Considered a cult classic horror film, American Psycho garnered a lot of unanswered questions about the true meaning behind it. Was Patrick Bateman (Christian Bale) truly an American psycho? Or were all the crimes he had committed in his head? There were moments in American Psycho where Patrick partook in heinous acts of murdering people he deemed unworthy of existence. He killed not only his colleague but a homeless man, a dog, a supposed girlfriend, and sex workers.
Source:https://www.cbr.com/american-psycho-ending-explained/