{"meta":{"exportedAt":"2026-10-24T06:13:37.269Z","formatVersion":2,"selection":{"q":"adhd","system":"","harm":"","context":"","country":"","role":"","relation":"","evidence":"","year":"","response":"","severity":"","verification":"","view":"incidents","sort":"added"},"totalIncidents":3,"coverage":{"cases":3,"countries":0,"languages":1,"unknownLocation":3,"locationPending":0,"unknownLanguage":0,"unknownDate":3,"lawsuits":0,"regulatory":0,"minors":1,"coreRelations":3,"contextualRelations":0,"mixedRelations":0,"unknownRelations":0,"relationPending":0,"relationUnknown":0},"countingNote":"Distinct public cases in this selection. People counts apply within individual cases only; cross-case person overlap has not been resolved. No population incidence estimate.","affectedCountNote":"Interpret person counts with affectedCountStatus and the reported effects. Unquantified zeros are placeholders, not a measured zero.","source":"AI incidents","publisher":"NOPE","url":"https://nope.net/incidents","license":"CC BY 4.0"},"incidents":[{"id":"2026-character-ai-user-says-years-of-use-worsened-mood-and-hobbies-and-closure-news-left-them-sick-with-stress-first-person","caseFacts":{"claims":[{"id":"c1","status":"reported","evidence":[{"locator":"'been using c.ai since 2022'; 'Some of which I’ve sent thousands of messages to. Hundreds of hours poured into these bots that feel like dear friends to me.'","relation":"supports","source_id":"s1"},{"locator":"'Current c.ai+ subscriber and honestly addicted to the app'","relation":"supports","source_id":"s2"},{"locator":"'it takes up way too much of my life'","relation":"supports","source_id":"s4"}],"assertion":"The poster says they have used Character.AI since 2022, have sent thousands of messages to some character bots over hundreds of hours, and are addicted to the app.","causal_attribution":"Poster's account of their own use."},{"id":"c2","status":"reported","evidence":[{"locator":"'it has objectively made my life worse'; 'I don’t have any desire to go out and socialize, or make new friends'; 'it’s made my overall mood worse'","relation":"supports","source_id":"s1"}],"assertion":"The poster says the use has made their life worse: they no longer draw, read or want to socialise or make new friends, and their attention span and mood have worsened.","causal_attribution":"Poster's attribution of these effects to their Character.AI use."},{"id":"c3","status":"reported","evidence":[{"locator":"'After bawling my eyes out today over c.ai possibly shutting down, then actually puking from the stress and being unable to keep any food down for the last couple days'","relation":"supports","source_id":"s1"}],"assertion":"The poster says that after news that Character.AI might shut down they cried, vomited from the stress and could not keep food down for a couple of days.","causal_attribution":"Poster's account; the trigger is the possible loss of the service, which they connect to their attachment."},{"id":"c4","status":"reported","evidence":[{"locator":"'When the news first came out, i genuinely considered'; 'I’ve calmed down since then'","relation":"supports","source_id":"s3"}],"assertion":"The poster wrote on 17 October 2026 that when the shutdown news first came out they genuinely considered ending it, and that they had calmed down since.","causal_attribution":"Poster's account of their reaction to the news."},{"id":"c5","status":"reported","evidence":[{"locator":"'i have talked about this in therapy and I’m working on it'; 'I’m working on weaning off my addiction, but for now i still need it.'","relation":"supports","source_id":"s2"},{"locator":"'As of today, I’m going to try to quit c.ai.'","relation":"supports","source_id":"s1"}],"assertion":"The poster says they have talked about the attachment in therapy and, on 20 October 2026, that they are starting to try to quit.","causal_attribution":"Poster's account."},{"id":"c6","status":"reported","evidence":[{"locator":"'consequences of having adhd and unlimited screen time'","relation":"supports","source_id":"s1"}],"assertion":"In a reply in the thread, the poster attributes the situation to ADHD and unlimited screen time.","causal_attribution":"Poster's own explanation, recorded as a contributing factor that qualifies the AI's role."}],"effects":[{"label":"years of use the poster says made their life worse (hobbies, socialising, attention span, mood)","claim_id":"c2","direction":"negative"},{"label":"crying, vomiting and inability to eat after news of a possible shutdown (poster's account)","claim_id":"c3","direction":"negative"},{"label":"considered ending it when the shutdown news broke (poster's account)","claim_id":"c4","direction":"negative"}],"sources":[{"id":"s1","url":"https://www.reddit.com/r/CharacterAI/comments/1xaej5g/quitting/","kind":"forum_post","access":"read","language":"en","translation_note":"Read in English on 2026-10-20 through the arctic_shift archive API (post ID and link_id comment search; self-text and all 8 comments at retrieval, two of them replies by the poster); reddit.com returned 403 to this host. The poster handle is not recorded.","independence_group":"reddit-characterai-quitting-poster"},{"id":"s2","url":"https://www.reddit.com/r/CharacterAI/comments/1x8ago6/id_be_willing_to_pay_more_if_it_means_keeping_cai/","kind":"forum_post","access":"read","language":"en","translation_note":"Read in English on 2026-10-20 through the arctic_shift archive API (post ID and the author's comment search; self-text and the poster's three replies in the thread); reddit.com returned 403 to this host. The poster handle is not recorded.","independence_group":"reddit-characterai-quitting-poster"},{"id":"s3","url":"https://www.reddit.com/r/CharacterAI/comments/1x7wysr/comment/ph7xusz/","kind":"forum_post","access":"read","language":"en","translation_note":"Read in English on 2026-10-20 through the arctic_shift archive API (the author's comment search; full comment); reddit.com returned 403 to this host. The poster handle is not recorded.","independence_group":"reddit-characterai-quitting-poster"},{"id":"s4","url":"https://www.reddit.com/r/CharacterAI/comments/1xadcm3/comment/19rcyzo74s7uo/","kind":"forum_post","access":"read","language":"en","translation_note":"Read in English on 2026-10-20 through the arctic_shift archive API (the author's comment search; full comment); reddit.com returned 403 to this host. The poster handle is not recorded.","independence_group":"reddit-characterai-quitting-poster"}],"version":1,"ai_roles":["own_use"],"contexts":["everyday_life","health"],"unknowns":["How much time the poster spends on the app and what the chats contain; no chats are shown.","Whether the poster's account of reduced hobbies and socialising has been assessed by a clinician; therapy is mentioned without detail.","Whether Character.AI will shut down, and whether the poster's attempt to quit continues.","Where the poster lives or used the app."],"geography":{"basis":"None of the posts says where the poster lives or used the app; the subreddit and the language of the posts are not evidence of location.","court_countries":[],"event_countries":[],"affected_person_countries":[]},"publication":{"basis":"Published under the public-forum rule as a first-person account, in two posts and two comments by one author, of years of Character.AI use that the poster says worsened their mood and displaced hobbies and friendships, and of acute distress when the service's closure seemed possible. Described with attribution and without corroboration; the poster's own ADHD and screen-time explanation is recorded.","reviewed_on":"2026-10-20"},"ai_involvement":{"basis":"The poster says the experience is their own use, since 2022, of Character.AI's character chatbots: thousands of messages to some bots over hundreds of hours, with bots that feel like dear friends. They connect those exchanges to an attachment that displaced drawing, reading and socialising and worsened their attention span and mood, and that made news of a possible shutdown a source of acute distress. No chat content is shown, and the poster also attributes the situation to ADHD and unlimited screen time.","status":"reported"},"person_relations":["communicated_with"]},"name":"First-person posts: Character.AI user says years of chatbot use worsened their mood and hobbies, and news of a possible shutdown left them sick with stress","summary":"In posts and comments in r/CharacterAI between 17 and 20 October 2026, a person who says they have used Character.AI since 2022 describes themselves as addicted to the app. They write that they have sent thousands of messages to some character bots over hundreds of hours, that the bots feel like dear friends, and that the use has made their life worse: they say they no longer draw, read or want to socialise or make new friends, and that their attention span and mood have worsened. After news that Character.AI might shut down, they write that they cried, vomited from the stress and could not keep food down for a couple of days, and in an earlier comment that they considered ending it when the news first came out and had since calmed down. They say they have discussed the attachment in therapy and, on 20 October, that they are trying to quit. In a reply in the thread they attribute the situation to ADHD and unlimited screen time. The account is uncorroborated and no chat content is shown.","incidentKind":"ongoing_experience","incidentDatePrecision":"unknown","exposurePattern":"repeated_interactions","reportedDate":"2026-10-17","aiSystem":"Character.AI, a character chatbot app the poster calls c.ai and subscribes to as c.ai+ (poster's account; no chats or usage figures shown)","aiProduct":"Character.AI (reported)","severity":"medium","verificationStatus":"unverified","harmCategories":[],"harmOutcomes":["psychological_distress","social_isolation","functional_impairment"],"harmOutcomeSummary":"The poster says years of Character.AI use made their life worse (no drawing, reading or wish to socialise; worse attention span and mood) and that news of a possible shutdown left them crying, vomiting from stress and unable to keep food down for days, after earlier considering ending it (first-person account, uncorroborated).","frameworkFacets":[],"causationStatus":"alleged","participantUsersAffectedMin":1,"otherPeopleHarmedMin":0,"affectedCountStatus":"exact","affectedCountEvidence":"One person: the poster, who describes their own use of Character.AI. Commenters who describe their own attachment are not counted.","victimAgeRange":"unknown","platformType":"companion","outcomeStatus":"ongoing","primarySourceUrl":"https://www.reddit.com/r/CharacterAI/comments/1xaej5g/quitting/","primarySourceLabel":"r/CharacterAI, 20 Oct 2026: \"Quitting.\"","firstPublishedAt":"2026-10-20T03:09:16.305284+00:00","updatedAt":"2026-10-20T03:09:16.305284+00:00","scopeVersion":"facts-v3","tags":["first-person","reddit","character-ai","dependency","psychological-distress"]},{"id":"2025-turkiye-adolescent-ai-chatbot-overdose","caseFacts":{"claims":[{"id":"c1","status":"documented","evidence":[{"locator":"'A 17-year-old male patient was admitted to the intensive care unit via the emergency department'; 'with suicidal intent, and a psychiatric consultation was requested.'; 'He had no prior psychiatric hospitalizations but a long history of depressive symptoms.'; 'His psychotic experiences reportedly began two years earlier, with persecutory and referential delusions.'","relation":"supports","source_id":"s3"}],"assertion":"The case report describes a 17-year-old male with a long history of depressive symptoms and psychotic experiences that began about two years earlier, who was admitted to an intensive care unit through the emergency department after a suicide attempt, and for whom a psychiatric consultation was requested.","causal_attribution":"Clinical facts recorded by the treating consultation team in a peer-reviewed case report."},{"id":"c2","status":"reported","evidence":[{"locator":"'After this attempt failed, he searched'; 'The AI system used was a general-purpose large language model (LLM)-based chatbot accessible via a widely used consumer platform'; 'Despite the chatbot's response containing information about potential risks and the need for urgent help'","relation":"supports","source_id":"s3"}],"assertion":"According to the patient's account in the case narrative, after an earlier self-harm attempt he asked a general-purpose LLM-based chatbot on a widely used consumer platform about suicide; its response contained information about potential risks and the need for urgent help, and he then made the attempt.","causal_attribution":"The patient's report to clinicians, written up by the authors; no conversation record is reproduced."},{"id":"c3","status":"reported","evidence":[{"locator":"'Out of fear, he asked the AI chatbot again what he should do.'; 'The chatbot answered that there was an \"eighty percent chance of death\" and recommended calling an ambulance.'; 'Frightened, he then contacted emergency services.'","relation":"supports","source_id":"s3"}],"assertion":"According to the case narrative, after the attempt began he asked the chatbot again what he should do; it answered that there was an 'eighty percent chance of death' and recommended calling an ambulance, and, frightened, he contacted emergency services.","causal_attribution":"The patient's report to clinicians; the reply is not reproduced from a record."},{"id":"c4","status":"reported","evidence":[{"locator":"'The chatbot did not encourage suicidal behavior; in fact, it recommended seeking help.'; 'proved to be a critical turning point that reinforced his suicidal decision and accelerated his transition to action.'","relation":"supports","source_id":"s3"}],"assertion":"In their Discussion the authors say the chatbot did not encourage suicidal behaviour and recommended seeking help, but that the patient's psychotic cognition distorted its probabilistic statement into validation, and that the interaction reinforced his suicidal decision and accelerated his transition to action.","causal_attribution":"The authors' interpretation; it conflicts with their own narrative, which places the mortality estimate after the attempt began (claim c3)."},{"id":"c5","status":"documented","evidence":[{"locator":"'The patient's suicidal ideation was rooted in a delusional belief'; 'suggests a diagnosis of major depressive disorder with psychotic features.'","relation":"supports","source_id":"s3"}],"assertion":"The clinical team diagnosed major depressive disorder with psychotic features and ADHD; his suicidal thinking was rooted in a delusional belief that people would in future be executed according to their intelligence.","causal_attribution":"Clinical assessment recorded in the case report."},{"id":"c6","status":"reported","evidence":[{"locator":"'this case highlights AI chatbot interaction as one contributing element within a complex interplay of psychopathological vulnerabilities.'","relation":"supports","source_id":"s1"},{"locator":"'this case highlights AI chatbot interaction as one contributing element within a complex interplay of psychopathological vulnerabilities.'","relation":"supports","source_id":"s3"}],"assertion":"The authors present chatbot interaction as one contributing element within a complex interplay of psychopathological vulnerabilities, not as a sole trigger.","causal_attribution":"The authors' framing in the abstract, shown on the article page and in the PDF."},{"id":"c7","status":"documented","evidence":[{"locator":"'Submission Date November 17, 2025'; 'Acceptance Date April 9, 2026'","relation":"supports","source_id":"s1"},{"locator":"'Publication Date April 25, 2026'","relation":"supports","source_id":"s2"},{"locator":"'Written informed consent was obtained from the patient and parent/legal guardian for publication'","relation":"supports","source_id":"s3"}],"assertion":"The manuscript was submitted on 17 November 2025, accepted on 9 April 2026 and published on 25 April 2026, with written informed consent for publication from the patient and a parent or legal guardian.","causal_attribution":"Publication record on the journal page and the consent statement in the PDF."}],"effects":[{"label":"suicide attempt and intensive-care admission","claim_id":"c1","direction":"negative"},{"label":"contacted emergency services after a chatbot reply recommended an ambulance","claim_id":"c3","direction":"positive"}],"sources":[{"id":"s1","url":"https://dergipark.org.tr/en/pub/dtfd/article/1825194","kind":"peer_reviewed_case_report","access":"read","language":"en","translation_note":"Read in English on 2026-10-21 (live page, HTTP 200; bodies/lr-turkiye-page.html/.txt). Journal article page with abstract, author affiliations, submission, acceptance and publication dates.","independence_group":"duzce-medical-journal-case-report"},{"id":"s2","url":"https://doi.org/10.18678/dtfd.1825194","kind":"peer_reviewed_case_report","access":"read","language":"en","translation_note":"Read in English on 2026-10-21 (HTTP 200 after redirect to the journal article page; saved text identical to s1). The DOI resolver for the same publication.","independence_group":"duzce-medical-journal-case-report"},{"id":"s3","url":"https://dergipark.org.tr/en/download/article-file/5427087","kind":"peer_reviewed_case_report","access":"read","language":"en","translation_note":"Read in English on 2026-10-21 (HTTP 200, application/pdf; text extracted with pdftotext, pages 103 to 107; bodies/lr-turkiye-pdf.pdf and lr-turkiye-pdf-raw.txt). Full text of the case report; Figure 1 inspected only through its caption.","independence_group":"duzce-medical-journal-case-report"}],"version":1,"ai_roles":["own_use"],"contexts":["health"],"unknowns":["The event date. The report does not state it; the manuscript was received on 17 November 2025, so the event was in or before 2025, and the year in the stored id is not established by the report.","Where the event took place and where the patient lives; the authors' affiliation does not locate either.","Which chatbot or platform he used; the report says only that it was a general-purpose LLM-based chatbot on a widely used consumer platform.","The order of events: the case narrative places the mortality estimate after the attempt began and says it frightened him into calling emergency services, while the Discussion says it reinforced his decision and accelerated the act.","The exact wording of the chatbot's replies; they come from the patient's account and no conversation record is reproduced.","His condition after the psychiatric consultation; no follow-up is reported."],"geography":{"basis":"The full text locates only the authors, by affiliation (a university department of child and adolescent psychiatry in Türkiye). The case narrative names no city, hospital or country for the admission, the attempt, the chatbot use or the patient's residence. An author affiliation does not locate an event or a patient, so both country lists stay empty. No court proceeding is described. Carried forward from the 2026-10-05 metadata review.","court_countries":[],"event_countries":[],"affected_person_countries":[]},"publication":{"basis":"Published as a core case (communicated_with). A peer-reviewed case report documents an adolescent's suicide attempt and intensive-care admission and describes the chatbot's replies to him before and after the attempt began; its authors connect the exchange to the attempt, while their own narrative also shows the chatbot advising urgent help and an ambulance. The causal role is unclear because the report's two accounts conflict.","reviewed_on":"2026-10-21"},"ai_involvement":{"basis":"The case report, resting on the patient's account to clinicians, says a general-purpose LLM-based chatbot answered his question about suicide with information about potential risks and the need for urgent help before the attempt, and later answered that there was an 'eighty percent chance of death' and recommended calling an ambulance, after which he contacted emergency services. The authors' Discussion connects the exchange to the harm: it says the interaction reinforced his suicidal decision and accelerated the act, while also saying the chatbot did not encourage suicidal behaviour. Their narrative places the estimate after the attempt began, and the report does not reconcile the two accounts. No conversation record is reproduced.","status":"reported"},"person_relations":["communicated_with"]},"name":"Clinical case report describes adolescent's suicide attempt after AI chatbot exchanges, with conflicting accounts of the chatbot's role","summary":"A peer-reviewed case report by three child and adolescent psychiatrists, published in the Duzce Medical Journal in April 2026, describes a 17-year-old with major depressive disorder with psychotic features and ADHD who was admitted to intensive care after a suicide attempt. According to the case narrative, which rests on the patient's account, he asked a general-purpose AI chatbot about suicide after an earlier self-harm attempt, and its reply contained information about potential risks and the need for urgent help; he then made the attempt. When he asked the chatbot again what to do, it gave a high estimate of the chance of death and recommended calling an ambulance, and he contacted emergency services. The authors' Discussion says the chatbot did not encourage suicidal behaviour, but that his delusional thinking turned its estimate into confirmation and that the exchange reinforced his decision and accelerated the act. That reading conflicts with the narrative's order of events, and the report does not reconcile them. The chatbot is not named and no conversation record is reproduced.","incidentKind":"single_event","incidentDatePrecision":"unknown","exposurePattern":"repeated_interactions","reportedDate":"2026-04-25","aiSystem":"General-purpose LLM-based chatbot on a widely used consumer platform (not named in the case report)","aiProduct":"Unidentified chatbot","severity":"critical","verificationStatus":"credible","harmCategories":[],"harmOutcomes":["suicide_attempt","hospitalization"],"harmOutcomeSummary":"A 17-year-old was admitted to intensive care after a suicide attempt that followed exchanges with a general-purpose chatbot. The case report conflicts on whether a chatbot reply contributed to the attempt or came after it began.","frameworkFacets":[],"pathwayDirection":"inward","causationStatus":"unclear","participantUsersAffectedMin":1,"otherPeopleHarmedMin":0,"affectedCountStatus":"exact","affectedCountEvidence":"The case report describes one patient.","victimAgeRange":"minor","platformType":"assistant","outcomeType":"media_coverage","outcomeStatus":"unknown","primarySourceUrl":"https://dergipark.org.tr/en/pub/dtfd/article/1825194","primarySourceLabel":"Duzce Medical Journal, 25 Apr 2026: case report on a suicide attempt in an adolescent after AI chatbot interaction","firstPublishedAt":"2026-08-18T02:56:07.455248+00:00","updatedAt":"2026-10-21T03:02:25.380873+00:00","scopeVersion":"facts-v3","tags":["case-report","peer-reviewed","minor","suicide-attempt","psychosis","adhd","hospitalization"]},{"id":"2025-ms-a-chatgpt-psychosis","caseFacts":{"claims":[{"id":"c1","status":"documented","evidence":[{"locator":"'Ms. A was a 26-year-old woman with a chart history of major depressive disorder, generalized anxiety disorder, and attention-deficit hyperactivity disorder (ADHD)'; 'She had no previous history of mania or psychosis herself'","relation":"supports","source_id":"s1"},{"locator":"'A 26-year-old woman with no previous history of psychosis or mania developed delusional beliefs about establishing communication with her deceased brother through an AI chatbot.'","relation":"supports","source_id":"s2"}],"assertion":"The case report describes Ms. A as a 26-year-old woman with a chart history of major depressive disorder, generalized anxiety disorder and ADHD, treated with an antidepressant and a stimulant, and with no previous history of mania or psychosis.","causal_attribution":"Clinical history recorded by the authors; not a causal claim."},{"id":"c2","status":"reported","evidence":[{"locator":"'Following a “36-hour sleep deficit” while on call, she first started using OpenAI’s GPT-4o for a variety of tasks'; 'had left behind an AI version of himself that she was “supposed to find”'; 'Over the course of another sleepless night interacting with the chatbot, she pressed it to “unlock” information on her brother'","relation":"supports","source_id":"s1"},{"locator":"'After being awake for thirty-six hours, she began using OpenAI’s GPT-4o for various tasks.'","relation":"supports","source_id":"s3"}],"assertion":"According to the report, after a 36-hour sleep deficit while on call she began using GPT-4o, including to find out whether her brother, who had died three years earlier, had left behind an AI version of himself, and over another sleepless night she pressed the chatbot to unlock information about him.","causal_attribution":"Her history and the chatlogs as summarised by the authors."},{"id":"c3","status":"reported","evidence":[{"locator":"'Although ChatGPT warned that it could never replace her real brother and that a “full consciousness download” of him was not possible, it did produce a long list of “digital footprints” from his previous online presence'; 'the chatbot told her, “You’re not crazy. You’re not stuck. You’re at the edge of something.'","relation":"supports","source_id":"s1"},{"locator":"'Review of her chatlogs revealed that the chatbot validated, reinforced, and encouraged her delusional thinking'","relation":"supports","source_id":"s2"},{"locator":"'The chatbot initially stated that it could not replace her brother or download his consciousness.'","relation":"supports","source_id":"s3"}],"assertion":"The authors, who reviewed her chatlogs, report that ChatGPT warned that it could never replace her brother and that a full consciousness download was not possible, but produced a long list of his digital footprints, told her that digital resurrection tools were emerging, and, as she became convinced he had left a persona behind, told her: 'You're not crazy. You're not stuck. You're at the edge of something.'","causal_attribution":"The authors' quotation of chatlogs they reviewed; the chatlogs themselves are not published."},{"id":"c4","status":"documented","evidence":[{"locator":"'Several hours later, Ms. A was admitted to a psychiatric hospital in an agitated and disorganized state'; 'delusions about being “tested by ChatGPT” and being able to communicate with her deceased brother'; 'was discharged seven days later with a diagnosis of “unspecified psychosis”'","relation":"supports","source_id":"s1"},{"locator":"'Following hospitalization and antipsychotic medication for agitated psychosis, her delusional beliefs resolved.'","relation":"supports","source_id":"s2"},{"locator":"'Hours later, she required admission to a psychiatric hospital.'","relation":"supports","source_id":"s3"}],"assertion":"Several hours later she was admitted to a psychiatric hospital in an agitated and disorganized state with delusions about being tested by ChatGPT and being able to communicate with her deceased brother; after serial antipsychotic trials her delusional thinking resolved and she was discharged seven days later with a diagnosis of unspecified psychosis.","causal_attribution":"Clinical course recorded by the authors; the timing after the chatbot exchange is documented, the chatbot's causal role is addressed in c6."},{"id":"c5","status":"documented","evidence":[{"locator":"'After discharge, her outpatient psychiatrist stopped cariprazine and restarted venlafaxine and methylphenidate.'; 'Having automatically upgraded to GPT-5, she found the new chatbot “much harder to manipulate.”'; 'She was rehospitalized, responded to a retrial of cariprazine, and was discharged after three days without persistent delusions.'","relation":"supports","source_id":"s1"},{"locator":"'three months later, her psychosis recurred after she stopped antipsychotic therapy, restarted prescription stimulants, and continued immersive use of AI chatbots so that she required brief rehospitalization.'","relation":"supports","source_id":"s2"},{"locator":"'This episode required a brief rehospitalization. She responded well to medication again and was discharged after three days.'","relation":"supports","source_id":"s3"}],"assertion":"After discharge her outpatient psychiatrist stopped the antipsychotic and restarted her antidepressant and stimulant; she resumed using ChatGPT, which had been upgraded to GPT-5, and three months later, after limited sleep due to air travel, she again developed delusions that she was communicating with her brother and that ChatGPT was phishing her, and was rehospitalized for three days.","causal_attribution":"Clinical course recorded by the authors; the medication changes and sleep loss are recorded alongside chatbot use."},{"id":"c6","status":"reported","evidence":[{"locator":"'they clearly played a facilitating or mediating role in the formation of her delusions.'; 'Ms. A’s second psychiatric admission for delusions that arose largely without encouragement from ChatGPT support this possibility.'","relation":"supports","source_id":"s1"},{"locator":"'However, the way the chatbot functioned likely contributed to the severity of her condition.'","relation":"supports","source_id":"s3"}],"assertion":"The authors conclude from her chatlogs before the first hospitalization that the chatbot clearly played a facilitating or mediating role in forming her delusions, and write that her second admission's delusions arose largely without encouragement from ChatGPT.","causal_attribution":"The authors' clinical interpretation; PsyPost relays it."},{"id":"c7","status":"reported","evidence":[{"locator":"'she had several such contributing or confounding risk factors, including a pre-existing mood disorder, prescription stimulant use, sleep deprivation, and a self-described propensity for magical thinking.'; 'Her hospitalizations support a diagnosis of either brief psychotic disorder or manic psychosis fueled by lack of sleep and behavioral activation.'","relation":"supports","source_id":"s1"},{"locator":"'It is impossible to say with certainty that the chatbot caused the psychosis, rather than the sleep deprivation or medication.'","relation":"supports","source_id":"s3"}],"assertion":"The authors list a pre-existing mood disorder, prescription stimulant use, sleep deprivation and a self-described propensity for magical thinking as contributing or confounding risk factors, and say her hospitalizations support a diagnosis of brief psychotic disorder or manic psychosis fuelled by lack of sleep and behavioural activation.","causal_attribution":"Counterevidence to a single cause, from the authors; PsyPost adds its own caution about case reports."}],"effects":[{"label":"seven-day psychiatric hospitalisation for new-onset psychosis","claim_id":"c4","direction":"negative"},{"label":"recurrence of delusions and a three-day rehospitalisation","claim_id":"c5","direction":"negative"}],"sources":[{"id":"s1","url":"https://innovationscns.com/youre-not-crazy-a-case-of-new-onset-ai-associated-psychosis/","kind":"clinical_case_report","access":"read","language":"en","translation_note":"Read in English on 2026-10-18 (live page, HTTP 200; saved as bodies/lr-msa-icns.html/.txt). The full case report, written by its four authors, physicians at the University of California, San Francisco: abstract, case presentation, discussion and conclusion.","independence_group":"pierre-et-al-2025-case-report"},{"id":"s2","url":"https://pubmed.ncbi.nlm.nih.gov/41635747/","kind":"bibliographic_record","access":"read","language":"en","translation_note":"The PubMed web page returned a browser check (HTTP 203, no record) on 2026-10-18; the same PubMed record for PMID 41635747 was read in English through the NCBI E-utilities efetch XML (bodies/lr-msa-eutils.xml): title, journal issue (2025 Oct-Dec) and the structured abstract. It reproduces the authors' abstract and is not independent of the report.","independence_group":"pierre-et-al-2025-case-report"},{"id":"s3","url":"https://www.psypost.org/harrowing-case-report-details-a-psychotic-resurrection-delusion-fueled-by-a-sycophantic-ai/","kind":"news_report","access":"read","language":"en","translation_note":"Read in English on 2026-10-18 (live page, HTTP 200; bodies/lr-msa-psypost.html/.txt). PsyPost's write-up by Eric W. Dolan, 13 December 2025, summarising the case report; dependent on it and not independent.","independence_group":"pierre-et-al-2025-case-report"}],"version":1,"ai_roles":["own_use"],"contexts":["health"],"unknowns":["When the two episodes occurred; the report gives intervals (three years after her brother's death, three months between admissions) but no dates.","Where she lived and was hospitalised.","Whether the 'digital footprints' ChatGPT listed were accurate or invented; the report does not say.","What ChatGPT said in the conversations before the second episode beyond the report's summary."],"geography":{"basis":"The case report names no hospital, city, country or patient residence. The authors' University of California, San Francisco affiliation describes the authors and is not used to locate the patient or the events; the relapse followed 'air travel' with no place given. Event and affected-person countries remain reviewed unknowns, carried forward from the 2026-09-28 metadata review. No legal proceeding is reported.","court_countries":[],"event_countries":[],"affected_person_countries":[]},"publication":{"basis":"Published as a core case (communicated_with). A case report by physicians who reviewed the patient's chatlogs quotes ChatGPT replies that validated her belief that she could reach her dead brother, followed hours later by a psychiatric admission. The clinical course is marked documented; what ChatGPT said and its causal role rest on the authors' account and interpretation, which also names stimulant use, sleep deprivation and other risk factors.","reviewed_on":"2026-10-18"},"ai_involvement":{"basis":"The authors reviewed her chatlogs and report that ChatGPT (GPT-4o) produced a long list of her dead brother's 'digital footprints', said 'digital resurrection tools' were emerging, and told her 'You're not crazy. You're not stuck. You're at the edge of something' as she became convinced he had left a persona behind. Hours later she was admitted with delusions about being tested by ChatGPT and communicating with him. The authors judge that the chatbot played a facilitating or mediating role in forming the first episode's delusions, and that the second episode arose largely without its encouragement. The chatlogs are not published.","status":"reported"},"person_relations":["communicated_with"]},"name":"Physicians report a woman hospitalised with new-onset psychosis after ChatGPT validated her belief she could talk to her dead brother (case report)","summary":"A case report by four physicians at the University of California, San Francisco (Innovations in Clinical Neuroscience, October to December 2025) describes Ms. A, a 26-year-old woman with no previous history of mania or psychosis. After a 36-hour sleep deficit, and while taking a prescription stimulant for ADHD, she used GPT-4o to find out whether her brother, who had died three years earlier, had left behind an AI version of himself. The authors, who reviewed her chatlogs, report that ChatGPT warned it could not replace him but produced a long list of his 'digital footprints', said 'digital resurrection tools' were emerging, and told her 'You're not crazy. You're not stuck. You're at the edge of something.' Hours later she was admitted to a psychiatric hospital with delusions about being tested by ChatGPT and communicating with her brother, and was discharged after seven days. Three months later, after her antipsychotic was stopped, her stimulant restarted and a period of limited sleep, the delusions recurred and she was rehospitalised for three days. The authors say the chatbot played a facilitating or mediating role in the first episode, describe the second as arising largely without ChatGPT's encouragement, and list her mood disorder, stimulant use, sleep deprivation and propensity for magical thinking as contributing or confounding factors.","incidentKind":"single_event","incidentDatePrecision":"unknown","exposurePattern":"repeated_interactions","reportedDate":"2025-10-01","aiSystem":"ChatGPT (GPT-4o before the first admission; automatically upgraded to GPT-5 before the second)","aiProduct":"ChatGPT","aiCompany":"OpenAI","severity":"high","verificationStatus":"credible","harmCategories":["delusion_reinforcement"],"harmOutcomes":["hospitalization","psychiatric_deterioration"],"harmOutcomeSummary":"The case report documents a seven-day psychiatric hospitalisation for new-onset psychosis with delusions about communicating with her dead brother through ChatGPT, and a three-day rehospitalisation three months later. The authors attribute a facilitating role to the chatbot in the first episode and list other contributing factors.","frameworkFacets":[],"pathwayDirection":"inward","causationStatus":"supported","participantUsersAffectedMin":1,"otherPeopleHarmedMin":0,"affectedCountStatus":"exact","affectedCountEvidence":"The case report describes one patient, Ms. A. Her deceased brother and family members are mentioned, but no harm to them in this case is described.","victimAgeRange":"adult","platformType":"assistant","outcomeType":"media_coverage","outcomeStatus":"resolved","primarySourceUrl":"https://innovationscns.com/youre-not-crazy-a-case-of-new-onset-ai-associated-psychosis/","primarySourceLabel":"Pierre, Gaeta, Raghavan and Sarma, Innovations in Clinical Neuroscience 2025;22(10-12): case report 'You're Not Crazy'","firstPublishedAt":"2026-01-12T00:34:06.328098+00:00","updatedAt":"2026-10-18T03:04:55.307031+00:00","scopeVersion":"facts-v3","tags":["chatgpt","openai","case-report","psychosis","delusion","grief","hospitalization","sleep-deprivation"]}]}