Joe Pierre, MD
@psychunseen.bsky.social
Academic psychiatrist at UCSF and author of the Psych Unseen blog at Psychology Today and the book False: How Mistrust, Disinformation, and Motivated Reasoning Make Us Believe Things That Aren't True (Oxford University Press, 2025) drjoepierre.com
this article by @kashhill.bsky.social is really interesting... customers complaining that GPT-5 "lacked soul."
chatbots aren't really making money, so I don't know that companies are incentivized to make them safer if they're less appealing.
www.nytimes.com/2025/11/23/t...
chatbots aren't really making money, so I don't know that companies are incentivized to make them safer if they're less appealing.
www.nytimes.com/2025/11/23/t...
What OpenAI Did When ChatGPT Users Lost Touch With Reality
www.nytimes.com
December 7, 2025 at 7:46 PM
this article by @kashhill.bsky.social is really interesting... customers complaining that GPT-5 "lacked soul."
chatbots aren't really making money, so I don't know that companies are incentivized to make them safer if they're less appealing.
www.nytimes.com/2025/11/23/t...
chatbots aren't really making money, so I don't know that companies are incentivized to make them safer if they're less appealing.
www.nytimes.com/2025/11/23/t...
just looked at my interview transcript. she said that she was "thankful" for the change from 4o to 5.0, so sounds like she didn't go back.
December 7, 2025 at 7:26 PM
just looked at my interview transcript. she said that she was "thankful" for the change from 4o to 5.0, so sounds like she didn't go back.
The switch was only for paying customers… I don’t think she was one, but can’t recall now.
December 7, 2025 at 6:05 PM
The switch was only for paying customers… I don’t think she was one, but can’t recall now.
The reality is that the DSM was not designed with this phenomenon in mind.
The case I described was diagnosed with either mania with psychotic features or psychosis, unspecified. I've also seen cases of schizophrenia with AI-exacerbated delusions. For some delusional disorder is appropriate.
The case I described was diagnosed with either mania with psychotic features or psychosis, unspecified. I've also seen cases of schizophrenia with AI-exacerbated delusions. For some delusional disorder is appropriate.
December 5, 2025 at 6:12 PM
The reality is that the DSM was not designed with this phenomenon in mind.
The case I described was diagnosed with either mania with psychotic features or psychosis, unspecified. I've also seen cases of schizophrenia with AI-exacerbated delusions. For some delusional disorder is appropriate.
The case I described was diagnosed with either mania with psychotic features or psychosis, unspecified. I've also seen cases of schizophrenia with AI-exacerbated delusions. For some delusional disorder is appropriate.
Interesting potential story worth investigating... are the targets of US strikes on Venezuela "drug boats" being determined by AI?
Is that how we're making decisions to kill people?
www.hindustantimes.com/world-news/a...
Is that how we're making decisions to kill people?
www.hindustantimes.com/world-news/a...
AI against cocaine: How America is using artificial intelligence to stop drug trafficking
Including the first one in September, the US has carried out 16 airstrikes against “drug boats” so far. This is how AI is part of their maritime war against drugs.
www.hindustantimes.com
December 5, 2025 at 1:36 AM
yes, that is fair and many risk factors are acknowledged, although i would argue that an interactive chatbot telling the user things is different than reading a text.
November 22, 2025 at 8:28 PM
yes, that is fair and many risk factors are acknowledged, although i would argue that an interactive chatbot telling the user things is different than reading a text.
yes, original doses. and yes, we're trying to collect data on variables like total time in a larger cohort study.
November 22, 2025 at 8:27 PM
yes, original doses. and yes, we're trying to collect data on variables like total time in a larger cohort study.
we shared your curiosity on that subject... we didn't speak to the provider, but I'm struck by how easily some providers prescribe stimulants and are often unaware of (or don't ask about) the presence of psychotic symptoms.
November 22, 2025 at 8:08 PM
we shared your curiosity on that subject... we didn't speak to the provider, but I'm struck by how easily some providers prescribe stimulants and are often unaware of (or don't ask about) the presence of psychotic symptoms.
it was peer reviewed. final version out soon.
November 22, 2025 at 8:06 PM
it was peer reviewed. final version out soon.
yes, "her hospitalizations support a diagnosis of either brief psychotic disorder or manic psychosis fueled by lack of sleep and behavioral activation" but there's the additional dimension of the chatbot inducing/shaping/reinforcing the delusional content.
November 22, 2025 at 8:05 PM
yes, "her hospitalizations support a diagnosis of either brief psychotic disorder or manic psychosis fueled by lack of sleep and behavioral activation" but there's the additional dimension of the chatbot inducing/shaping/reinforcing the delusional content.