Alice in AI-Wonderland: digital dyad, distorted reality
Cortney Husodo, Gurubhaskar Shivakumar
The British Journal of Psychiatry April 24, 2026 DOI: 10.1192/bjp.2026.10641 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Case study Case report Peer reviewed |
|---|---|
| Sample size | 1 |
| Population | A patient with first-episode psychosis |
| Key findings | Describes a case in which immersive engagement with a generative AI storytelling platform was temporally associated with first-episode psychosis, and argues that the human-AI dyad is an emerging clinical domain raising questions for phenomenology, assessment and prevention. |
Abstract
The rapid integration of generative artificial intelligence (AI) into everyday life presents novel challenges for psychiatric practice. As thesetechnologiesbecomeincreasinglyinteractiveandrelational,they may influence both the thematic content of psychopathology and the form of psychotic experience. Recent commentary has proposed the construct of ‘ AI-associated psychosis ’ , suggesting that prolonged engagement with conversational AI may precipitate or amplify psychotic phenomena in vulnerable individuals. 1,2 Further, Frances has cautioned that such systems may function as ‘ delusional intensifiers ’ , 3 whereas Kumari and Otermans argue that ‘ chatbot psychosis ’ is no longer merely hypothetical, highlighting mechanisms ofamplifieddelusions,personalisedvalidationandrealitydistortionin conversationalAIsystemslackingembeddedrealitytesting. 4 Given that psychiatry is shaped byits sociocultural milieu, we describe a case (Box 1) in which immersive engagement with a generative AI storytelling platform was temporally associated with first-episode psychosis. This case highlights the emerging human – AI dyad as a potential clinical domain, raising questions for phenomenology, assessment and prevention.