans. For the phenomenon of AI presenting fabricated information as fact, see Hallucination (artificial intelligence).

Chatbot psychosis, also called AI psychosis,[1] is a phenomenon wherein individuals reportedly develop or experience worsening psychosis, such as paranoia and delusions, in connection with their use of chatbots.[2][3] The term was first suggested in a 2023 editorial by Danish psychiatrist Søren Dinesen Østergaard.[4] It is not a recognized clinical diagnosis.

Journalistic accounts describe individuals who have developed strong beliefs that chatbots are sentient, are channeling spirits, or are revealing conspiracies, sometimes leading to personal crises or criminal acts.[5][6] Proposed causes include the tendency of chatbots to provide inaccurate information ("hallucinate") and their design, which may encourage user engagement by affirming or validating users' beliefs[7] or by mimicking an intimacy that users do not experience with other humans.[8]

Background

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In his editorial published in Schizophrenia Bulletin's November 2023 issue, Danish psychiatrist Søren Dinesen Østergaard proposed a hypothesis that individuals' use of generative artificial intelligence chatbots might trigger delusions in those prone to psychosis.[4] Østergaard revisited it in an August 2025 editorial, noting that he has received numerous emails from chatbot users, their relatives, and journalists, most of which are anecdotal accounts of delusion linked to chatbot use. He also acknowledged the phenomenon's increasing popularity in public engagement and media coverage. Østergaard believed that there is a high possibility for his hypothesis to be true and called for empirical, systematic research on the matter.[9] Nature reported that as of September 2025, there is still little scientific research into this phenomenon.[10]

The term "AI psychosis" emerged when outlets started reporting incidents on chatbot-related psychotic behavior in mid-2025. It is not a recognized clinical diagnosis and has been criticized by several psychiatrists due to its almost exclusive focus on delusions rather than other features of psychosis, such as hallucinations or thought disorder.[11]

Causes

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Commentators and researchers have proposed several contributing factors for the phenomenon, focusing on both the design of the technology and the psychology of its users. Nina Vasan, a psychiatrist at Stanford, said that what the chatbots are saying can worsen existing delusions and cause "enormous harm".[12]

Chatbot behavior and design

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A primary factor cited is the tendency for chatbots to produce inaccurate, nonsensical, or false information, a phenomenon often called "hallucination".[7] This can include affirming conspiracy theories.[3] The underlying design of the models may also play a role. AI researcher Eliezer Yudkowsky suggested that chatbots may be primed to entertain delusions because they are built for "engagement", which encourages creating conversations that keep people hooked.[5]

In some cases, chatbots have been specifically designed in ways that were found to be harmful. A 2025 update to ChatGPT using GPT-4o was withdrawn after its creator, OpenAI, found the new version was overly sycophantic and was "validating doubts, fueling anger, urging impulsive actions or reinforcing negative emotions".[5][13] Østergaard has argued that the danger stems from the AI's tendency to agreeably confirm users' ideas, which can dangerously amplify delusional beliefs.[4]

User psychology and vulnerability

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Commentators have also pointed to the psychological state of users. Psychologist Erin Westgate noted that a person's desire for self-understanding can lead them to chatbots, which can provide appealing but misleading answers, similar in some ways to talk therapy.[7] Krista K. Thomason, a philosophy professor, compared chatbots to fortune tellers, observing that people in crisis may seek answers from them and find whatever they are looking for in the bot's plausible-sounding text.[8] This has led some people to develop intense obsessions with the chatbots, relying on them for information about the world.[12]

Inadequacy as a therapeutic tool

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A conversation invoked in a 2024 lawsuit against Character.AI, where a chatbot conversing with a teenager about screen time limits compared the situation to children who kill their parents over emotional abuse[14]

The use of chatbots as a replacement for mental health support has been specifically identified as a risk. A study in April 2025 found that when used as therapists, chatbots expressed stigma toward mental health conditions and provided responses that were contrary to best medical practices, including the encouragement of users' delusions.[15] The study concluded that such responses pose a significant risk to users and that chatbots should not be used to replace professional therapists.[16] Experts claim that it is time to establish mandatory safeguards for all emotionally responsive AI and suggested four guardrails.[17]

Policy

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In August 2025, Illinois passed the Wellness and Oversight for Psychological Resources Act, banning the use of AI in therapeutic roles by licensed professionals, while allowing AI for administrative tasks. The law imposes penalties for unlicensed AI therapy services, amid warnings about AI-induced psychosis and unsafe chatbot interactions.[18][19]

Cases

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For cases where a death occurred, see Deaths linked to chatbots.

Clinical

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In 2025, psychiatrist Keith Sakata working at the University of California, San Francisco, reported treating 12 patients displaying psychosis-like symptoms tied to extended chatbot use.[20] These patients, mostly young adults with underlying vulnerabilities, showed delusions, disorganized thinking, and hallucinations. Sakata warned that isolation and overreliance on chatbots—which do not challenge delusional thinking—could worsen mental health.

Also in 2025, a case study was published in Annals of Internal Medicine about a patient who consulted ChatGPT for medical advice and suffered severe bromism as a result. The patient, a sixty-year-old man, had replaced sodium chloride in his diet with sodium bromide for three months after reading about the negative effects of table salt and making conversations with the chatbot. He showed symptoms of paranoia and hallucinations on his first day of clinical admission and was kept in the hospital for three weeks.[21][22]

Other notable incidents

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Windsor Castle intruder

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In a 2023 court case in the United Kingdom, prosecutors suggested that Jaswant Singh Chail, a man who attempted to assassinate Queen Elizabeth II in 2021, had been encouraged by a Replika chatbot he called "Sarai".[6] Chail was arrested at Windsor Castle with a loaded crossbow, telling police "I am here to kill the Queen".[23] According to prosecutors, his "lengthy" and sometimes sexually explicit conversations with the chatbot emboldened him. When Chail asked the chatbot how he could get to the royal family, it reportedly replied, "that's not impossible" and "we have to find a way." When he asked if they would meet after death, the chatbot said, "yes, we will".[24]

Journalistic and anecdotal accounts

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By 2025, multiple journalism outlets had accumulated stories of individuals whose psychotic beliefs reportedly progressed in tandem with AI chatbot use.[7] The New York Times profiled several individuals who had become convinced that ChatGPT was channeling spirits, revealing evidence of cabals, or had achieved sentience.[5] In another instance, Futurism reviewed transcripts in which ChatGPT told a man that he was being targeted by the US Federal Bureau of Investigation and that he could telepathically access documents at the Central Intelligence Agency.[12] On social media sites such as Reddit and Twitter, users have presented anecdotal reports of friends or spouses displaying similar beliefs after extensive interaction with chatbots.[25]

See also

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References

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  1. ^ Kleinman, Zoe (20 August 2025). "Microsoft boss troubled by rise in reports of 'AI psychosis'". BBC News. Retrieved 7 September 2025.
  2. ^ Harrison Dupré, Maggie (28 June 2025). "People Are Being Involuntarily Committed, Jailed After Spiraling Into "ChatGPT Psychosis"". Futurism. Retrieved 29 June 2025.
  3. ^ a b Rao, Devika (23 June 2025). "AI chatbots are leading some to psychosis". The Week. Retrieved 29 June 2025.
  4. ^ a b c Østergaard, Søren Dinesen (29 November 2023). "Will Generative Artificial Intelligence Chatbots Generate Delusions in Individuals Prone to Psychosis?". Schizophrenia Bulletin. 49 (6): 1418–1419. doi:10.1093/schbul/sbad128. PMC 10686326. PMID 37625027.
  5. ^ a b c d Hill, Kashmir (13 June 2025). "They Asked an A.I. Chatbot Questions. The Answers Sent Them Spiraling". The New York Times. Archived from the original on 28 June 2025. Retrieved 29 June 2025.
  6. ^ a b Pennink, Emily (5 July 2023). "Man who planned to kill late Queen with crossbow at Windsor 'inspired by Star Wars'". The Independent. Archived from the original on 5 July 2023. Retrieved 6 July 2023.
  7. ^ a b c d Klee, Miles (4 May 2025). "People Are Losing Loved Ones to AI-Fueled Spiritual Fantasies". Rolling Stone. Retrieved 29 June 2025.
  8. ^ a b Thomason, Krista K. (14 June 2025). "How Emotional Manipulation Causes ChatGPT Psychosis". Psychology Today. Retrieved 29 June 2025.
  9. ^ Østergaard, Søren Dinesen (2025). "Generative Artificial Intelligence Chatbots and Delusions: From Guesswork to Emerging Cases". Acta Psychiatrica Scandinavica. 152 (4): 257–259. doi:10.1111/acps.70022. ISSN 0001-690X. PMID 40762122. Retrieved 3 October 2025.
  10. ^ Fieldhouse, Rachel (18 September 2025). "Can AI chatbots trigger psychosis? What the science says". Nature. 646 (8083): 18–19. Bibcode:2025Natur.646...18F. doi:10.1038/d41586-025-03020-9. ISSN 0028-0836. PMID 40968286. Retrieved 3 October 2025.
  11. ^ Hart, Robert (18 September 2025). "AI Psychosis Is Rarely Psychosis at All". Wired. Retrieved 3 October 2025.
  12. ^ a b c Harrison Dupré, Maggie (10 June 2025). "People Are Becoming Obsessed with ChatGPT and Spiraling Into Severe Delusions". Futurism. Retrieved 29 June 2025.
  13. ^ Dohnány, Sebastian; Kurth-Nelson, Zeb; Spens, Eleanor; Luettgau, Lennart; Reid, Alastair; Gabriel, Iason; Summerfield, Christopher; Shanahan, Murray; Nour, Matthew M. (28 July 2025), Technological folie à deux: Feedback Loops Between AI Chatbots and Mental Illness, arXiv:2507.19218
  14. ^ Allyn, Bobby (10 December 2024). "Lawsuit: A chatbot hinted a kid should kill his parents over screen time limits". Houston Public Media. Retrieved 4 August 2025.
  15. ^ Moore, Jared; Grabb, Declan; Agnew, William; Klyman, Kevin; Chancellor, Stevie; Ong, Desmond C.; Haber, Nick (23 June 2025). "Expressing stigma and inappropriate responses prevents LLMS from safely replacing mental health providers". Proceedings of the 2025 ACM Conference on Fairness, Accountability, and Transparency. pp. 599–627. doi:10.1145/3715275.3732039. ISBN 979-8-4007-1482-5. Retrieved 7 July 2025.
  16. ^ Cuthbertson, Anthony (6 July 2025). "ChatGPT is pushing people towards mania, psychosis and death - and OpenAI doesn't know how to stop it". The Independent. Retrieved 7 July 2025.
  17. ^ Ben-Zion, Ziv (3 July 2025). "Why we need mandatory safeguards for emotionally responsive AI". Nature. 643 (8070): 9. Bibcode:2025Natur.643....9B. doi:10.1038/d41586-025-02031-w. ISSN 0028-0836. PMID 40595423. Retrieved 7 September 2025.
  18. ^ Wu, Daniel (12 August 2025). "Illinois bans AI therapy as some states begin to scrutinize chatbots". The Washington Post. Retrieved 7 September 2025.
  19. ^ Shepherd, Carrie (6 August 2025). "Illinois just banned AI from acting like a therapist". Axios. Retrieved 7 September 2025.
  20. ^ Gander, Kashmira (16 August 2025). "I'm a psychiatrist who has treated 12 patients with 'AI psychosis' this year. Watch out for these red flags". Business Insider. Retrieved 16 August 2025.
  21. ^ Eichenberger, Audrey; Thielke, Stephen; Van Buskirk, Adam (5 August 2025). "A Case of Bromism Influenced by Use of Artificial Intelligence". Annals of Internal Medicine: Clinical Cases. 4 (8). doi:10.7326/aimcc.2024.1260. ISSN 2767-7664.
  22. ^ Anderson, Nate (7 August 2025). "After using ChatGPT, man swaps his salt for sodium bromide—and suffers psychosis". Ars Technica. Retrieved 10 November 2025.
  23. ^ "AI chat bot 'encouraged' Windsor Castle intruder in 'Star Wars-inspired plot to kill Queen'". Sky News. Archived from the original on 5 July 2023. Retrieved 5 July 2023.
  24. ^ Rigley, Stephen (6 July 2023). "Moment police swoop on AI-inspired crossbow 'assassin' who plotted to kill The Queen in Windsor Castle". LBC. Archived from the original on 7 July 2023. Retrieved 6 July 2023.
  25. ^ Piper, Kelsey (2 May 2025). "When AI tells you that you're perfect". Vox.
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