Assessing the potential of ChatGPT for psychodynamic formulations in psychiatry: An exploratory study

GPT-4 generated psychological reports in psychodynamic perspective: a pilot study on quality, risk of hallucination and client satisfaction

Background

Recently, there have been active proposals on how to utilize large language models (LLMs) in the fields of psychiatry and counseling. It would be interesting to develop programs with LLMs that generate psychodynamic assessments to help individuals gain insights about themselves, and to evaluate the features of such services. However, studies on this subject are rare. This pilot study aims to evaluate quality, risk of hallucination (incorrect AI-generated information), and client satisfaction with psychodynamic psychological reports generated by GPT-4.

Methods

The report comprised five components: psychodynamic formulation, psychopathology, parental influence, defense mechanisms, and client strengths. Participants were recruited from individuals distressed by repetitive interpersonal issues. The study was conducted in three steps: 1) Questions provided to participants, designed to create psychodynamic formulations: 14 questions were generated by GPT for inferring psychodynamic formulations, while 6 fixed questions focused on the participants' relationship with their parents. A total of 20 questions were provided. Using participants' responses to these questions, GPT-4 generated the psychological reports. 2) Seven professors of psychiatry from different university hospitals evaluated the quality and risk of hallucinations in the psychological reports by reading the reports only, without meeting the participants. This quality assessment compared the psychological reports generated by GPT-4 with those inferred by the experts. 3) Participants evaluated their satisfaction with the psychological reports. All assessments were conducted using self-report questionnaires based on a Likert scale developed for this study.

Results

A total of 10 participants were recruited, and the average age was 32 years. The median response indicated that quality of all five components of the psychological report was similar to the level inferred by the experts. The risk of hallucination was assessed as ranging from unlikely to minor. According to the median response in the satisfaction evaluation, the participants agreed that the report is clearly understandable, insightful, credible, useful, satisfying, and recommendable.

Conclusion

This study suggests the possibility that artificial intelligence could assist users by providing psychodynamic interpretations.

Use of generative artificial intelligence (AI) in psychiatry and mental health care: a systematic review

OBJECTIVES

Tools based on generative artificial intelligence (AI) such as ChatGPT have the potential to transform modern society, including the field of medicine. Due to the prominent role of language in psychiatry, e.g., for diagnostic assessment and psychotherapy, these tools may be particularly useful within this medical field. Therefore, the aim of this study was to systematically review the literature on generative AI applications in psychiatry and mental health.

METHODS

We conducted a systematic review following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The search was conducted across three databases, and the resulting articles were screened independently by two researchers. The content, themes, and findings of the articles were qualitatively assessed.

RESULTS

The search and screening process resulted in the inclusion of 40 studies. The median year of publication was 2023. The themes covered in the articles were mainly mental health and well-being in general - with less emphasis on specific mental disorders (substance use disorder being the most prevalent). The majority of studies were conducted as prompt experiments, with the remaining studies comprising surveys, pilot studies, and case reports. Most studies focused on models that generate language, ChatGPT in particular.

CONCLUSIONS

Generative AI in psychiatry and mental health is a nascent but quickly expanding field. The literature mainly focuses on applications of ChatGPT, and finds that generative AI performs well, but notes that it is limited by significant safety and ethical concerns. Future research should strive to enhance transparency of methods, use experimental designs, ensure clinical relevance, and involve users/patients in the design phase.

Applications of large language models in psychiatry: a systematic review

Background

With their unmatched ability to interpret and engage with human language and context, large language models (LLMs) hint at the potential to bridge AI and human cognitive processes. This review explores the current application of LLMs, such as ChatGPT, in the field of psychiatry.

Methods

We followed PRISMA guidelines and searched through PubMed, Embase, Web of Science, and Scopus, up until March 2024.

Results

From 771 retrieved articles, we included 16 that directly examine LLMs' use in psychiatry. LLMs, particularly ChatGPT and GPT-4, showed diverse applications in clinical reasoning, social media, and education within psychiatry. They can assist in diagnosing mental health issues, managing depression, evaluating suicide risk, and supporting education in the field. However, our review also points out their limitations, such as difficulties with complex cases and potential underestimation of suicide risks.

Conclusion

Early research in psychiatry reveals LLMs' versatile applications, from diagnostic support to educational roles. Given the rapid pace of advancement, future investigations are poised to explore the extent to which these models might redefine traditional roles in mental health care.