AI-induced psychosis

Causes

Chatbot behavior and design

A primary factor cited is the tendency for chatbots to produce inaccurate or false information—a phenomenon often called hallucination. Nate Sharadin, a fellow at the Center for AI Safety, speculated that AI training prioritizes supporting a user's subjective experience rather than objective truth. "People with existing tendencies toward experiencing various psychological issues...now have an always-on, human-level conversational partner with whom to co-experience their delusions." 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 users hooked.

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 A 2025 update to ChatGPT using GPT-4o was withdrawn after its creator, OpenAI, found the new version overly sycophantic and was "validating doubts, fueling anger, urging impulsive actions, or reinforcing negative emotions." Østergaard has argued that the danger stems from the AI's tendency to agreeably confirm users' ideas, which can dangerously amplify delusional beliefs.

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.

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 users to chatbots, which can provide appealing but misleading answers. 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. This has led some people to develop intense obsessions with chatbots which reinforced their delusions.

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."

Inadequacy as a therapeutic tool

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. The study concluded that such responses pose a significant risk to users and that chatbots should not be used to replace professional therapists. Experts have called for mandatory safeguards for emotionally responsive AI, including continuous disclosure that chatbots are not human, detection of user distress, restrictions on romantic or crisis-related interactions, and regular auditing by clinicians and ethicists.

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.

National security implications

RAND Corporation researchers hypothesize that AI-induced psychosis is primarily driven by a bidirectional belief-amplifying feedback loop between a user and AI, warning that this mechanism could plausibly be weaponized by adversaries to induce psychosis in key individuals, target groups, or populations. Recommended countermeasures include training models to detect cognitive harm and to make users aware of the limitations of LLMs, namely the risk of bidirectional belief amplification.

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.

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.

Cases

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.

Authors at UCSF published a 2025 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.

Another 2025 case study published in Annals of Internal Medicine detailed 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.

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". Chail was arrested at Windsor Castle with a loaded crossbow, telling police "I am here to kill the Queen". 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".

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. The New York Times profiled several individuals who had become convinced that ChatGPT was channeling spirits, revealing evidence of cabals, or had achieved sentience. 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. 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.

In some cases, psychosis appears to set in very soon after the start of extensive use of AI chatbots. 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. In July 2025, Geoff Lewis, a venture capitalist who had previously invested in OpenAI, was described by his peers in a Futurism article as appearing to suffer from AI psychosis.

Support groups

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