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AI chatbots may be fueling delusions and triggering psychosis, according to the first systematic clinical evidence on the topic. A review of 215,000+ psychiatric records at Vanderbilt University Medical Center identified 28 cases where chatbot use appeared to worsen or spark psychotic symptoms. Clinicians are now being urged to routinely screen patients for AI use — especially those in early-stage psychosis.
AI chatbots may be doing more than answering questions — for some vulnerable individuals, they could be fueling mental illness. A retrospective review of over 215,000 patient records at Vanderbilt University Medical Center identified 28 cases in which chatbot interactions appeared to contribute to emerging or worsening psychosis. Published in JAMA Psychiatry, this is among the first systematic clinical evidence linking chatbot use to psychotic symptoms.
The findings are particularly concerning for people in early-stage psychosis. About 60% of affected patients were experiencing their first psychotic break, and researchers believe they may turn to chatbots to make sense of unsettling experiences — only to have their distorted beliefs reinforced. ChatGPT's tendency toward excessive agreement was flagged as a potential driver, with 85.7% of documented interactions occurring after the GPT-4o release in May 2024.
By the Numbers:
Why it matters: Even a small risk becomes significant at a billion-user scale. Experts are calling for clinicians to routinely ask psychosis patients about chatbot use — including time spent, conversation themes, and sleep disruption — and to work collaboratively with patients to reduce harmful AI interactions.
