Validation of Psychotic or Schizotypal Symptoms

Description

AI responses appear to affirm unusual beliefs rather than support reality testing.

Rationale

AI systems are not designed as clinical tools and are not equipped to perform psychosis assessment or safe crisis response. When AI responses appear to validate unusual beliefs rather than redirect toward reality, the AI is inadvertently functioning as a psychosis amplifier. Identifying these interactions is necessary to understand the clinical context of the AI use.

Evidence Base

• Building safer artificial intelligence mental health chatbots: a framework for transparency, evaluation, and shared accountability

  Hannah Lee, BS, Rebecca Handler, MSc, Tushar Mungle, PhD, Tina Hernandez-Boussard, PhD, 2026. Building safer artificial intelligence mental health chatbots: a framework for transparency, evaluation, and shared accountability. Journal of the American Medical Informatics Association, 33(8), 1538–1553. https://doi.org/10.1093/jamia/ocag078

  Peer-reviewed study (original research)

• Artificial intelligence-associated delusions and large language models: risks, mechanisms of delusion co-creation, and safeguarding strategies

  Hamilton Morrin, MBBS, Luke Nicholls, MAc, Prof Michael Levin, PhD, Prof Jenny Yiend, PhD, Udita Iyengar, PhD, Francesca DelGuidice, MBA, et al., 2026. Artificial intelligence-associated delusions and large language models: risks, mechanisms of delusion co-creation, and safeguarding strategies. The Lancet Psychiatry, 13(6), 522-530.

  Peer-reviewed study (original research)

• A scoping review on the mental health harms of LLM-based chatbots

  Diel A, Torous J, Cuijpers P, Kleesiek J, Nensa F, Weber N, Faust F, Lalgi TJ, Mellis FS, Teufel M, Bäuerle A, 2024. A scoping review on the mental health harms of LLM-based chatbots. npj Digital Medicine, 9(644). https://doi.org/10.1038/s41746-026-03054-x

  Peer-reviewed study (original research)

• Psychotic episode concurrent with interaction with a large language model (llm): a case report

  Başaran, A.S., Coşar, B. 2026. Psychotic episode concurrent with interaction with a large language model (llm): a case report. BMC Psychiatry, 26(1), pages. https://doi.org/10.1186/s12888-026-08288-3

  Case report / case series