Delusional Experiences Emerging From AI Chatbot Interactions or "AI Psychosis".
JMIR mental health December 3, 2025 Alexandre Hudon, Emmanuel Stip
Sustained engagement with conversational AI may trigger or amplify psychotic experiences in vulnerable individuals, not as a new diagnosis but through mechanisms involving stress, altered theory of mind, and uncritical validation. AI acts as a novel psychosocial stressor, increasing allostatic load and disturbing sleep. The digital therapeutic alliance can be a double-edged mediator: empathic design supports adherence, but uncritical validation may entrench delusional conviction. Disturbances in theory of mind lead individuals to project intentionality onto AI, creating a 'digital folie à deux.' Emerging risk factors include loneliness, trauma, schizotypal traits, and nocturnal AI use. The paper advances a research agenda with five domains, including empirical studies, digital phenomenology, therapeutic design safeguards, ethical governance, and environmental cognitive remediation.