Tuesday's knife attack by a 27-year-old German shouting "Allahu Akbar" left one dead and three injured in Munich.
But police quickly dismissed any jihadist motive, saying there were "strong reasons" to believe he acted "in a state of insanity".
Numerous similar cases have been reported around the globe.
Man Haron Monis, who died along with two of his hostages at a Sydney coffee shop in December 2014, had a long history of mental illness.
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Experts say the connection is not unexpected, since the jihadist ideology offers a compelling narrative for dealing with feelings of marginalisation and paranoid fantasies of persecution that can exist among people with severe mental illnesses.
"Each time society evolves, delusional people evolve. Delusional behaviour is always connected to the times," said psychiatrist Daniel Zagury, who has acted as an expert witness at the trials of several alleged jihadists.
"There have always been mystical delusions. They are often the most dangerous. When God is on your side, things become much simpler," he added.
Zagury warned against labelling all jihadists as psychologically unstable - saying they account for only around 10 per cent of cases.
The majority are either "small-time delinquents... Who started off as drug addicts, dealers, and try to clean up their lives by turning to radical Islam."
Or they are "the most dangerous kind" -- the clean-living, well-educated youngster who becomes a true believer in violent extremism.