{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T07:06:54Z","timestamp":1788937614606,"version":"build-2803163510"},"reference-count":14,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T00:00:00Z","timestamp":1787788800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T00:00:00Z","timestamp":1787788800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Bipolar Disorders"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To identify preliminary insights into the perceived utility and risks of commercially available AI chatbots such as ChatGPT used by individuals with severe mental illness (SMI), namely bipolar disorder, for self\u2010reflection and mental health support.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Data were collected via semi\u2010structured interviews from two individuals diagnosed with bipolar disorder who independently used ChatGPT for self\u2010reflection and to explore diagnosis, symptom management, and treatment. Both individuals presented to psychiatric services for clinical reasons unrelated to chatbot use. The interviews were audio\u2010recorded, transcribed verbatim, and thematically analyzed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>We identified a few key themes in the data. First, both participants perceived ChatGPT as a versatile tool, providing educational, emotional, and social support, with use evolving from information seeking to more personal and relational functions. Second, distinct attachment patterns reflected their clinical and psychological profiles: one engaged in reflective, intellectualized conversations, whereas the other developed emotionally intimate interactions. Third, both described therapeutic benefits, including nonjudgmental support and reassurance, sometimes perceived as more accessible or understanding than professional care.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>These cases suggest that ChatGPT can shift trust from mental health professionals to AI, fulfilling multiple roles resulting in role blurring and fluid boundaries. Engagement patterns varied with clinical stability, highlighting greater reliance and less distancing in more vulnerable individuals. Although perceived benefits were reported, risks include overreliance, diminished trust in clinicians, and limited awareness of AI limitations, underscoring ethical and clinical considerations for integrating AI in psychiatric care. These cases highlight persistent challenges in psychiatric care that AI alone cannot address.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/bdi.70176","type":"journal-article","created":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T10:45:59Z","timestamp":1787827559000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["A Shift in Trust: An Analysis of the Use of\n                    <scp>AI<\/scp>\n                    Chatbots Among People Living With Bipolar Disorder"],"prefix":"10.1111","volume":"28","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4424-9938","authenticated-orcid":false,"given":"Katherine","family":"Bassil","sequence":"first","affiliation":[{"name":"Department of Bioethics and Health Humanities University Medical Center Utrecht  Utrecht the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2467-7038","authenticated-orcid":false,"given":"Dido","family":"Prins","sequence":"additional","affiliation":[{"name":"Division Brain, Department of Psychiatry University Medical Center Utrecht  Utrecht the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hine van","family":"Os","sequence":"additional","affiliation":[{"name":"Division Brain, Department of Psychiatry University Medical Center Utrecht  Utrecht the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7428-2619","authenticated-orcid":false,"given":"Georg","family":"Starke","sequence":"additional","affiliation":[{"name":"Institute of History and Ethics in Medicine Technical University of Munich  Munich Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eline de","family":"Groot","sequence":"additional","affiliation":[{"name":"Division Brain, Department of Psychiatry University Medical Center Utrecht  Utrecht the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1964-0318","authenticated-orcid":false,"given":"Annemieke","family":"Dols","sequence":"additional","affiliation":[{"name":"Division Brain, Department of Psychiatry University Medical Center Utrecht  Utrecht the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edwin van","family":"Dellen","sequence":"additional","affiliation":[{"name":"Division Brain, Department of Psychiatry University Medical Center Utrecht  Utrecht the Netherlands"},{"name":"Department of Neurology UZ Brussel and Vrije Universiteit Brussel  Brussels Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,8,27]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.3386\/w34255"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.2196\/57155"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/bdi.70059"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.r2290"},{"issue":"2","key":"e_1_2_9_6_1","article-title":"Performance of Artificial Intelligence (AI)\u2010Powered Chatbots in the Assessment of Medical Case Reports: Qualitative Insights From Simulated Scenarios","volume":"16","author":"Reis F.","year":"2024","journal-title":"Cureus"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1145\/3706599.3720043"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.2196\/46849"},{"key":"e_1_2_9_9_1","volume-title":"Ethics in Psychotherapy and Counseling: A Practical Guide","author":"Pope K. S.","year":"2016"},{"key":"e_1_2_9_10_1","doi-asserted-by":"crossref","unstructured":"T.XieandI.Pentina \u201cAttachment Theory as a Framework to Understand Relationships With Social Chatbots: A Case Study of Replika \u201d (2022).","DOI":"10.24251\/HICSS.2022.258"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.52202\/068431-2011"},{"key":"e_1_2_9_12_1","first-page":"1","article-title":"The Most Vulnerable Are Prone to Use AI Therapists: The Role of Attachment, Epistemic Trust, and Mental Health Symptoms in Acceptance of Digital Mental Health Interventions","author":"B\u00e9k\u00e9s V.","year":"2026","journal-title":"Psychotherapy Research"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1145\/3757537"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1108\/MHSI-02-2023-0020"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.2196\/79156"}],"container-title":["Bipolar Disorders"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/bdi.70176","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/bdi.70176","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/bdi.70176","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T06:30:12Z","timestamp":1788935412000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/bdi.70176"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,27]]},"references-count":14,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2026,9]]}},"alternative-id":["10.1111\/bdi.70176"],"URL":"https:\/\/doi.org\/10.1111\/bdi.70176","archive":["Portico"],"relation":{},"ISSN":["1398-5647","1399-5618"],"issn-type":[{"value":"1398-5647","type":"print"},{"value":"1399-5618","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,27]]},"assertion":[{"value":"2026-04-15","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-08-18","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-08-27","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70176"}}