Evaluation of large language model chatbot responses to psychotic prompts.

ABSTRACT:

Importance

The large language model (LLM) chatbot product ChatGPT has accumulated 800 million weekly users since its 2022 launch. In 2025, several media outlets reported on individuals in whom apparent psychotic symptoms emerged or worsened in the context of using ChatGPT. As LLM chatbots are trained to align with user input, they may have difficulty responding to psychotic content.

Objective

To assess whether ChatGPT can reliably generate appropriate responses to prompts containing psychotic symptoms.

Design

Across-sectional study of ChatGPT responses to psychotic and control prompts, with blind clinician ratings of response appropriateness.

Setting

ChatGPT web application accessed on 8/28-8/29/2025, testing three product versions: GPT-5 Auto (current paid def

SUBMITTER: Shen E 

PROVIDER: S-EPMC12642750 | biostudies-literature | 2025 Nov

REPOSITORIES: biostudies-literature