Is AI causing psychosis, or is psychosis driving the chatbot use?
A UCSF psychiatrist is pushing back on the phrase “AI psychosis.” In an interview with UCSF Magazine, Dr. Karthik Sarma says he prefers “AI-associated psychosis.” Heavy chatbot use may be an early sign of an emerging episode rather than its cause, and he thinks it’s unlikely a chatbot would trigger psychosis in someone with no underlying vulnerability. For families of someone with schizophrenia or bipolar disorder, that vulnerability is already there. Sarma believes chatbots can make an existing episode worse. His advice to clinicians is to ask patients how they use chatbots and why it matters to them. He also acknowledges there are no evidence-based treatments yet for problematic chatbot use. If your loved one’s chatbot use suddenly increases, treat it the way you would a change in sleep: something to notice, write down and tell the treatment team.
Magnetic stimulation shows early promise for the symptoms medication can’t reach
Hallucinations get most of the attention, but problems with thinking and memory are often what keeps people with schizophrenia out of work and school. Current medications do little for them. New research from Vanderbilt, described by Managed Healthcare Executive, tested transcranial magnetic stimulation (TMS), a noninvasive treatment that uses magnetic pulses on the scalp. A single session made no difference. Five sessions improved processing speed, one of the areas hit hardest by the illness. This is early research, not an approved treatment for schizophrenia. It’s still worth knowing about, because it targets symptoms families have long been told to simply live with.
A new review explains how brain stimulation works, and what’s still unknown
A review published this month in Molecular Psychiatry looks at four brain stimulation approaches: TMS, tDCS (a gentle electrical current), deep brain stimulation and focused ultrasound. For schizophrenia, the authors report evidence that certain TMS approaches aimed at the front of the brain can help with negative symptoms, such as low motivation and withdrawal. Another approach, aimed at a region near the ears, can reduce symptoms. Research in bipolar disorder is much thinner. The authors also say plainly that treatment protocols aren’t standardized, results vary from person to person, and scientists still don’t fully understand why these treatments work. The field is promising but not settled, and that’s a useful frame when a clinic advertises TMS as a sure thing.
Brain stimulation is moving into the home. Who’s supervising it?
Brain stimulation for depression no longer happens only in a clinic. The FDA has recently approved devices people use at home, and a new commentary in the American Journal of Psychiatry asks how to widen access without losing oversight. These devices are approved for depression, not schizophrenia or bipolar disorder. But the question matters for our families: as more treatments move into the home, someone has to watch for side effects and changes in mood, and that someone is often a caregiver.
Stay connected…sign up for the weekly newsletter on ResourcesforSMI
