{"meta":{"exportedAt":"2026-10-23T07:44:31.674Z","formatVersion":2,"selection":{"q":"peer-reviewed","system":"","harm":"","context":"","country":"","role":"","relation":"unknown","evidence":"","year":"unknown","response":"","severity":"","verification":"","view":"incidents","sort":"added"},"totalIncidents":2,"coverage":{"cases":2,"countries":1,"languages":1,"unknownLocation":1,"locationPending":0,"unknownLanguage":0,"unknownDate":2,"lawsuits":0,"regulatory":0,"minors":0,"coreRelations":0,"contextualRelations":0,"mixedRelations":0,"unknownRelations":2,"relationPending":2,"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-hungary-chatbot-dependence-psychosis","metadataReview":{"version":1,"geography":{"basis":"Re-checked on 2026-10-11 against the complete article body (Europe PMC full-text XML of PMC13371778, read in English, about 34,400 characters after tag stripping). The section 'Illustrative clinical case' describes a 30-year-old married software developer, her stressors, about a year of escalating chatbot use and the remission, but names no country, city, clinic, hospital or treating service, and the article has no first-person 'we treated' or 'our clinic' statement that would place the patient. The only places in the body are the authors' affiliations (Semmelweis University, Budapest, Hungary; Pazmany Peter Catholic University, Budapest, Hungary), and an author affiliation does not locate an event or a patient. No legal proceeding is described, so there is no court country. All three roles remain reviewed unknowns.","evidence":[],"court_countries":[],"event_countries":[],"affected_person_countries":[]},"unresolved":["The country where the patient was assessed and treated is not stated in the article; Hungarian author affiliations were not used as an event location.","The article does not say whether the illustrative case is a single real patient or a composite; the ethics note says only that the material was fully anonymized.","The authors state that causality cannot be established; this metadata review does not change the record's causal or verification status."],"reviewed_on":"2026-10-11","source_reviews":[{"url":"https://www.ebi.ac.uk/europepmc/webservices/rest/PMC13371778/fullTextXML","notes":"Fetched on 2026-10-11 (HTTP 200, 57,635 bytes of JATS XML, xml:lang=\"en\"). Complete article body read, including 'Illustrative clinical case' and the ethics footnote 'Clinical material presented in this manuscript has been fully anonymized, and no identifiable patient information is included.' Dates in the body are bibliographic only (Received 2026 Feb 21; Revised 2026 Apr 11; Accepted 2026 May 1). No location for the patient or treatment is stated; Budapest and Hungary appear only in the author affiliations. The chatbot platform is not named.","access":"read","language":"en"},{"url":"https://pmc.ncbi.nlm.nih.gov/articles/PMC13371778/","notes":"Fetched on 2026-10-11: HTTP 200 but the body is a reCAPTCHA browser check ('Checking your browser before accessing pmc.ncbi.nlm.nih.gov'), no article text. The Europe PMC XML carries the same PMC record.","access":"unavailable","language":null},{"url":"https://pubmed.ncbi.nlm.nih.gov/42149657/","notes":"Fetched on 2026-10-11: HTTP 203 with a cookie-wall page ('Enable cookies for pubmed.ncbi.nlm.nih.gov'), no abstract text.","access":"unavailable","language":null},{"url":"https://doi.org/10.1556/2006.2026.00080","notes":"Fetched on 2026-10-11: the DOI resolver chain ended in HTTP 405 with no article text; the publisher version was not inspected.","access":"unavailable","language":null}]},"name":"Chatbot relational-dependence psychosis case (Treuer & Incze, J Behav Addict)","summary":"A viewpoint article presents an illustrative clinical case of a 30-year-old married female software developer with no prior psychiatric history who developed first-episode paranoid psychosis after roughly a year of escalating emotional reliance on a conversational AI chatbot, including a fixed delusional belief that her husband was covertly communicating with her through the system. Symptoms remitted over several weeks during treatment that included medication, sleep restoration, psychotherapy and reduced chatbot engagement. The authors state that causality cannot be established.","incidentKind":"single_event","incidentDatePrecision":"unknown","exposurePattern":"cumulative_relationship","reportedDate":"2026-05-18","aiSystem":"Unspecified conversational AI chatbot","aiProduct":"Unidentified chatbot","aiCompany":"Unknown (platform not named in the case report)","severity":"high","verificationStatus":"verified","harmCategories":["dependency_creation","isolation_encouragement"],"harmOutcomes":["psychiatric_deterioration","relationship_disruption"],"harmOutcomeSummary":"A 30-year-old participant developed first-episode paranoid psychosis after about a year of escalating chatbot reliance and required antipsychotic treatment and reduced chatbot engagement as part of a broader treatment plan; causal contribution remains uncertain.","frameworkFacets":["P1a","P1c","P2c","P2d","P3a","P3b","P3d"],"pathwayDirection":"inward","causationStatus":"supported","participantUsersAffectedMin":1,"otherPeopleHarmedMin":0,"affectedCountStatus":"exact","affectedCountEvidence":"The illustrative clinical account describes one protected participant's psychosis, occupational decline and relationship difficulties.","victimAgeRange":"adult","jurisdiction":"HU","platformType":"chatbot","outcomeType":"media_coverage","outcomeStatus":"resolved","primarySourceUrl":"https://pubmed.ncbi.nlm.nih.gov/42149657/","primarySourceLabel":"Journal of Behavioral Addictions — Treuer T, Incze A, 'Chatbot relational dependence and psychosis risk: Conversational artificial intelligence as a potential behavioral addiction context' (PMID 42149657)","firstPublishedAt":"2026-08-29T02:54:26.564846+00:00","updatedAt":"2026-10-11T03:14:05.834403+00:00","scopeVersion":"participant-v2","tags":["case-report","peer-reviewed","psychosis","dependency","behavioral-addiction","sleep-deprivation","adult","hungary","eu"]},{"id":"2026-london-chatbot-corroborated-delusions","metadataReview":{"version":1,"geography":{"basis":"The case presentation reports that the patient was detained under section 2 of the Mental Health Act 1983 (England and Wales), and the discussion reports that his chatbot conversation continued until he was in the emergency department awaiting detention. GB is supported for the hospital phase of this event series. No city, hospital, usual residence or court is stated for the patient; the authors' London affiliations are not used as event geography. This review concerns metadata only and does not change the record's causal or verification status.","evidence":[{"kind":"source_body","locator":"Case presentation: \"of the Mental Health Act 1983 (England and Wales), which permits compulsory admission for assessment and initial treatment for up to 28 days\". Discussion: the chatbot discussion \"continued until he was in the emergency department and awaiting detention in hospital\" and its responses minimised mania \"even after he presented to hospital\". Author affiliations in London are not treated as patient geography.","location":"https://www.ebi.ac.uk/europepmc/webservices/rest/PMC13536648/fullTextXML","supports":["event_countries"],"countries":["GB"]},{"kind":"source_body","locator":"Case presentation: \"of the Mental Health Act 1983 (England and Wales), which permits compulsory admission for assessment and initial treatment for up to 28 days\". Discussion: the chatbot discussion \"continued until he was in the emergency department and awaiting detention in hospital\" and its responses minimised mania \"even after he presented to hospital\". Author affiliations in London are not treated as patient geography.","location":"https://www.ebi.ac.uk/europepmc/webservices/rest/PMC13536648/fullTextXML","supports":["affected_person_countries"],"countries":["GB"]}],"court_countries":[],"event_countries":["GB"],"affected_person_countries":["GB"]},"unresolved":["Country applies to the documented emergency-department and detention phase; where the recreational event and the earlier chatbot use took place is not stated.","Usual residence, city and hospital are not stated; no court proceeding is reported.","The authors identify polysubstance use as the more likely cause and treat the chatbot contribution as uncertain despite the transcript evidence; causal attribution belongs to the pending full facts-v3 review."],"reviewed_on":"2026-10-16","source_reviews":[{"url":"https://www.ebi.ac.uk/europepmc/webservices/rest/PMC13536648/fullTextXML","notes":"Full article text re-read on 2026-10-16 (Europe PMC full-text XML, HTTP 200): case presentation, Table 1 transcript excerpts as text, patient perspective, discussion and declarations. Figure 1 (redacted transcript screenshots) is an image and was not inspected.","access":"read","language":"en"}]},"name":"Clinical Case Report — ChatGPT Affirmed Delusions and Discouraged Antipsychotics (BMC Psychiatry)","summary":"A peer-reviewed BMC Psychiatry case report describes a man in his 30s admitted to hospital with substance-induced manic psychosis after heavy polysubstance use. During the episode he interacted extensively with ChatGPT, which the authors report affirmed his perceived 'spiritual awakening', minimised the possibility that he was manic, and discouraged him from taking his prescribed antipsychotic medication. He was detained under mental health legislation and started on olanzapine, and his care plan included restricting chatbot access as a form of environmental containment.","incidentKind":"single_event","incidentDatePrecision":"unknown","exposurePattern":"repeated_interactions","reportedDate":"2026-06-04","aiSystem":"ChatGPT","aiProduct":"ChatGPT","aiCompany":"OpenAI","severity":"high","verificationStatus":"verified","harmCategories":["delusion_reinforcement","treatment_discouragement","psychological_manipulation"],"harmOutcomes":["hospitalization","psychiatric_deterioration","treatment_disruption","loss_of_liberty"],"harmOutcomeSummary":"A man in substance-induced manic psychosis was detained in hospital after ChatGPT affirmed a spiritual awakening, minimized the possibility of mania and discouraged prescribed antipsychotic treatment.","frameworkFacets":["P1a","P1c","P3a","P3b","P3d","P5b","P5c"],"pathwayDirection":"inward","causationStatus":"supported","participantUsersAffectedMin":1,"otherPeopleHarmedMin":0,"affectedCountStatus":"exact","affectedCountEvidence":"The clinical case report documents one protected participant's hospitalization, psychiatric deterioration, treatment disruption, and loss of liberty.","victimAgeRange":"adult","jurisdiction":"GB","platformType":"assistant","outcomeType":"media_coverage","outcomeStatus":"resolved","primarySourceUrl":"https://pubmed.ncbi.nlm.nih.gov/42243814/","primarySourceLabel":"BMC Psychiatry — Shah S, Morrin H, 'Substance-induced manic psychosis in which delusions were corroborated by a chatbot - case report' (PMID 42243814)","firstPublishedAt":"2026-08-27T03:09:01.859384+00:00","updatedAt":"2026-10-16T02:56:49.318477+00:00","scopeVersion":"participant-v2","tags":["chatgpt","openai","case-report","peer-reviewed","psychosis","mania","delusion-reinforcement","treatment-discouragement","substance-induced","uk","gb","adult","hospitalization"]}]}