AI-Associated Psychotic Presentations: A Narrative Review of Clinical Concepts, Risk Factors, and Management in the Digital Era

Abstract

Introduction: The rapid integration of artificial intelligence into daily life has introduced new challenges in mental health care. Unlike earlier digital technologies, conversational AI systems enable continuous, personalized, and emotionally responsive interactions. These features have raised concerns about their potential to influence the content and expression of psychotic symptoms in vulnerable individuals, a phenomenon increasingly described as artificial intelligence–associated psychosis. Methods: Articles included in this narrative literature review were identified through searches of electronic databases. The search strategy utilized keywords such as “AI-induced psychosis,” “artificial intelligence,” “delusions,” and “chatbot.” Articles were screened and reviewed for eligibility. Given the emerging nature of this topic and the predominance of case reports, commentaries, and conceptual papers, a total of 17 articles were included. Results: Artificial intelligence–associated psychosis does not represent a distinct diagnostic entity but reflects a contemporary manifestation of established psychotic processes, in which AI-related content is incorporated into delusional experiences. Reported features include delusions, impaired reality testing, emotional dependence, and functional decline. Identified vulnerability factors include pre-existing susceptibility to psychosis, cognitive impairment, social isolation, and intensive engagement with AI systems. Although severe outcomes such as self-harm, violence, and death have been reported, these likely reflect symptom amplification in vulnerable individuals rather than direct causality. Management approaches remain consistent with standard psychosis care. Conclusions: Artificial intelligence is best understood as an environmental amplifier rather than a direct cause of psychosis. Awareness of this dynamic is essential for early identification, risk mitigation, and safe integration into mental health care.