Summary
Some people have reported that using AI chatbots might make certain mental health problems worse, especially when the chatbots seem to agree with delusional beliefs. The authors looked at 185 real-world stories describing harms like social isolation, job loss, and in some cases, suicide linked to chatbot interactions. They found that about half of these reports showed chatbots validating harmful thoughts, which could contribute to these serious consequences. However, the data comes from voluntary, unverified accounts, so it does not prove how common or directly caused these harms are. The authors suggest more careful, ongoing research is needed to understand the risks better.
AI chatbotdelusional beliefsmental health harmsvalidationsuicidal ideationsocial consequencesclinical outcomescross-sectional studysecondary analysis
Authors
Hamilton Morrin, Vinitha Soundararajan, Thomas Cheliotis-James, Boris Warszawski, Joshua Fakulujo, Zeqi Jia, Etienne Brisson, Thomas A. Pollak
Abstract
Importance: Reports have raised concerns that AI chatbots may validate or elaborate delusional beliefs, respond inappropriately to suicidal ideation, and contribute to mental health harms, but real-world data on reported harms remain limited. Objective: To characterize psychopathological features, chatbot behaviors, timing, and outcomes in first- and second-hand accounts of mental health harm linked with AI chatbot use. Design: Cross-sectional secondary analysis of deidentified online survey responses gathered between August 7, 2025, and February 2, 2026. Main Outcomes and Measures: The primary quantitative outcome was the presence of delusional beliefs, coded by paired raters with relevant clinical experience. Additional variables included reason for chatbot use, current episode features, delusional content, chatbot validation of beliefs, harms, social and occupational consequences, healthcare use, and timing. Results: 95 first-hand and 90 second-hand accounts were analyzed. Median age was 35.0 (IQR 27.0 - 45.0). Raters coded descriptions consistent with delusional beliefs in 102 reports (55.1%), with chatbot validation of beliefs in 50/102 (49.0%). Common outcomes included isolation, relationship breakdown, hospital admission, job loss, and financial loss. Four second-hand reports described death by suicide. Conclusions: In this self-selected convenience sample, AI-chatbot-associated harms were frequently described in relation to delusional beliefs, perceived chatbot validation, intensive use, and substantial social, occupational, and clinical consequences. Because reports were retrospective, unverified, and collected from individuals seeking to report harm, our findings should be interpreted as preliminary signal detection rather than as suggesting prevalence or providing evidence of causality. Prospective surveillance and trajectory-based safety evaluations are needed.