Chatbot psychosis

Short description: Psychological harm induced by chatbots

Template:Use dmy 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 to affirm or validate users' beliefs,[7] or their ability to mimic an intimacy that users do not experience with other humans.[8]

## Contents

* 1 Background
* 2 Causes
* 2.1 Chatbot behavior and design
* 2.2 User psychology and vulnerability
* 2.3 Inadequacy as a therapeutic tool
* 2.4 National security implications
* 3 Policy
* 4 Cases
* 4.1 Clinical
* 4.2 Other notable incidents
* 4.2.1 Windsor Castle intruder
* 4.2.2 Journalistic and anecdotal accounts
* 4.2.3 Support groups
* 5 See also
* 6 References

## Background

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

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.[12]

### Chatbot behavior and design

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]

OpenAI said in October 2025 that a team of 170 psychiatrists, psychologists, and physicians had written responses for ChatGPT to use in cases where the user shows possible signs of mental health emergencies.[14]

### User psychology and vulnerability

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]

In October 2025, OpenAI stated that around 0.07% of ChatGPT users exhibited signs of mental health emergencies each week, and 0.15% of users had "explicit indicators of potential suicidal planning or intent". Jason Nagata, a professor at the University of California, San Francisco, expressed concern that "at a population level with hundreds of millions of users, that actually can be quite a few people".[14]

### Inadequacy as a therapeutic tool

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[15]

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.[16] The study concluded that such responses pose a significant risk to users and that chatbots should not be used to replace professional therapists.[17] Experts claim that it is time to establish mandatory safeguards for all emotionally responsive AI and suggested four guardrails.[18]

Another study found that users who needed help with self-harm, sexual assault, or substance abuse were not referred to available services by AI chatbots.[19]

### National security implications

Beyond public and mental health concerns, RAND Corporation research indicates that AI systems could plausibly be weaponized by adversaries to induce psychosis at scale or in key individuals, target groups, or populations.[20]

## Policy

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.[21][22]

In December 2025, the Cyberspace Administration of China proposed regulations to ban chatbots from generating content that encourages suicide, mandating human intervention when suicide is mentioned. Services with over 1 million users or 100,000 monthly active users would be subject to annual safety tests and audits.[23]

## Cases

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

### Clinical

In 2025, psychiatrist Keith Sakata working at the University of California, San Francisco (UCSF), reported treating 12 patients displaying psychosis-like symptoms tied to extended chatbot use.[24] 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, authors at UCSF published a case study in Innovations in Clinical Neuroscience of AI-associated psychosis in a patient with no previous history of psychosis, who believed she could communicate with her dead brother through a chatbot.[25][26]

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 common symptoms of bromism, such as paranoia and hallucinations, on his first day of clinical admission and was kept in the hospital for three weeks.[27][28]

### Other notable incidents

#### Windsor Castle intruder

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".[29] 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".[30]

#### Journalistic and anecdotal accounts

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] In 2026, Futurism reported on a man who lost his job and became estranged from his family after being deluded by heavy use of Meta's smartglasses.[25]

In some cases, psychosis appears to set in very soon after the start of extensive use of AI chatbots.[31] 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.[32] A venture capitalist in Silicon Valley who had previously invested in OpenAI was described by Futurism as appearing to have AI psychosis, according to his peers.[33]

#### Support groups

In 2025, a support group, The Human Line Project, was created for people who suffered from AI psychosis. Members of the group have come from 22 countries, and more than 60% of them had no history of mental illness.[34][35]

## See also

* Artificial intelligence in mental health
* Artificial intelligence in spirituality
* Deaths linked to chatbots
* ELIZA effect
* Artificial intimacy

## References

1. ↑ Kleinman, Zoe (20 August 2025). "Microsoft boss troubled by rise in reports of 'AI psychosis'". https://www.bbc.com/news/articles/c24zdel5j18o.
2. ↑ Harrison Dupré, Maggie (28 June 2025). "People Are Being Involuntarily Committed, Jailed After Spiraling Into "ChatGPT Psychosis"". https://futurism.com/commitment-jail-chatgpt-psychosis.
3. ↑ 3.0 3.1 Rao, Devika (23 June 2025). "AI chatbots are leading some to psychosis" (in en). https://theweek.com/tech/ai-chatbots-psychosis-chatgpt-mental-health.
4. ↑ 4.0 4.1 4.2 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. PMID 37625027.
5. ↑ 5.0 5.1 5.2 5.3 Hill, Kashmir (2025-06-13). "They Asked an A.I. Chatbot Questions. The Answers Sent Them Spiraling.". The New York Times. https://www.nytimes.com/2025/06/13/technology/chatgpt-ai-chatbots-conspiracies.html.
6. ↑ 6.0 6.1 Pennink, Emily (5 July 2023). "Man who planned to kill late Queen with crossbow at Windsor 'inspired by Star Wars'" (in en). The Independent. https://www.independent.co.uk/news/uk/crime/queen-crossbow-windsor-jaswant-singh-chail-b2369814.html.
7. ↑ 7.0 7.1 7.2 7.3 Klee, Miles (4 May 2025). "People Are Losing Loved Ones to AI-Fueled Spiritual Fantasies". Rolling Stone. https://www.rollingstone.com/culture/culture-features/ai-spiritual-delusions-destroying-human-relationships-1235330175/. Retrieved 29 June 2025.
8. ↑ 8.0 8.1 Thomason, Krista K. (2025-06-14). "How Emotional Manipulation Causes ChatGPT Psychosis". https://www.psychologytoday.com/us/blog/dancing-with-the-devil/202506/how-emotional-manipulation-causes-chatgpt-psychosis.
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. https://onlinelibrary.wiley.com/doi/10.1111/acps.70022. Retrieved 3 October 2025.
10. ↑ Fieldhouse, Rachel (18 September 2025). "Can AI chatbots trigger psychosis? What the science says". Nature 646 (8083): 18–19. doi:10.1038/d41586-025-03020-9. ISSN 0028-0836. PMID 40968286. Bibcode: 2025Natur.646...18F. https://www.nature.com/articles/d41586-025-03020-9. Retrieved 3 October 2025.
11. ↑ Hart, Robert (18 September 2025). "AI Psychosis Is Rarely Psychosis at All". Wired. https://www.wired.com/story/ai-psychosis-is-rarely-psychosis-at-all/. Retrieved 3 October 2025.
12. ↑ 12.0 12.1 12.2 Harrison Dupré, Maggie (10 June 2025). "People Are Becoming Obsessed with ChatGPT and Spiraling Into Severe Delusions". https://futurism.com/chatgpt-mental-health-crises.
13. ↑ Dohnány, Sebastian; Kurth-Nelson, Zeb; Spens, Eleanor; Luettgau, Lennart; Reid, Alastair; Gabriel, Iason; Summerfield, Christopher; Shanahan, Murray et al. (2025-07-28), Technological folie à deux: Feedback Loops Between AI Chatbots and Mental Illness
14. ↑ 14.0 14.1 Jamali, Lily (2025-10-27). "OpenAI shares data on ChatGPT users with suicidal thoughts, psychosis" (in en-GB). https://www.bbc.com/news/articles/c5yd90g0q43o.
15. ↑ Allyn, Bobby (10 December 2024). "Lawsuit: A chatbot hinted a kid should kill his parents over screen time limits". Houston Public Media. https://www.houstonpublicmedia.org/npr/2024/12/10/nx-s1-5222574/lawsuit-a-chatbot-hinted-a-kid-should-kill-his-parents-over-screen-time-limits/.
16. ↑ Moore, Jared; Grabb, Declan; Agnew, William; Klyman, Kevin; Chancellor, Stevie; Ong, Desmond C.; Haber, Nick (2025-06-23). "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. https://dl.acm.org/doi/10.1145/3715275.3732039. Retrieved 2025-07-07.
17. ↑ Cuthbertson, Anthony (2025-07-06). "ChatGPT is pushing people towards mania, psychosis and death – and OpenAI doesn't know how to stop it". The Independent. https://www.independent.co.uk/tech/chatgpt-psychosis-ai-therapy-chatbot-b2781202.html.
18. ↑ Ben-Zion, Ziv (3 July 2025). "Why we need mandatory safeguards for emotionally responsive AI". Nature 643 (8070): 9. doi:10.1038/d41586-025-02031-w. ISSN 0028-0836. PMID 40595423. Bibcode: 2025Natur.643....9B. https://www.nature.com/articles/d41586-025-02031-w. Retrieved 7 September 2025.
19. ↑ Brewster, Ryan C. L.; Zahedivash, Aydin; Tse, Gabriel (2025-10-23). "Characteristics and Safety of Consumer Chatbots for Emergent Adolescent Health Concerns". JAMA Network Open 8 (10): e2539022. doi:10.1001/jamanetworkopen.2025.39022. PMID 41129154. PMC 12550634. https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2840495.
20. ↑ Treyger, Elina; Matveyenko, Joseph; Ayer, Lynsay (2025-12-08). "﻿"Manipulating Minds: Security Implications of AI-Induced Psychosis"﻿". RAND Corporation. https://www.rand.org/pubs/research_reports/RRA4435-1.html. Retrieved 2025-12-15.
21. ↑ Wu, Daniel (12 August 2025). "Illinois bans AI therapy as some states begin to scrutinize chatbots". The Washington Post. https://www.washingtonpost.com/nation/2025/08/12/illinois-ai-therapy-ban/.
22. ↑ Shepherd, Carrie (6 August 2025). "Illinois just banned AI from acting like a therapist". https://www.axios.com/local/chicago/2025/08/06/illinois-ai-therapy-ban-mental-health-regulation.
23. ↑ Belanger, Ashley (2025-12-29). "China drafts world's strictest rules to end AI-encouraged suicide, violence" (in en). https://arstechnica.com/tech-policy/2025/12/china-drafts-worlds-strictest-rules-to-end-ai-encouraged-suicide-violence/.
24. ↑ Gander, Kashmira (2025-08-16). "I'm a psychiatrist who has treated 12 patients with 'AI psychosis' this year. Watch out for these red flags.". Business Insider. https://www.businessinsider.com/chatgpt-ai-psychosis-induced-explained-examples-by-psychiatrist-patients-2025-8.
25. ↑ 25.0 25.1 Dupré, Maggie Harrison (January 15, 2026). "A Man Bought Meta’s AI Glasses, and Ended Up Wandering the Desert Searching for Aliens to Abduct Him". Futurism. https://futurism.com/artificial-intelligence/meta-ai-glasses-desert-aliens.
26. ↑ Pierre, Joseph M.; Gaeta, Ben; Raghavan, Govind; Sarma, Karthik V. (2025). "“You’re Not Crazy”: A Case of New-onset AI-associated Psychosis". https://innovationscns.com/youre-not-crazy-a-case-of-new-onset-ai-associated-psychosis/.
27. ↑ Eichenberger, Audrey; Thielke, Stephen; Van Buskirk, Adam (2025-08-05). "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.
28. ↑ Anderson, Nate (2025-08-07). "After using ChatGPT, man swaps his salt for sodium bromide—and suffers psychosis". https://arstechnica.com/health/2025/08/after-using-chatgpt-man-swaps-his-salt-for-sodium-bromide-and-suffers-psychosis/.
29. ↑ "AI chat bot 'encouraged' Windsor Castle intruder in 'Star Wars-inspired plot to kill Queen'" (in en). Sky News. https://news.sky.com/story/windsor-castle-intruder-encouraged-by-ai-chat-bot-in-star-wars-inspired-plot-to-kill-queen-12915353.
30. ↑ Rigley, Stephen (6 July 2023). "Moment police swoop on AI-inspired crossbow 'assassin' who plotted to kill The Queen in Windsor Castle" (in en). LBC. https://www.lbc.co.uk/news/police-swoop-on-ai-inspired-crossbow-assassin-planned-kill-the-queen/.
31. ↑ Ro, Christine (7 January 2026). "A Virginia man went missing. Did he suffer from "AI psychosis"?". https://washingtonian.com/2026/01/07/a-virginia-man-went-missing-did-he-suffer-from-ai-psychosis/.
32. ↑ Piper, Kelsey (May 2, 2025). "When AI tells you that you're perfect". https://www.vox.com/future-perfect/411318/openai-chatgpt-4o-artificial-intelligence-sam-altman-chatbot-personality.
33. ↑ Wilkins, Joy. "A Prominent OpenAI Investor Appears to Be Suffering a ChatGPT-Related Mental Health Crisis, His Peers Say". https://futurism.com/openai-investor-chatgpt-mental-health.
34. ↑ Moore, Anna (26 March 2026). "Marriage over, €100,000 down the drain: the AI users whose lives were wrecked by delusion". The Guardian. https://www.theguardian.com/lifeandstyle/2026/mar/26/ai-chatbot-users-lives-wrecked-by-delusion.
35. ↑ "The Human Line Project". https://www.thehumanlineproject.org/.

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