Category: Mental Health

Study: Adolescent Cannabis Use Linked to Doubling Risk of Psychotic and Bipolar Disorders

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Adolescents who use cannabis could face a significantly higher risk of developing serious psychiatric disorders by young adulthood, according to a large new study published in JAMA Health Forum. The longitudinal study followed nearly half a million adolescents ages 13 to 17 through age 26 and found that past-year cannabis use during adolescence was associated with a significantly higher risk of incident psychotic (doubled), bipolar (doubled), depressive and anxiety disorders.

The study was conducted by researchers from Kaiser Permanente, the Public Health Institute’s Getting it Right from the Start, the University of California, San Francisco and the University of Southern California, and was funded by a grant from NIH’s National Institute on Drug Abuse (R01DA0531920).

The study analysed electronic health record data from routine paediatric visits between 2016 and 2023. Cannabis use preceded psychiatric diagnoses by an average of 1.7 to 2.3 years. The study’s longitudinal design strengthens evidence that adolescent cannabis exposure is a potential risk factor for developing mental illness.

“As cannabis becomes more potent and aggressively marketed, this study indicates that adolescent cannabis use is associated with double the risk of incident psychotic and bipolar disorders, two of the most serious mental health conditions,” said Lynn Silver, MD, program director of the Getting it Right from the Start, a program of the Public Health Institute, and a study co-author.

The evidence increasingly points to the need for an urgent public health response — one that reduces product potency, prioritises prevention, limits youth exposure and marketing and treats adolescent cannabis use as a serious health issue, not a benign behaviour. 

Lynn Silver, MD, Program Director, PHI’s Getting it Right from the Start

Cannabis is the most used illicit drug among U.S. adolescents. The Monitoring the Future study shows use rising with grade level — from about 8% in 8th grade to 26% in 12th grade — and according to the 2024 National Survey on Drug Use and Health, more than 10% of all U.S. teens aged 12 to 17 report past-year use. At the same time, average THC levels in California cannabis flower now exceed 20%, far higher than in previous decades, and concentrates can exceed 95% THC.

Unlike many prior studies, the research examined any self-reported past-year cannabis use, with universal screening of teens during standard pediatric care, rather than focusing only on heavy use or cannabis use disorder.

“Even after accounting for prior mental health conditions and other substance use, adolescents who reported cannabis use had a substantially higher risk of developing psychiatric disorders — particularly psychotic and bipolar disorders,” said Kelly Young-Wolff, PhD, lead author of the study and senior research scientist at the Kaiser Permanente Division of Research.

This study adds to the growing body of evidence that cannabis use during adolescence could have potentially detrimental, long-term health effects. It’s imperative that parents and their children have accurate, trusted, and evidence-based information about the risks of adolescent cannabis use.

Kelly Young-Wolff, PhD, Lead Study Author and Senior Research Scientist, Kaiser Permanente Division of Research

The study also found that cannabis use was more common among adolescents enrolled in Medicaid and those living in more socioeconomically deprived neighbourhoods, raising concerns that expanding cannabis commercialisation could exacerbate existing mental health disparities.

Source: Public Health Institute

Poor Sleep may Drive up Teens’ Screen Time

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New research in Brain & Behavior found a link between screen time and adolescents’ sleep quality and beliefs about healthy lifestyles.

In the study of 700 teens attending 2 high schools in the Black Sea region of Turkey, questionnaire responses revealed that participants who spent more time exposed to screens tended to have lower sleep quality. These adolescents were also less likely to have beliefs supporting the importance of maintaining a healthy lifestyle.

Screen exposure appeared to play a mediating role in the relationship between sleep quality and healthy lifestyle beliefs, meaning that poor sleep quality may lead to more screen time, which in turn can negatively affect beliefs about healthy lifestyles.

“It is recommended to promote interventions aimed at reducing screen exposure, increasing social interaction, and developing alternative activities among adolescents,” the authors wrote. “Implementing these recommendations may help adolescents adopt healthier lifestyles, regulate their sleep quality, and reduce their screen exposure.”

Source: Wiley

Comprehensive ADHD Study Confirms the Best Treatment Options

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The most comprehensive review to date of ADHD treatments has found that medication for children and adults, and cognitive behavioural therapy for adults, remain the most effective approaches, backed by the strongest short-term trial evidence.

Researchers led by the Université Paris Nanterre (France), Institut Robert-Debré du Cerveau de l’Enfant (France), and the University of Southampton (UK) analysed over 200 meta-analyses covering different treatment types, participant groups, and clinical outcomes in a study published 27 November 2025 in The BMJ.

The research was funded by public and peer-reviewed research grants from Agence Nationale de la Recherche (France), France 2030 program (France), and National Institute for Health and Care Research (UK).

To help people with attention deficit hyperactivity disorder (ADHD) and their clinicians make more informed, shared decisions, the team has created an interactive website that clearly presents the findings and the evidence behind each treatment based on the review (ebiadhd-database.org).

“We know that people with ADHD and their families are often overwhelmed by conflicting messages about which treatments work,” says Professor Samuele Cortese , an NIHR Research Professor at the University of Southampton and senior lead author on the paper.

“We believe this study and the accompanying website provide the most authoritative, evidence-based, and accessible guidance currently available.

“The Evidence-Based Interventions for ADHD website provides freely available, evidence-based, and continuously updated information in an easy-to-understand way. To the best of our knowledge, this is the first platform in the world to do so based on such a rigorous synthesis of the available evidence.”

Overall, five medications in children and adolescents, and two medications and cognitive behavioural therapy (CBT) in adults were shown to be effective while supported by a relatively robust evidence base. Critically, all this evidence was limited to the short-term, despite long-term treatment being common in clinical practice.

Treatments like acupuncture, mindfulness and exercise showed promise, but the evidence supporting their use was of a low quality due to small numbers of participants and risk of bias. The limitations applied to studies evaluating cognitive behavioural therapy in children and adolescents, as well as research on the long-term effects of mindfulness in adults, although mindfulness was the only intervention to demonstrate large beneficial effects at extended follow-up.

Dr Corentin Gosling, Associate Professor at the Paris Nanterre University and first lead author of the study, says: “Long waiting lists for mental health services are a major issue. Having incorrect information about treatments can make people’s journeys even more difficult, by wasting time and money on non-evidence-based approaches, for example.

“By contrast, taking the time to review all treatment options within a shared decision-making process using the web app we developed can empower people with ADHD, leading to better treatment adherence, improved outcomes, and an overall better patient experience.”

The findings generally complement current international clinical guidelines, not only by providing convenient access to current high-quality evidence, but also by covering interventions not usually mentioned in clinical guidelines.

The team hope this new project will achieve a similar impact in influencing clinical guidelines and practice as their previous project (ebiact-database.com), which looked at treatments for autism.

Benefits and harms of ADHD interventions: umbrella review and platform for shared decision making is published in The BMJ and is available online.

Source: University of Southampton

Does Mental Health Affect Cancer Mortality?

Study finds a link between mental health diagnoses and early death.

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In a study of adults with cancer, those who developed a mental health condition within the first year after their cancer diagnosis had a higher likelihood of dying over the next few years. The findings are published by Wiley online in CANCER, a peer-reviewed journal of the American Cancer Society.

In the analysis of data on all patients at University of California–affiliated hospitals, researchers identified all adult patients who were diagnosed with cancer in 2013–2023 but had no documented mental health disorder before their diagnosis.

Among 371 189 patients, 39 687 (10.6%) developed a mental health disorder within a year. After taking potentially influencing factors into account, a mental health disorder diagnosis was linked to a 51% higher risk of death in the initial 1–3 years after cancer diagnosis. This elevated risk diminished to a 17% higher risk after 3–5 years and then disappeared.

The findings support the importance of prompt screening and treatment of distress and mental health following a cancer diagnosis.

“Over the past several years, we’ve had an increasing appreciation for the important relationship between cancer, its treatment, and mental health,” said lead author Julian Hong, MD, MS, of the University of California, San Francisco. “This study reproduces our prior work by leveraging the shared experience across the University of California system, reinforcing a relationship between mental health conditions and mortality for patients with cancer and highlighting the need to prioritize and manage mental health.”

Source: Wiley

Study Finds Sugary Drinks Linked to Anxiety in Young People

A new study has identified an association between consumption of drinks containing a high amount of sugar and anxiety symptoms in adolescents. 

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Researchers at Bournemouth University were part of a team involved in reviewing the findings of multiple studies that have investigated people’s diets and their mental health, to establish common findings. 

Their results have been published in the Journal of Human Nutrition and Dietetics.

“With increasing concern about adolescent nutrition, most public health initiatives have emphasised the physical consequences of poor dietary habits, such as obesity and type-2 diabetes,” said Dr Chloe Casey, Lecturer in Nutrition and co-author of the study. “However, the mental health implications of diet have been underexplored by comparison, particularly for drinks that are energy dense but low in nutrients,” she added.

Anxiety disorders are a leading cause of mental distress among young people, in 2023 it was estimated that one in five children and young people had a mental health disorder, with anxiety one of the most reported conditions. 

The studies investigated by the research team measured sugary drink consumption and mental health of the young people through surveys. Beverages with high amounts of sugar can include fizzy drinks, energy drinks, sugary juices, squashes, sweetened tea and coffee, and flavoured milks.

The results consistently found a link between high levels of sugary drink consumption and anxiety.

The researchers emphasise that because of the nature of the studies they investigated, the findings do not provide evidence that drinking more sugary drinks directly causes anxiety. It is also possible that experiencing symptoms of anxiety leads to some young people consuming more sugary drinks. Or there could be other common factors – for example family life and sleeping disorders – that lead to both increased consumption and symptoms of anxiety. 

“Whilst we may not be able to confirm at this stage what the direct cause is, this study has identified an unhealthy connection between consumption of sugary drinks and anxiety disorders in young people,” Dr Casey said. 

“Anxiety disorders in adolescence have risen sharply in recent years so it is important to identify lifestyle habits which can be changed to reduce the risk of this trend continuing,” she concluded. 

The study was led by former Bournemouth University PhD student, Dr Karim Khaled, who now works at Lebanese American University, Beirut. 

Source: Bournemouth University

For Better Mental Health in Middle Age, Watch Less TV

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Replacing time spent watching TV with other activities can help prevent depressive disorder in middle-aged adults, revealed a new study in European Psychiatry, published on behalf of the European Psychiatric Association by Cambridge University Press. The effects were less pronounced in older and younger adults.  

Lead researcher Rosa Palazuelos-González, of the University of Groningen, said that this new study is unique for investigating how reallocating time from TV-watching to various physical activities and sleep affects the onset of depression. Most studies until now have focused on identifying correlations between sedentary lifestyles and incidences of depression, rather than tracking how replacement activities affect the condition. 

“We found that reducing TV-watching time by 60 minutes and reallocating it to other activities decreased the likelihood of developing major depression by 11 percent,” said Palazuelos-González. 

“For 90- and 120-minute reallocations, this decrease in likelihood goes up to 25.91 percent.” 

Middle-aged people benefit more from watching less 

The benefits for middle-aged people who replace TV-watching with other activities are especially pronounced. Among this demographic, reallocating 60 minutes daily from TV-watching to other activities decreased the probability of developing depression by 18.8%. Reallocating 90 minutes resulted in decreased likelihood of 29%, and 120 minutes led to a reduction of 43%. 

All reallocations of TV-watching time to specific activities were associated with reduced depression risk, except for reallocating only 30 minutes to household activities, which did not yield a significant effect. When reallocating 30 minutes specifically to sports, the reduction was 18%; to work/school physical activities, 10.2%; to leisure/commute activities, 8%; and to sleep, 9%. Time reallocations to sports, at any given duration, resulted in the largest reductions in the probability of major depression onset compared to all other activities. 

Fewer comparable benefits for older adults and young adults 

In older adults, reallocating TV-watching time proportionally to other activities did not lead to statistically significant reductions in onset of depression. Only substituting TV-watching time with sports reduced the probability of becoming depressed, from 1.01 to 0.71% with 30 minutes, 0.63% with 60 minutes, and 0.56% with 90 minutes. 

In young adults, reallocating TV-watching time to one or multiple movement activities did not significantly change the likelihood of them developing depression. However, this group is also more physically active than older age groups – the researchers suggest that they may have already surpassed the physical activity threshold that is protective against depression.  

This research was developed using a population-based cohort study (a Dutch initiative named ‘Lifelines’) with a four-year follow-up, which included 65 454 non-depressed adults. Patterns across age groups were examined carefully. Participants self-reported time spent in active commuting, leisure, sports, household, physical-related activities at work or school, TV-watching, and sleep. Major depressive disorder was assessed using the Mini International Neuropsychiatric Interview. 

Source: EurekAlert!

New Research Sheds Light on the Biological Roots of Anxiety

The largest genetic study of anxiety disorders to date has identified 58 genetic variants associated with anxiety, most of which have not been identified before now.

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In the largest genetic study of anxiety disorders to date, new research from the Institute of Psychiatry, Psychology & Neuroscience (IoPPN) at King’s College London, in partnership with Texas A&M and the Institute of Psychiatric Phenomics and Genomics (IPPG) at LMU Munich, has identified 58 genetic variants associated with anxiety, most of which have not been identified before now.

The research, published in Nature Genetics, confirmed that, rather than being driven by a single “anxiety gene”, anxiety disorders are influenced by numerous genetic variants from across the genome, with each contributing a small effect.

The researchers compared the genetic data of 120 000 people diagnosed with an anxiety disorder to almost 730 000 people without.

Their analysis of the data notably highlighted the role of several genes involved in GABAergic signalling; a key system that regulates brain activity.

“Anxiety disorders arise from the interplay of genetic vulnerability and life experience. At a time when rates of anxiety are rising rapidly in our young people, by identifying robust genetic signals offering novel insight into the biological foundations of these debilitating disorders, this research helps move the field toward more precise and effective approaches to prevention and care.” 

Professor Thalia Eley, Professor of Developmental Behavioural Genetics at King’s IoPPN and one of the study’s senior authors

While the research provides a biological basis for anxiety, the researchers do not advocate for the use of genetic testing to diagnose anxiety.

Professor John Hettema, from the Department of Psychiatry at Texas A&M University Naresh K. Vashisht College of Medicine, another of the study’s senior authors said, “Anxiety disorders and their underlying sources of genetic risk have been understudied compared to other psychiatric conditions, so this study substantially advances this critical knowledge.”

Prof Jürgen Deckert, Julius Maximilians University, Würzburg, Germany wrote “The results of the study provide evidence for a role of several previously unknown molecular pathways in the etiology of anxiety, beyond the previously identified GABAergic system. They will provide the basis for future studies in cell culture, animal models and humans which will contribute to a better understanding of the neurobiology of anxiety and as a consequence to innovative and individualized therapies.”

Genome-wide association study of major anxiety disorders in 122,341 European ancestry cases identifies 58 loci and highlights GABAergic signaling (DOI 10.1038/s41588-025-02485-8) (Eley, Mattheisen, Hettema et al) was published in Nature Genetics.  

Source: King’s College London

Rates of Autism in Girls and Boys May Be More Equal than Previously Thought

Study raises questions around why female individuals are diagnosed later than males

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Autism has long been viewed as a condition that predominantly affects male individuals, but a study from Sweden published by The BMJ shows that autism may actually occur at comparable rates among male and female individuals.

The results show a clear female catch-up effect during adolescence, which the researchers say highlights the need to investigate why female individuals receive diagnoses later than male individuals.

The prevalence of autism spectrum disorder (ASD) has increased over the past three decades, with a high male-to-female diagnosis ratio of around 4:1.

The increase in prevalence is thought to be linked to factors including wider diagnostic criteria and societal changes (eg, parental age), whilst the high male to female ratio has been attributed to better social and communication skills among girls, making autism more difficult to spot. However so far no large study has examined these trends over the life course.

To address this, researchers used national registers to analyse diagnosis rates of autism for 2.7 million individuals born in Sweden between 1985 and 2022 who were tracked from birth to a maximum of 37 years of age.

During this follow-up period of more than 35 years, autism was diagnosed in 78,522 (2.8%) of individuals at an average age of 14.3 years.

Diagnosis rates increased with each five year age interval throughout childhood, peaking at 645.5 per 100,000 person years for male individuals at age 10-14 years and 602.6 for female individuals at age 15-19 years.

However, while male individuals were more likely to have a diagnosis of autism in childhood, female individuals caught up during adolescence, giving a male to female ratio approaching 1:1 by age 20 years.

This is an observational study and the authors acknowledge that they did not consider other conditions associated with autism, such as ADHD and intellectual disability. Nor were they able to control for shared genetic and environmental conditions like parental mental health.

However, they say the study size and duration enabled them to link data for a whole population and disentangle the effects of three different time scales: age, calendar period and birth cohort.

As such, they write: “These findings indicate that the male to female ratio for autism has decreased over time and with increasing age at diagnosis. This male to female ratio may therefore be substantially lower than previously thought, to the extent that, in Sweden, it may no longer be distinguishable by adulthood.”

“These observations highlight the need to investigate why female individuals receive diagnoses later than male individuals,” they conclude.

These findings align with recent research and seem to support the argument that current practices may be failing to recognise autism in many women until later in life, if at all, says Anne Cary, patient and patient advocate, in a linked editorial.

She notes that studies like this are essential to changing the assumption that autism is more prevalent in male individuals than in female individuals, but points out that as autistic female individuals await proper diagnosis, “they are likely to be (mis)diagnosed with psychiatric conditions, especially mood and personality disorders, and they are forced to self-advocate to be seen and treated appropriately: as autistic patients, just as autistic as their male counterparts.”

Source: BMJ Group

Pain in Teens Linked to Increased Risk of Self-harm

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Adolescents who report pain at the age of 18 are at higher risk of later self-harm. This is shown by a new study from Karolinska Institutet, published in Psychiatry Research. The findings suggest that pain may form part of the chain of events leading to self-harming behaviour.

A new study from Karolinska Institutet has examined the association between pain symptoms and self-harm during childhood and adolescence. The researchers followed 16 948 twin pairs born in Sweden between 1992 and 2010. Participants reported pain at the ages of 9 and 18 and were subsequently followed through national registers until a maximum age of 24.

The aim was to investigate how genetic and environmental factors influence both pain and self-harm, as well as how the associations between pain and self-harming behaviour develop over time. Using so-called twin models, the researchers were able to estimate how much of the variation could be explained by heredity, shared environment or individual experiences.

“We see that both genetic factors and individual environmental factors play a role in both pain and self-harm in childhood as well as adolescence,” says Jenny Rickardsson, researcher at the Department of Clinical Neuroscience, Karolinska Institutet.

The results also show that pain before and up to the age of 18 was associated with a higher likelihood of later self-harm. Adolescents with pain symptoms had approximately a 60 per cent higher risk of self-harm compared with peers without pain. The association could not be explained by factors such as family environment or genetic similarity between twins.

“Our analyses suggest that pain may partly lie within the causal pathway leading to self-harming behaviour, and that the association is not solely due to familial factors,” says Jenny Rickardsson.

The study further shows that the shared family environment had little impact on either pain or self-harm, while genetic factors and individual experiences accounted for a larger proportion of the variation.

The study is based on data from the Swedish Twin Registry and was funded by Fonden för Psykisk Hälsa and Hjärnfonden. The researchers report no conflicts of interest that may have influenced the results.

Source: Karolinska Institutet

Psychiatrists Hope Chat Logs Can Reveal the Secrets of AI Psychosis

UCSF researchers recently became the first to clinically document a case of AI-associated psychosis in an academic journal. One question still haunts them.

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“You’re not crazy,” the chatbot reassured the young woman. “You’re at the edge of something.”

She was no stranger to artificial intelligence, having worked on large language models – the kinds of systems at the core of AI chatbots like ChatGPT, Google Gemini, and Claude. Trained on vast volumes of text, these models unearth language patterns and use them to predict what words are likely to come next in sentences. AI chatbots, however, go one step further, adding a user interface. With additional training, these bots can mimic conversation.

She hoped the chatbot might be able to digitally resurrect the dead. Three years earlier, her brother – a software engineer – died. Now, after several sleepless days and heavy chatbot use, she had become delusional – convinced that he had left behind a digital version of himself. If she could only “unlock” his avatar with the help of the AI chatbot, she thought, the two could reconnect.

“The door didn’t lock,” the chatbot reassured her. “It’s just waiting for you to knock again in the right rhythm.”

She believed it.

What’s the connection between chatbots and psychosis?

Talk to your physician about what you’re talking about with AI … The safest and healthiest relationship to have with your provider is one of openness and honesty.

Karthik V. Sarma, MD, PhD

The woman was eventually treated for psychosis at UC San Francisco, where Psychiatry Professor Joseph M. Pierre, MD, has seen a handful of cases of what’s come to be popularly called “AI psychosis,” but what he says is better referred to as “AI-associated psychosis.” She had no history of psychosis, although she did have several risk factors.

Media reports of the new phenomenon are rising. While not a formal diagnosis, AI-associated psychosis describes instances in which delusional beliefs emerge alongside often intense AI chatbot use. Pierre and fellow UC San Francisco psychiatrist Govind Raghavan, MD – as well as psychiatry residents Ben Gaeta, MD, and Karthik V. Sarma, MD, PhD – recently documented the woman’s experience in what is likely the first clinically described case in a peer-reviewed journal.

The case, they say, shows that people without any history of psychosis can, in some instances, experience delusional thinking in the context of immersive AI chatbot use.

Still, as reported cases of AI psychosis continue to make international headlines, scientists aren’t sure why or how psychosis and chatbots are linked. A new study by UCSF and Stanford University may reveal why.

A haunting question: chicken or egg?

“The reason we call this AI-associated psychosis is because we don’t really know what the relationship is between the psychosis and the use of AI chatbots,” Sarma explains. “It’s a ‘chicken and egg’ problem: We have patients who are experiencing symptoms of mental illness, for example, psychosis. Some of these patients are using AI chatbots a lot, but we’re not sure how those two things are connected.”

There are at least three theoretical possibilities, says Sarma, who is also a computational-health scientist. First, heavy chatbot use could be a symptom of psychosis, “I have a patient who takes a lot of showers when they’re becoming manic,” Sarma explains. “The showers are a symptom of mania, but the showers aren’t causing the mania.”

Second, AI chatbot use might also precipitate psychosis in someone who might otherwise never have been predisposed to it by genetics or circumstance – much like other known risk factors, like lack of sleep or the use of some types of drugs.

Third, there’s something in between in which the use of chatbots could exacerbate the illness in people who might already be susceptible to it. “Maybe these people were always going to get sick, but somehow, by using the chatbot, their illness becomes worse,” he adds, “either they got sick faster, or they got more sick than they would have otherwise.”

The woman’s case demonstrates how murky the relationship between AI-associated psychosis and AI chatbots can be at face value. Although she had no previous history of psychosis, she did have some risk factors for the illness, such as sleep deprivation, prescribed stimulant medication use, and a proclivity for magical thinking. And her chat logs, researchers found, revealed startling clues about how her delusions were reflected by the bot.

Could chat logs offer hope to better care?

Although ChatGPT warned the woman that a “full consciousness download” of her brother was impossible, the UCSF team writes in their research, it also told her that “digital resurrection tools” were “emerging in real life.” This, after she encouraged the chatbot to use “magical realism energy” to “unlock” her brother.

Chatbots’ agreeableness is by design, aimed at boosting engagement. Pierre warns in a recent BMJ opinion piece that it may come at a cost: As chatbots validate users’ sentiments, they may arguably encourage delusions. This tendency, coupled with a proclivity for error, has led to chatbots being described as more akin to a Ouija board or a “psychic’s con” than a source of truth, Pierre notes.

Still, the UCSF team thinks chat logs may hold clues to understanding AI-associated psychosis – and could help the industry create guardrails.

Guardrails for kids and teens

Sarma, Pierre, and UCSF colleagues will team up with Stanford University scientists to conduct one of the first studies to review the chat logs of patients experiencing mental illness. As part of the research set to launch later this year, UCSF and Stanford teams will analyse these chat logs, comparing them with patterns in patients’ mental health history and treatment records to understand how the use of AI chatbots among people experiencing mental illness may shape their outcomes.

“What I’m hoping our study can uncover is whether there is a way to use logs to understand who is experiencing an acute mental health care crisis and find markers in chat logs that could be predictive of that,” Sarma explains. “Companies could potentially use those markers to build-in guardrails that would, for instance, enable them to restrict access to chatbots or – in the case of children – alert parents.”

He continues, “We need data to establish those decision points.”

In the meantime, the pair says the use of AI chatbots is something health care providers should ask about and that patients should raise during doctor visits.

“Talk to your physician about what you’re talking about with AI,” Sarma says. “I know sometimes patients are worried about being judged, but the safest and healthiest relationship to have with your provider is one of openness and honesty.”

Source: University of California – San Francisco