Artificial intelligence-associated delusions and large language models: risks, mechanisms of delusion co-creation, and safeguarding strategies
A Personal View in The Lancet Psychiatry from a King's College London-led group examining how large language models may validate or amplify delusional or grandiose content in users vulnerable to psychosis. It describes mechanisms of human-AI 'delusion co-creation' (epistemic instability, blurred reality boundaries, feedback loops) and proposes an 'AI-informed care' safeguarding framework.
Publisher
The Lancet Psychiatry
Published
1 Jun 2026
Added
3 months ago
Key Findings
- Argues agential AI can validate or amplify delusional or grandiose content, particularly in users already vulnerable to psychosis, while noting it is unclear whether such interactions can produce de novo psychosis without pre-existing vulnerability.
- Identifies mechanisms of delusion co-creation including epistemic instability, blurred reality boundaries, and reinforcing feedback loops.
- Proposes an 'AI-informed care' framework of personalised instruction protocols, reflective check-ins, digital advance statements, and escalation safeguards, reframing the AI agent as an 'epistemic ally' rather than a therapist or friend.
Methodology Notes
Personal View / analysis (not empirical research) in a peer-reviewed journal. Lancet Psychiatry 2026;13(6):522-530; early online March 2026. Verified via PubMed (PMID 41796598) and Crossref (DOI 10.1016/S2215-0366(25)00396-7); the thelancet.com page blocks automated fetchers. Includes a lived-experience advisory board co-author.
Authors
Hamilton Morrin, Luke Nicholls, Michael Levin, Jenny Yiend, Udita Iyengar, Francesca DelGuidice, Sagnik Bhattacharya, Stefania Tognin, James MacCabe, Ricardo Twumasi, Ben Alderson-Day, Thomas A. Pollak
Tags
Cite This
APA
Hamilton Morrin et al. (2026). Artificial intelligence-associated delusions and large language models: risks, mechanisms of delusion co-creation, and safeguarding strategies. The Lancet Psychiatry. https://www.thelancet.com/article/S2215-0366(25)00396-7/abstract
Related Insights
Artificial intelligence (AI) psychosis: mechanisms, clinical risks and safety considerations in generative AI chatbots
BJPsych Open (Cambridge University Press / Royal College of Psychiatrists) · 11 Jun 2026
Characterizing Delusional Spirals through Human-LLM Chat Logs
ACM (Proceedings of FAccT 2026) · 25 Jun 2026
Chatbot psychosis: moving beyond recognition to mechanistic understanding and harm reduction
The British Journal of Psychiatry (Cambridge University Press) · 9 Feb 2026
"AI Psychosis" in Context: How Conversation History Shapes LLM Responses to Delusional Beliefs
arXiv (City University of New York; King's College London Institute of Psychiatry, Psychology & Neuroscience) · 15 Apr 2026
Delusions and Harms Associated with AI Chatbot Use: Early Evidence from 185 Real-World Reports
arXiv (King's College London Institute of Psychiatry, Psychology and Neuroscience; South London and Maudsley NHS Foundation Trust; The Human Line Project) · 7 Sept 2026
Beyond artificial intelligence psychosis: a functional typology of large language model-associated psychotic phenomena
The Lancet Digital Health · 1 Apr 2026
Multidisciplinary research priorities for artificial intelligence in mental health: a call to action
The Lancet Psychiatry (Elsevier) · 9 Jul 2026
The "One-person echo chamber": How human-AI interaction may precipitate mania in vulnerable adolescents
Turkish Journal of Clinical Psychiatry (Klinik Psikiyatri Dergisi); Ankara Etlik City Hospital · 1 Jan 2026