Ellis researched murders at the New York Public Library. His first draft of American Psycho left all the grisly scenes until last, to be added in later. In 2010, in conversation with Jeff Baker, Ellis commented:
Set in Manhattan during the Wall Street boom of the late 1980s, American Psycho follows the life of wealthy young investment banker Patrick Bateman. Bateman, in his mid-20s when the story begins, narrates his everyday activities, from his recreational life among the Wall Street elite of New York to his forays into murder by night. Through present tense stream-of-consciousness narrative, Bateman describes his daily life, ranging from a series of Friday nights spent at nightclubs with his colleagues — where they snort cocaine, critique fellow club-goers' clothing, trade fashion advice, and question one another on proper etiquette — to his loveless engagement to fellow yuppie Evelyn and his contentious relationship with his brother and senile mother. Bateman's stream of consciousness is occasionally broken up by chapters in which he directly addresses the reader in order to critique the work of 1980s pop music artists. The novel maintains a high level of ambiguity through mistaken identity and contradictions that introduce the possibility that Bateman is an unreliable narrator. Characters are consistently introduced as people other than themselves, and people argue over the identities of others they can see in restaurants or at parties. The question of whether any of the crimes depicted in the novel actually happened or whether they were simply the fantasies of a delusional psychotic is only perpetuated further by the cinematic adaptation.
After killing Paul Owen, one of his colleagues, Bateman appropriates his apartment as a place to host and kill more victims. Bateman's control over his violent urges deteriorates. His murders become increasingly sadistic and complex, progressing from simple stabbings to drawn-out sequences of rape, torture, mutilation, cannibalism, and necrophilia, and his grasp on sanity begins to slip. He introduces stories about serial killers into casual conversations and on several occasions openly confesses his murderous activities to his coworkers, who never take him seriously, do not hear what he says, or misunderstand him completely—for example, hearing the words "murders and executions" as "mergers and acquisitions." Bateman begins to experience bizarre hallucinations such as seeing a Cheerio interviewed on a talk show, being stalked by an anthropomorphic park bench, and finding a bone in his Dove Bar. These incidents culminate in a shooting spree during which he kills several random people in the street, resulting in a SWAT team being dispatched in a helicopter. This narrative episode sees the first-person perspective shift to third-person and the subsequent events are, although not for the first time in the novel, described in terms pertaining to cinematic portrayal. Bateman flees on foot and hides in his office, where he phones his attorney, Harold Carnes, and confesses all his crimes to the answering machine.
Later, Bateman revisits Paul Owen's apartment, where he had earlier killed and mutilated two prostitutes, carrying a surgical mask in anticipation of the decomposing bodies he expects to encounter. He enters the perfectly clean, refurbished apartment, however, filled with strong-smelling flowers meant, perhaps, to conceal a bad odor. The real estate agent, who sees his surgical mask, fools him into stating he was attending the apartment viewing because he saw an "ad in the Times" (when there was no such advertisement). She tells him to leave and never return.
At the end of the story, Bateman confronts Carnes about the message he left on his machine, only to find the attorney amused at what he considers a hilarious joke. Mistaking Bateman for another colleague, Carnes claims that the Patrick Bateman he knows is too much of a coward to have committed such acts. In the dialogue-laden climax, Carnes stands up to a defiant Bateman and tells him his claim of having murdered Owen is impossible, because he had dinner in London with him a few days before, not once but twice.
The book ends as it began, with Bateman and his colleagues at a new club on a Friday night, engaging in banal conversation. The sign seen at the end of the book simply reads "This is not an exit."
According to literary critic Jeffrey W. Hunter, American Psycho is largely a critique of the "shallow and vicious aspects of capitalism." The characters are predominantly concerned with material gain and superficial appearances, traits indicative of a postmodern world in which the 'surface' reigns supreme. This leads Patrick Bateman to act as if "everything is a commodity, including people," an attitude that is further evident in the rampant objectification of women that occurs in the novel. This distancing allows Bateman to rationalize his actions, in one anthropophagic scene, Bateman remarks "though it does sporadically penetrate how unacceptable some of what I'm doing actually is, I just remind myself that this thing, this girl, this meat, is nothing..."
Patrick Bateman's consumption of what he views as nothing more than a piece of meat is an almost parodically literal interpretation of a monster created by consumer culture. This, combined with sex, violence, drugs, and other desires of the id, is how Bateman realizes his base urges in a superficial world.Patrick Bateman - The narrator and anti-hero protagonist of the novel.
Evelyn Richards - Bateman's girlfriend.
Timothy Price - Bateman's best friend and colleague. Later appears as a teenager in Ellis' novel The Informers.
Paul Owen - Bateman's colleague who is later murdered by Bateman.
Jean - Bateman's secretary, whom Bateman refers to as "Jean, my secretary who is in love with me".
Luis Carruthers - A closeted homosexual co-worker who is in love with Bateman, something that disgusts the latter.
Courtney Lawrence - Luis' girlfriend who is having an affair with Bateman.
Craig McDermott - Bateman's colleague, part of a social foursome alongside Bateman, Timothy Price and David Van Patten.
David Van Patten - Bateman's colleague, also part of Bateman's main social group.
"Christie" – A prostitute, employed and abused sexually on multiple occasions by Bateman before he eventually murders her. Bateman gives her this name; her real one is never revealed.
Elizabeth - A dinner date of Bateman's, drugged and coerced into having sex with "Christie" before being murdered.
Marcus Halberstam – Bateman's colleague; Paul Owen repeatedly mistakes Bateman for Marcus.
Donald Kimball – Private detective hired to investigate Paul Owen's disappearance.
Alison Poole – Sexually assaulted by Bateman; created by Ellis' friend Jay McInerney in his novel Story of My Life and based on McInerney's former girlfriend Rielle Hunter; reappears as a main character in Ellis's later novel Glamorama, where she is involved with the lead character, Victor Ward.
Sean Bateman – Younger brother of Patrick Bateman and also the lead character of The Rules of Attraction.
Paul Denton – Friend of Paul Owen, who also appears in The Rules of Attraction where he is possibly romantically involved with Patrick's brother Sean.
Christopher Armstrong – Bateman's colleague at Pierce & Pierce.
Bethany – An old girlfriend of Patrick's whom, after a date, he murders in a particularly heinous manner.
Stash – Evelyn's friend, is HIV positive.
Vanden – Evelyn's friend from the East Village who attends Camden College, the main setting of The Rules of Attraction.
Al - A homeless man whom Bateman blinds and disfigures with a knife.
The book was originally to have been published by Simon & Schuster in March 1991, but the company withdrew from the project because of "aesthetic differences". Vintage Books purchased the rights to the novel and published the book after the customary editing process. The book was not published in hardcover in the United States until 2012, when a limited hardcover edition was published by Centipede Press, although a deluxe paperback was offered. Ellis received numerous death threats and hate mail after the publication of American Psycho.
In Germany, the book was deemed "harmful to minors", and its sales and marketing severely restricted from 1995 to 2000. In Australia, the book is sold shrink-wrapped and is classified "R18" under national censorship legislation. The book may not be sold to those under 18 years of age. Along with other Category 1 publications, its sale is theoretically banned in the state of Queensland and it may only be purchased shrink-wrapped. In Brisbane, the novel is available to those over 18 from all public libraries and can still be ordered and purchased (shrink-wrapped) from many book stores despite this prohibition. Bret Easton Ellis has commented on this, saying "I think it's adorable. I think it's cute. I love it." In New Zealand, the Government's Office of Film & Literature Classification has rated the book as R18. The book may not be sold or lent in libraries to those under 18 years of age. It is generally sold shrink wrapped in bookstores. In Canada, the book generated renewed controversy during the trial of serial killer Paul Bernardo after it was discovered that Bernardo owned a copy of the book and had "read it as his 'bible'."
Feminist activist Gloria Steinem was among those opposed to Ellis' book because of its portrayal of violence toward women. Steinem is the stepmother of Christian Bale, who played Bateman in the film. This coincidence is mentioned in Ellis' mock memoir Lunar Park.
Phil Collins, whose solo career is referenced in the book, recalled: "I didn't read it. At the time, I just thought, 'That's all we need: glorifying all this crap. I'm not interested.' Then the film came out and I thought it was very funny."
In 2000, writer Guinevere Turner and writer/director Mary Harron adapted American Psycho into a dark, comic film released by Lions Gate Films. This screenplay was selected over three others, including one by Ellis himself. Bateman is played by Christian Bale with Willem Dafoe and Reese Witherspoon in supporting roles. As a promotion for the film, one could register to receive e-mails "from" Patrick Bateman, supposedly to his therapist. The e-mails, written by a writer attached to the film and approved by Ellis, follow Bateman's life since the events of the film. American Psycho premiered at the 2000 Sundance Film Festival where it was touted as the next Fight Club. The Motion Picture Association of America (MPAA) gave the film an NC-17 rating for a scene featuring Bateman having a threesome with two prostitutes. The producers excised approximately 18 seconds of footage to obtain an R-rating for the film.
It polarized audiences and critics with some showering praise, others scorn. Upon its theatrical release, however, the film received positive reviews in crucial publications, including The New York Times which called it a "mean and lean horror comedy classic". Author Bret Easton Ellis said, "American Psycho was a book I didn't think needed to be turned into a movie," as "the medium of film demands answers," which would make the book "infinitely less interesting." The film currently holds a 67% "Fresh" rating on Rotten Tomatoes.
A direct-to-video spin-off, American Psycho 2 was released and directed by Morgan J. Freeman. This spin-off was not based on the novel or the original film, as its only connection with the original is the death of Patrick Bateman (played by Michael Kremko wearing a face mask), briefly shown in a flashback.
In 2009, Audible.com produced an audio version of American Psycho, narrated by Pablo Schreiber, as part of its Modern Vanguard line of audiobooks. A Hungarian version of the novel was written by Attila Hazai (1967-2012) called Budapesti skizo ("Budapest Psycho", 1997); it was Hazai's best known work but as of his death never translated into English.
In 2013, a Kickstarter campaign was launched by Ellis and others to get a musical stage adaptation made. The premiere of the musical, with music and lyrics by Duncan Sheik opened at the Almeida Theatre, London in December 2013. The role of Patrick Bateman was played by Matt Smith.
Also in 2013, FX was planning a TV series, set in the present, with Patrick Bateman in his 50s.