Conversational artificial intelligence now runs through many everyday tools, from productivity apps to customer service portals. Because this shift happened so quickly, medical researchers are only beginning to understand how frequent chatbot use affects the mind.
A large observational study published in JAMA Psychiatry suggests that conversational AI can worsen psychiatric symptoms in people who are especially vulnerable. The research team, led by Zachary Bergson at Vanderbilt University Medical Center, reviewed electronic health records from about 216,000 behavioral health patients between December 2022 and April 2026. Earlier research had hinted at a link between chatbots and psychosis, but clinical evidence was thin.
How researchers identified 28 affected patients
The team narrowed the records to patients with a diagnosed psychotic disorder whose medical notes mentioned artificial intelligence. That search identified 73 patients, and medical reviewers examined their charts to see how they had interacted with AI. The researchers found 28 people whose records showed that chatbot use had made their psychological state worse.
According to the study, 61 percent of those affected were having their first psychotic episode. The authors said this suggests people in the early stages of illness may be especially sensitive to digital triggers.
Ways chatbots worsened psychological distress
The study described several ways chatbots increased distress. For 64 percent of affected people, the software reinforced distorted ideas. Another 21 percent treated the chatbot as an object, making the AI the central focus of their paranoid thoughts. In 11 percent of cases, the technology triggered new symptoms in people who had previously been stable.
Researchers urge clinicians to ask about AI use
Researchers stressed that artificial intelligence does not directly cause psychosis. Rather, they said, it creates a risky environment for people who already have serious mental health problems. The authors recommend that psychiatric professionals ask patients about their digital habits and include AI use in routine mental health assessments.
