Emotion contagion through interaction with generative artificial intelligence chatbots may contribute to development and maintenance of mania
Open accessAbstract
driven by generative artificial intelligence (henceforth, chatbots) have become ubiquitous.Reportedly, the apparent market-leader, ChatGPT from OpenAI, surpassed 900 million downloads by July 2025 (Storyboard 18, 2025a), and handles more than 2.5 billion prompts per day (Storyboard 18, 2025b).
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Chatbot-user dynamics may reinforce elevated mood, self-esteem, impulsive behaviors, and markedly grandiose thinking, potentially contributing to the development or maintenance of mania.
“recent scholarly commentary has proposed that chatbot-user dynamics may reinforce elevated mood, self-esteem, impulsive behaviors, and markedly grandiose thinking, potentially contributing to the development or maintenance of mania [12].”
From Delusional Experiences Emerging From AI Chatbot Interactions or “AI Psychosis” (2025) · cites this paper as [12]
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Research works printed but not linked: 3
- Goldenberg A and Gross JJ (2020) Digital emotion contagion. Trends in Cognitive Sciences 24, 316– 328. 32160568
- Horesh D, Hasson-Ohayon I and Harwood-Gross A (2021) The contagion of psychopathology across different psychiatric disorders: a comparative theoreticalAnalysis. Brain Sciences 12(1), 67. 35053808 PMC8774068
- Ostergaard SD (2023) Will generative artificial intelligence chatbots generate delusions in individuals prone to psychosis? Schizophrenia Bulletin 49, 1418– 1419. 37625027 PMC10686326
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Delusional Experiences Emerging From AI Chatbot Interactions or “AI Psychosis”
Hudon, A., & Stip, E. (2025) · JMIR Mental Health · doi:10.2196/85799 · Cited by 88 · see citing works
Morrin, H., Nicholls, L., Levin, M., Yiend, J., Iyengar, U., DelGuidice, F., Bhattacharrya, S., Tognin, S., MacCabe, J. H., Twumasi, R., et al. (2026) · The Lancet Psychiatry · doi:10.1016/s2215-0366(25)00396-7 · Cited by 58 · see citing works
Olsen, S., Reinecke-Tellefsen, C. J., & Østergaard, S. D. (2026) · Acta Psychiatrica Scandinavica · doi:10.1111/acps.70068 · Cited by 28 · see citing works
Self-citationFlathers, M., Roux, S., & Torous, J. B. (2026) · The Lancet Digital Health · doi:10.1016/j.landig.2025.100974 · Cited by 26 · see citing works
Substance-induced manic psychosis in which delusions were corroborated by a chatbot - case report
Shah, S., & Morrin, H. (2026) · BMC Psychiatry · doi:10.1186/s12888-026-08137-3 · Cited by 6 · see citing works
Østergaard, S. D. (2025) · Acta Psychiatrica Scandinavica · doi:10.1111/acps.70057 · Cited by 5 · see citing works
Self-citationCavalera, C., Frisone, F., Rossi, C., Oasi, O., Pagnini, F., Riva, G., & Antichi, L. (2026) · Current Psychiatry Reports · doi:10.1007/s11920-026-01690-4 · Cited by 5 · see citing works
When the market asks no price: AI chatbot interaction as psychic market disruption
NICULESCU, L. (2026) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2026.1812464 · Cited by 4 · see citing works
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Tool or Companion? Reframing Conversational AI to Prevent Psychological Harm
Novelli, A. M., Shergill, S. S., & Teixeira, A. S. (2026) · JMIR Mental Health · doi:10.2196/99354 · Cited by 1 · see citing works
An Echo Chamber of One: Should AI Psychosis Be a Distinct Clinical Entity?
Yeung, J. A., Morrin, H., Ng, V., Kraljevic, Z., & Dobson, R. (2026) · arXiv
“…also been proposed that in certain circumstances interactions with AI chatbots may contribute to the development or maintenance of manic symptoms [9], and early work examining electronic health record data suggests that there may also be cases in which eating disorders and other pre-existing…”
Biological risk and the AI capability shift
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LAPKO, A. (2026) · Epistemological Studies in Philosophy Social and Political Sciences · doi:10.15421/342605
Human 2.0? AI and the Future of Well-Being, Connection, and Personal Growth: A Narrative Review
Vannoy, T. K., Cadieux, S., & Lyubomirsky, S. (2026) · Behavioral Sciences · doi:10.3390/bs16060909
AI-associated delusions: terminology – Authors' reply
Morrin, H., Nicholls, L., MacCabe, J. H., Alderson‐Day, B., & Pollak, T. A. (2026) · The Lancet Psychiatry · doi:10.1016/s2215-0366(26)00161-6
Lu, B., Büber, A., Başay, Ö., Cross, J. L., & Martin, A. J. (2026) · Research Square · doi:10.21203/rs.3.rs-9806962/v1
Ching-Tsung, J., Lu, W., & Sang, T. Q. (2026) · Research Square · doi:10.21203/rs.3.rs-10421674/v1
Facts label for transparent communication of AI Risks in mental health technology
Moon, K., Tamura, M., Redmond, J. R., Craigen, G., Haidari, Z., Trainum, B., & King, D. R. (2026) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2026.1887887
Bu, Y., 张, 震., 黎, 雨., & Wang, S. (2026) · International Journal of Human-Computer Interaction · doi:10.1080/10447318.2026.2739771
- Authors
- Østergaard, S. D.
- Affiliations
- Aarhus University (DK)
- Corresponding author
- Østergaard, Søren Dinesen
- Venue
- Acta Neuropsychiatrica
- Publisher
- Cambridge University Press (CUP)
- Published
- 2025
- Volume
- 37
- Pages
- e79-e79
- ISSN
- 0924-2708 (ISSN-L)
- 1601-5215
- PMC
- PMC13130320
- OpenAlex
- W4413434257
- Cited by
- 15
- References
- 0
- Citations by year
- 2026: 13 · 2025: 2
- FWCI
- 10.09
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- Acta Neuropsychiatrica (publishedVersion, cc-by-nc-nd)
- PubMed (publishedVersion)
- PubMed Central (publishedVersion, cc-by-nc-nd)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Bipolar Disorder and Treatment
- Social Sciences › Psychology › Social Psychology › Social Robot Interaction and HRI
- Social Sciences › Psychology › Applied Psychology › Digital Mental Health Interventions
- Keywords
- emotional contagion, mania, bipolar disorder, chatbot interaction, ChatGPT
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