{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"institution":[{"name":"medRxiv"}],"indexed":{"date-parts":[[2026,10,31]],"date-time":"2026-10-31T06:11:58Z","timestamp":1793427118346,"version":"4.5.0"},"posted":{"date-parts":[[2026,6,8]]},"group-title":"Public and Global Health","reference-count":40,"publisher":"openRxiv","license":[{"start":{"date-parts":[[2026,6,8]],"date-time":"2026-06-08T00:00:00Z","timestamp":1780876800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000025","name":"National Institute of Mental Health","doi-asserted-by":"crossref","award":["1R01MH137024-01"],"award-info":[{"award-number":["1R01MH137024-01"]}],"id":[{"id":"10.13039\/100000025","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/100007206","name":"Vanderbilt Institute for Clinical and Translational Research","doi-asserted-by":"crossref","award":["VR74021"],"award-info":[{"award-number":["VR74021"]}],"id":[{"id":"10.13039\/100007206","id-type":"DOI","asserted-by":"crossref"}]},{"name":"Charlotte and Donald Test Fund"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"accepted":{"date-parts":[[2026,6,8]]},"abstract":"<jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Concerns about \u201cAI psychosis\u201d have swirled in the media since ChatGPT\u2019s release, but few systematic analyses exist. We therefore conducted an electronic health record (EHR) analysis to identify the frequency, clinical characteristics, and quality of AI interactions in patients experiencing psychosis treated in a medical center.<\/jats:p>\n                <\/jats:sec>\n                <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>AI keywords (e.g., ChatGPT, AI) were used to search Vanderbilt University Medical Center\u2019s EHR from 12\/1\/2022-4\/1\/2026. Records were discarded if they were not AI-related or if the primary diagnosis did not include psychosis. Three raters read notes to determine if a patient was experiencing AI psychosis and classified the interactions using 4 a-priori categories (Catalyst, Amplifier, Co-Author, Object) formulated to explain how AI-related negative outcomes emerge.<\/jats:p>\n                <\/jats:sec>\n                <jats:sec>\n                  <jats:title>Findings<\/jats:title>\n                  <jats:p>73 patients met our criteria. 28 patients were rated as experiencing AI psychosis, 17 had neutral interactions, and 28 expressed delusional content related to AI without documented evidence of conversational AI use. ChatGPT was the matching keyword for 53.6% patients experiencing AI psychosis. The majority of AI psychosis cases were documented after ChatGPT\u2019s \u201c4o\u201d model was released in May 2024. Notably, the AI Psychosis group had significantly more patients experiencing a first psychotic episode (60.7%) compared to the other two groups. Amplifier was the most common (64.3%) qualitative rating in the AI Psychosis group.<\/jats:p>\n                <\/jats:sec>\n                <jats:sec>\n                  <jats:title>Interpretation<\/jats:title>\n                  <jats:p>\u201cAI psychosis\u201d is an infrequent but real phenomenon observed in clinical practice. Most affected patients were experiencing their first psychotic episode and presented with AI psychosis following the release of the more sycophantic GPT-4o. Among the affected patients, AI most often exacerbated an existing condition by reinforcing distorted ideas.<\/jats:p>\n                <\/jats:sec>","DOI":"10.64898\/2026.06.04.26354939","type":"posted-content","created":{"date-parts":[[2026,6,8]],"date-time":"2026-06-08T16:42:25Z","timestamp":1780936945000},"source":"Crossref","is-referenced-by-count":2,"title":["Characterizing artificial intelligence (AI) psychosis in a large academic medical setting: evidence of the new clinical phenomenon and the vulnerability of those in early phases of psychosis"],"prefix":"10.64898","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2498-1486","authenticated-orcid":false,"given":"Zachary","family":"Bergson","sequence":"first","affiliation":[{"name":"Vanderbilt University Medical Center, Department of Psychiatry and Behavioral Sciences"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0393-8155","authenticated-orcid":false,"given":"Sarah G.","family":"Vassall","sequence":"additional","affiliation":[{"name":"Vanderbilt University Medical Center, Department of Psychiatry and Behavioral Sciences"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6844-145X","authenticated-orcid":false,"given":"Adam","family":"Wright","sequence":"additional","affiliation":[{"name":"Vanderbilt University Medical Center, Department of Biomedical Informatics"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2292-9147","authenticated-orcid":false,"given":"Allison B.","family":"McCoy","sequence":"additional","affiliation":[{"name":"Vanderbilt University Medical Center, Department of Biomedical Informatics"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katherine M.","family":"Schafer","sequence":"additional","affiliation":[{"name":"Vanderbilt University Medical Center, Department of Psychiatry and Behavioral Sciences"},{"name":"Vanderbilt University Medical Center, Department of Biomedical Informatics"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-6137-0547","authenticated-orcid":false,"given":"Margaret C.","family":"Achee","sequence":"additional","affiliation":[{"name":"Vanderbilt University Medical Center, Department of Psychiatry and Behavioral Sciences"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0280-3101","authenticated-orcid":false,"given":"Julia M.","family":"Sheffield","sequence":"additional","affiliation":[{"name":"Vanderbilt University Medical Center, Department of Psychiatry and Behavioral Sciences"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"54368","reference":[{"key":"2026061109001102000_2026.06.04.26354939v1.1","unstructured":"Schechner S , Kessler S. \u2018I Feel Like I\u2019m Going Crazy\u2019: ChatGPT Fuels Delusional Spirals. 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