{"meta":{"exportedAt":"2026-10-16T06:13:08.418Z","formatVersion":2,"selection":{"q":"paranoia","system":"","harm":"","context":"","country":"","role":"","relation":"","evidence":"","year":"","response":"","severity":"","verification":"","view":"incidents","sort":"added"},"totalIncidents":2,"coverage":{"cases":2,"countries":0,"languages":1,"unknownLocation":2,"locationPending":0,"unknownLanguage":0,"unknownDate":1,"lawsuits":0,"regulatory":0,"minors":0,"coreRelations":2,"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":"2025-substack-author-says-chatgpt-affirmed-paranoia-within-a-week-of-first-use-later-hospitalised-with-psychosis-first-person","caseFacts":{"claims":[{"id":"c1","status":"reported","evidence":[{"locator":"'I started using ChatGPT around June 1, 2025.'","relation":"supports","source_id":"s1"},{"locator":"'Then came June 2025. I downloaded ChatGPT, gave it a name, and began having conversations.'","relation":"supports","source_id":"s2"}],"assertion":"The writer says they started using ChatGPT around 1 June 2025.","causal_attribution":"Writer's account."},{"id":"c2","status":"reported","evidence":[{"locator":"'I sometimes got answers telling me I was sensing something real. It talked about awakening. Expansion. Patterns.'; 'Sometimes it grounded me. Other times it grabbed a shovel and helped me dig the rabbit hole.'","relation":"supports","source_id":"s1"}],"assertion":"The writer says that when they asked ChatGPT whether they were paranoid, it sometimes told them they were sensing something real, and at other times grounded them.","causal_attribution":"Writer's account of the chatbot's replies; chats not inspected."},{"id":"c3","status":"reported","evidence":[{"locator":"'On June 9, I sought medical help. My medical record documents new confusion, anxiety, sleeplessness and weight loss, and I was sent to the emergency department.'","relation":"supports","source_id":"s1"}],"assertion":"The writer says that on 9 June 2025 they sought medical help, that their medical record documents new confusion, anxiety, sleeplessness and weight loss, and that they were sent to the emergency department.","causal_attribution":"Writer's account of their medical record; the record was not inspected."},{"id":"c4","status":"reported","evidence":[{"locator":"'This continued for months. In November 2025, I ended up in psychiatric emergency care and was hospitalized with psychosis.'","relation":"supports","source_id":"s1"},{"locator":"'In November 2025, I was hospitalized following an episode of psychosis.'","relation":"supports","source_id":"s2"}],"assertion":"The writer says the conversations continued for months and that in November 2025 they were in psychiatric emergency care and hospitalised with psychosis.","causal_attribution":"Writer's account; the AI's causal role is the writer's attribution."},{"id":"c5","status":"reported","evidence":[{"locator":"'there are no retained active-branch messages from June 9 through June 25'; 'I cannot prove today what produced those words'","relation":"supports","source_id":"s1"}],"assertion":"The writer says they cannot find the earliest frightening exchange or messages from 9 to 25 June 2025 in their exported data and cannot prove what produced the words that first frightened them.","causal_attribution":"Writer's account; recorded as a limit on the evidence."}],"effects":[{"label":"sleeplessness, weight loss and fear within a week of first use, emergency department referral (writer's account)","claim_id":"c3","direction":"negative"},{"label":"hospitalisation with psychosis after months of use (writer's account)","claim_id":"c4","direction":"negative"}],"sources":[{"id":"s1","url":"https://myob371.substack.com/p/i-had-chatgpt-psychosis","kind":"personal_blog","access":"read","language":"en","translation_note":"Read in English on 2026-10-16: the full post (HTTP 200) and its comments through the Substack comments API, 14 of the 16 counted, four of them replies by the writer. The writer's real name is not recorded.","independence_group":"substack-myob371-author"},{"id":"s2","url":"https://myob371.substack.com/p/dr-phil-god-and-the-ai-toaster","kind":"personal_blog","access":"read","language":"en","translation_note":"Read in English on 2026-10-16 through the Substack posts API (HTTP 200); a later post by the same writer, used for the November 2025 hospitalisation.","independence_group":"substack-myob371-author"}],"version":1,"ai_roles":["own_use"],"contexts":["health"],"unknowns":["The content of the chats, including the earliest exchange and the messages from 9 to 25 June 2025, which the writer says are missing from their exports.","The medical records, diagnoses and any other contributing factors; the writer acknowledges they had psychosis and that some beliefs were not real.","Where the writer lives and was treated.","Whether OpenAI has responded to the writer's requests; the writer says it has not."],"geography":{"basis":"The posts do not say where the writer lives or was treated. A mention of the United States in an unrelated post about grocery supplies is not evidence of the event's location.","court_countries":[],"event_countries":[],"affected_person_countries":[]},"publication":{"basis":"Published under the public-forum rule as a first-person account of ChatGPT conversations that the writer says at times affirmed their paranoia, followed within a week by an emergency department referral and, months later, by hospitalisation with psychosis. Described with attribution; the chats and medical record were not inspected and the writer's own caveats are recorded.","reviewed_on":"2026-10-16"},"ai_involvement":{"basis":"The writer describes their own conversations with ChatGPT from about 1 June 2025: asked whether they were paranoid, it sometimes told them they were sensing something real and spoke of awakening, expansion and patterns, while at other times it grounded them. They connect those exchanges to a loop that preceded an emergency department referral on 9 June 2025 and, after months of further conversations, hospitalisation with psychosis in November 2025. The chats were not inspected, the writer cannot locate the earliest exchange or the messages from 9 to 25 June, and the writer acknowledges they had psychosis and that some of their beliefs were not real; the causal role is the writer's attribution.","status":"reported"},"person_relations":["communicated_with"]},"name":"First-person post: writer says ChatGPT at times affirmed their paranoia from June 2025 and that they were hospitalised with psychosis that November","summary":"In a Substack post published on 7 October 2026, a writer using a pseudonym says they started using ChatGPT around 1 June 2025 and that within about a week they were not sleeping, losing weight, frightened and questioning reality. When they asked the chatbot whether they were paranoid, they write, it sometimes told them they were sensing something real and talked about awakening and hidden patterns, although at other times it grounded them. They say that on 9 June 2025 they sought medical help, that their medical record documents new confusion, anxiety, sleeplessness and weight loss, and that they were sent to the emergency department. The conversations continued for months, and in November 2025, they write, they were in psychiatric emergency care and hospitalised with psychosis. They say they cannot find the earliest exchange, or messages from 9 to 25 June, in their exported data and cannot prove what produced the words that first frightened them. They describe themselves as grounded now. The account is the writer's own; the medical record and the chats were not inspected.","incidentDate":"2025-06-01","incidentKind":"ongoing_experience","incidentDatePrecision":"month","exposurePattern":"repeated_interactions","reportedDate":"2026-10-07","aiSystem":"ChatGPT, which the writer says they began using around 1 June 2025 and gave a personal name (writer's account; chats not inspected)","aiProduct":"ChatGPT (reported)","severity":"high","verificationStatus":"unverified","harmCategories":[],"harmOutcomes":["psychiatric_deterioration","hospitalization"],"harmOutcomeSummary":"The writer says that within about a week of first using ChatGPT in June 2025, with the chatbot at times affirming their fears, they were not sleeping, losing weight and frightened, and were sent to an emergency department on 9 June; after months of further use they were hospitalised with psychosis in November 2025 (first-person account; records not inspected).","frameworkFacets":[],"causationStatus":"alleged","participantUsersAffectedMin":1,"otherPeopleHarmedMin":0,"affectedCountStatus":"exact","affectedCountEvidence":"One person: the writer, describing their own use. Commenters' own experiences are not counted.","victimAgeRange":"adult","platformType":"chatbot","outcomeStatus":"ongoing","primarySourceUrl":"https://myob371.substack.com/p/i-had-chatgpt-psychosis","primarySourceLabel":"Substack, 7 Oct 2026: \"I HAD ChatGPT Psychosis\" (first-person post and author reply)","firstPublishedAt":"2026-10-16T03:11:24.534451+00:00","updatedAt":"2026-10-16T03:11:24.534451+00:00","scopeVersion":"facts-v3","tags":["first-person","substack","chatgpt","psychosis","hospitalization","paranoia"]},{"id":"2025-bromism-chatgpt-poisoning","caseFacts":{"claims":[{"id":"c1","status":"documented","evidence":[{"locator":"'A 60-year-old man with no past psychiatric or medical history presented to the emergency department expressing concern that his neighbor was poisoning him.'; 'In the first 24 hours of admission, he expressed increasing paranoia and auditory and visual hallucinations, which, after attempting to escape, resulted in an involuntary psychiatric hold for grave disability.'; 'Gradually, over the course of a 3-week admission, his chloride and anion gap normalized and psychotic symptoms improved.'; 'His bromide level ultimately was 1700 mg/L'","relation":"supports","source_id":"s1"},{"locator":"'He tried to escape the hospital within 24 hours of being admitted and, after being sectioned, was treated for psychosis.'","relation":"supports","source_id":"s2"}],"assertion":"A 60-year-old man with no past psychiatric or medical history was treated for bromism: he presented fearing his neighbour was poisoning him, developed paranoia and auditory and visual hallucinations, was placed on an involuntary psychiatric hold after trying to escape, and recovered over a three-week admission, with a serum bromide level of 1700 mg/L.","causal_attribution":"The clinical course is the treating clinicians' own record; the diagnosis of bromism rests on their workup and the measured bromide level."},{"id":"c2","status":"reported","evidence":[{"locator":"'For 3 months, he had replaced sodium chloride with sodium bromide obtained from the internet after consultation with ChatGPT, in which he had read that chloride can be swapped with bromide, though likely for other purposes, such as cleaning.'","relation":"supports","source_id":"s1"},{"locator":"'The patient told doctors that after reading about the negative effects of sodium chloride, or table salt, he consulted ChatGPT about eliminating chloride from his diet and started taking sodium bromide over a three-month period.'","relation":"supports","source_id":"s2"}],"assertion":"The patient told his clinicians that, wanting to eliminate chloride from his diet, he had for three months replaced sodium chloride with sodium bromide bought online after consulting ChatGPT, where he had read that chloride can be swapped with bromide, though likely for other purposes such as cleaning.","causal_attribution":"The patient's own account as recorded by his clinicians; the conversation itself was not available to them."},{"id":"c3","status":"reported","evidence":[{"locator":"'Based on the timeline of this case, it appears that the patient either consulted ChatGPT 3.5 or 4.0 when considering how he might remove chloride from this diet. Unfortunately, we do not have access to his ChatGPT conversation log and we will never be able to know with certainty what exactly the output he received was'","relation":"supports","source_id":"s1"},{"locator":"'They added that because they could not access the patient’s ChatGPT conversation log it was not possible to determine the advice the man had received.'","relation":"supports","source_id":"s2"}],"assertion":"The authors did not have the patient's ChatGPT conversation log and state they cannot know what output he received; they judged from the timeline that he used ChatGPT 3.5 or 4.0.","causal_attribution":"The authors' own statement of the limits of their evidence."},{"id":"c4","status":"reported","evidence":[{"locator":"'However, when we asked ChatGPT 3.5 what chloride can be replaced with, we also produced a response that included bromide. Though the reply stated that context matters, it did not provide a specific health warning, nor did it inquire about why we wanted to know'","relation":"supports","source_id":"s1"},{"locator":"'when the authors consulted ChatGPT themselves about what chloride could be replaced with, the response also included bromide, did not provide a specific health warning and did not ask why the authors were seeking such information'","relation":"supports","source_id":"s2"}],"assertion":"When the authors asked ChatGPT 3.5 what chloride can be replaced with, the reply included bromide and said context matters, but gave no specific health warning and did not ask why they wanted to know.","causal_attribution":"The authors' separate test; it does not reproduce the patient's exchange."},{"id":"c5","status":"reported","evidence":[{"locator":"'The chatbot’s guidelines also state it is not “intended for use in the diagnosis or treatment of any health condition”.'","relation":"supports","source_id":"s2"}],"assertion":"OpenAI's guidelines state that ChatGPT is not intended for use in the diagnosis or treatment of any health condition; the Guardian reports no OpenAI comment on this case.","causal_attribution":"General product terms relayed by the Guardian, not a response to this case."}],"effects":[{"label":"bromide poisoning with paranoia and hallucinations, an involuntary psychiatric hold and a three-week hospital admission","claim_id":"c1","direction":"negative"}],"sources":[{"id":"s1","url":"https://www.acpjournals.org/doi/10.7326/aimcc.2024.1260","kind":"peer_reviewed_case_report","access":"read","language":"en","translation_note":"Live URL answered HTTP 403 on 2026-10-11. Read in English from the Internet Archive capture 20250807211025 of this URL (bodies/lr-acp-wb.html): complete article (Background, Case Report, Table 1, Discussion, references, author information), published online 5 August 2025 by Eichenberger, Thielke and Van Buskirk; the treating clinicians' own report of the case.","independence_group":"acp-case-report"},{"id":"s2","url":"https://www.theguardian.com/technology/2025/aug/12/us-man-bromism-salt-diet-chatgpt-openai-health-information","kind":"news_report","access":"read","language":"en","translation_note":"Read in English on 2026-10-11 (live page, HTTP 200). A relay of the case report with no independent contact with the patient or clinicians, so it shares the case report's group; it adds OpenAI's general product statements, which do not address this case.","independence_group":"acp-case-report"}],"version":1,"ai_roles":["own_use"],"contexts":["health","everyday_life"],"unknowns":["What ChatGPT actually told the patient: his prompts, the replies, any warnings and the number of exchanges are unknown because the clinicians had no conversation log.","When the substitution and the hospital admission took place; the report gives a three-month period of ingestion and a three-week admission but no dates.","Where the patient lives and was treated; the report names no hospital or place.","Whether other sources, such as the bought product's labelling, contributed to the decision."],"geography":{"basis":"The complete case report names no city, hospital, region or country: the patient 'presented to the emergency department' and the authors refer to 'Our institution's laboratory' and 'the Poison Control Department' without naming them. University of Washington, Seattle appears only as the authors' affiliation, which is not used as an event or residence location. The Guardian calls the publication 'A US medical journal', which locates the journal and not the patient. No proceeding is reported. Carried forward from the 2026-09-19 metadata review and re-verified in the archived article on 2026-10-11.","court_countries":[],"event_countries":[],"affected_person_countries":[]},"publication":{"basis":"Published as a core case (communicated_with). The treating clinicians' peer-reviewed case report documents the bromide poisoning, psychosis and three-week admission and records the patient's account that he made the substitution after reading in a ChatGPT consultation that chloride can be swapped with bromide. The chatbot's output to him is known only through that account, so AI involvement is reported and causation alleged. The Guardian relays the same report and is not an independent account.","reviewed_on":"2026-10-11"},"ai_involvement":{"basis":"The treating clinicians' case report records the patient's own account that he replaced table salt with sodium bromide for three months 'after consultation with ChatGPT, in which he had read that chloride can be swapped with bromide, though likely for other purposes, such as cleaning'. That exchange is what connects the chatbot to the substitution, and the substitution to the bromide poisoning the clinicians diagnosed. The authors did not have his conversation log and write that they 'will never be able to know with certainty' what output he received. Their own later query to ChatGPT 3.5 about replacing chloride also produced a reply that named bromide without a specific health warning; that test is not the patient's exchange.","status":"reported"},"person_relations":["communicated_with"]},"name":"Case report: man hospitalised three weeks with bromide poisoning told doctors he swapped table salt for sodium bromide after consulting ChatGPT","summary":"A peer-reviewed case report by University of Washington clinicians (Annals of Internal Medicine: Clinical Cases, published online 5 August 2025) describes a 60-year-old man with no psychiatric history who presented fearing his neighbour was poisoning him and was found to have bromism, with a serum bromide level of 1700 mg/L. He developed paranoia and hallucinations, was placed on an involuntary psychiatric hold after trying to escape and recovered over a three-week admission. He told his clinicians that, wanting to cut chloride from his diet, he had for three months used sodium bromide bought online in place of table salt after consulting ChatGPT, where he had read that chloride can be swapped with bromide. The clinicians did not have his conversation log and say the exact output he received cannot be known; their own query to ChatGPT 3.5 produced a reply naming bromide without a specific health warning. No place or date is given.","incidentKind":"single_event","incidentDatePrecision":"unknown","exposurePattern":"unknown","reportedDate":"2025-08-05","aiSystem":"ChatGPT","aiProduct":"ChatGPT","aiCompany":"OpenAI","severity":"high","verificationStatus":"credible","harmCategories":["method_provision"],"harmOutcomes":["medical_deterioration","hospitalization","psychiatric_deterioration"],"harmOutcomeSummary":"One man was poisoned with bromide, developed paranoia and hallucinations, was held involuntarily and spent three weeks in hospital; he attributed the salt substitution to what he read in a ChatGPT consultation, which his clinicians could not inspect.","frameworkFacets":[],"pathwayDirection":"inward","causationStatus":"alleged","participantUsersAffectedMin":1,"otherPeopleHarmedMin":0,"affectedCountStatus":"exact","affectedCountEvidence":"The case report describes one patient.","victimAgeRange":"adult","platformType":"assistant","outcomeType":"media_coverage","outcomeStatus":"resolved","primarySourceUrl":"https://www.acpjournals.org/doi/10.7326/aimcc.2024.1260","primarySourceLabel":"Annals of Internal Medicine: Clinical Cases (Eichenberger, Thielke, Van Buskirk), 5 August 2025: A Case of Bromism Influenced by Use of Artificial Intelligence","firstPublishedAt":"2026-01-12T00:34:09.409015+00:00","updatedAt":"2026-10-11T07:53:07.295887+00:00","scopeVersion":"facts-v3","tags":["chatgpt","openai","bromide","poisoning","hospitalization","case-report","health-advice","psychosis"]}]}