A Psychic Duelist is an individual in the Yu-Gi-Oh! 5D's series (both anime and manga) who has the ability to materialize real Duel Monsters using cards and causing Life Point damage inflicted to the opponent to become real damage and pain, even outside of a Duel. When a Duel involves a Psychic Duelist it is known as a Psychic Duel.
Akiza Izinski and Sayer have displayed such abilities in the series. In the case of Akiza, inflicting the pain was involuntary and was fueled by her hatred and violent nature prior to meeting and later befriending Yusei Fudo.
Toby was also a Psychic Duelist, but he was never shown using his powers before his death in the series.
Like a Shadow Duel, a Psychic Duel is capable of causing destruction to the area where the Duel is taking place, though a Shadow Duel is stated to be far more powerful.
Society has been known to reject Psychic Duelists. Akiza Izinski was even neglected by her own parents due to the nature of her powers which had been causing legitimate injury. Akiza caused many accidents while Dueling, easily turning society against her. As a result, she took on the persona of the Black Rose.
Sayer founded the Arcadia Movement, explaining his motive as creating a refuge for Psychic Duelists to protect them from the world and use their powers to get revenge on everyone for neglecting them. Hypocritically, he himself abuses the socially neglected. The Arcadia Movement is rumored to conduct suspicious unconventional experiments, and Akiza painfully discovers that she is among the list of experimented subjects after Sayer's supposed death and her second Duel with Yusei.