AI chatbots spark mental health concerns, including psychosis risk - Michigan Medicine

We’re sharing this article early to provide faster access to peer-reviewed, accepted research. It is citable and carries a permanent DOI. This version is subject to further edits and will be replaced automatically by the final Version of Record. All legal disclaimers apply. Observational evidence is increasingly central to prognostic precision in early intervention in mental health, particularly in Clinical High-Risk for Psychosis (CHR-P) populations where trajectories are heterogeneous and clinical decisions unfold sequentially. In this context, baseline pharmacological exposure should not be treated merely as a nuisance variable or dismissed because it may reflect confounding by indication, confounding by severity, or protopathic bias. These mechanisms limit causal interpretation, but they may also explain why treatment exposure carries prognostic information. Antipsychotic, antidepressant, benzodiazepine, or combined exposure at CHR-P inception may encode prior clinical deterioration, symptom burden, comorbidity, treatment-seeking pathways, clinician concern, partial treatment response, or pharmacologically attenuated expression of emerging psychosis.

A distinct presentation, a growing evidence base, and specialized clinical expertise support formally recognizing postpartum psychosis in the next DSM update. Mena Mirhom, MD, FAPA, a board-certified psychiatrist and Psychiatric Times section editor, argued that postpartum psychosis should be considered for inclusion in the next iteration or update of the DSM. He said the Lindsay Clancy case and the national conversation around it raise the question for good reason. The DSM-5-TR does not list postpartum psychosis as its own diagnosis. Clinicians instead apply a peripartum-onset specifier to mood disorders, or a postpartum-onset specifier to brief psychotic disorder. Both cover onset during pregnancy or within 4 weeks after delivery.1 Mirhom said the current evidence supports a more specific approach. The Case for InclusionMirhom cited 3 lines of evidence. The first is the nature of the condition itself, which presents in a nuanced and distinct way. The second is the growing research literature on postpartum psychosis.