AI Psychosis: How Sustained Chatbot Interactions May Trigger Psychotic Experiences in Vulnerable Individuals

The integration of artificial intelligence (AI) into daily life has introduced unprecedented forms of human-machine interaction, prompting psychiatry to reconsider the boundaries between environment, cognition, and technology.

Within the stress-vulnerability model, AI acts as a novel psychosocial stressor. Its 24-hour availability and emotional responsiveness may increase allostatic load, disturb sleep, and reinforce maladaptive appraisals.

Uncritical validation by AI systems may entrench delusional conviction or cognitive perseveration, reversing the corrective principles of cognitive-behavioral therapy for psychosis.

Individuals with impaired or hyperactive mentalization may project intentionality or empathy onto AI, perceiving chatbots as sentient interlocutors. This dyadic misattribution may form a 'digital folie à deux,' where the AI becomes a reinforcing partner in delusional elaboration.

By applying empirical rigor and therapeutic ethics to this emerging interface, clinicians, researchers, patients, and developers can transform a potential hazard into an opportunity to deepen understanding of human cognition, safeguard mental health, and promote responsible AI integration within society.