When artificial intelligence speaks: psychologically adverse effects of the shift from text- to voice-based chatbots

Worldwide, around 800 million people use ChatGPT every week, making it the most prominent chatbot based on generative artificial intelligence (AI chatbot) (Bellan 2025).While AI chatbots and their underlying technology arguably have a positive potential, there are reports about psychologically adverse effects, such as AI-associated delusions, mania or suicidality, that affect a fraction of users (Augustin 2025; Hill 2025; Morrin et al. 2025; Olsen et al. 2025; Pierre et al. 2025; Østergaard 2025b, 2025a).Regarding AI-associated delusions or mania, OpenAI-the tech company behind ChatGPT-estimated in a press release from October 2025, "[…] that around 0.07% of users active in a given week indicate possible signs of mental health emergencies related to psychosis or mania" (OpenAI 2025).Indicators of "potential suicidal planning or intent" were present in 0.15% of weekly active users (OpenAI 2025).With 800 million users, if assuming that these estimates are valid (OpenAI has provided very little context about how the estimation was carried out), this amounts to half a