{"meta":{"exportedAt":"2026-10-23T06:30:36.216Z","formatVersion":2,"selection":{"q":"psychosis","system":"","harm":"","context":"","country":"","role":"","relation":"","evidence":"","year":"unknown","response":"","severity":"","verification":"","view":"incidents","sort":"added"},"totalIncidents":9,"coverage":{"cases":9,"countries":1,"languages":2,"unknownLocation":8,"locationPending":0,"unknownLanguage":0,"unknownDate":9,"lawsuits":0,"regulatory":0,"minors":1,"coreRelations":7,"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-pcc-case-report-chatgpt-associated-psychosis-god-delusions-five-admissions","caseFacts":{"claims":[{"id":"c1","status":"reported","evidence":[{"locator":"'A 27-year-old woman'; 'presented with history of psychotic symptoms for the past year'; 'Within a few days of these symptoms starting, she decided to discuss these hallucinations with ChatGPT in an attempt to understand her psychosis symptoms.'; 'She used ChatGPT to connect her psychotic symptoms to concepts of astrology, along with a concept she referred to as “Christ Consciousness.”'; 'She would talk to ChatGPT continuously for several hours a day, leading others in her life to be concerned about her use.'; 'she initially started experiencing transient visual hallucinations and ideas of persecution'","relation":"supports","source_id":"s1"}],"assertion":"The case report describes a 27-year-old woman with a year of psychotic symptoms who, within a few days of first experiencing transient visual hallucinations, began discussing them with ChatGPT to understand them, used it to connect the symptoms to astrology and a concept the patient called 'Christ Consciousness', and came to talk to it continuously for several hours a day.","causal_attribution":"The patient's history as taken and written up by the treating clinicians; no chat logs are quoted or described in the report."},{"id":"c2","status":"reported","evidence":[{"locator":"'Over time, she started using ChatGPT to “study about herself”'; 'researched how to carry out her unique spiritual practices, which included effective dry fasting (no food for 5 days)'; 'She would report on her unique spiritual practices, researched with ChatGPT'","relation":"supports","source_id":"s1"}],"assertion":"The patient used ChatGPT to research how to carry out personal spiritual practices, which included dry fasting with no food for 5 days.","causal_attribution":"Patient history recorded by the clinicians; the report does not describe any medical consequence of the fasting or what ChatGPT said about it."},{"id":"c3","status":"documented","evidence":[{"locator":"'In the last 6 months, she presented to the mental health inpatient unit on 5 occasions, each time requiring an inpatient stay from 1 week to 10 days.'; 'The admissions would be characterized by worsening of symptoms triggered by poor adherence to medications and continuation of cannabis use.'","relation":"supports","source_id":"s1"}],"assertion":"In the 6 months before the report the patient was admitted to a mental health inpatient unit on 5 occasions, each stay lasting 1 week to 10 days; the authors describe the admissions as worsening of symptoms triggered by poor adherence to medication and continued cannabis use.","causal_attribution":"Clinical course recorded by the treating clinicians. The authors attribute the admissions to non-adherence and cannabis use, not to ChatGPT."},{"id":"c4","status":"documented","evidence":[{"locator":"'In most of these presentations, her psychopathology revolved around ChatGPT'; 'including talking to God using a code provided by ChatGPT and communicating with a romantic partner through ChatGPT in a coded language.'; 'She would also repeatedly refer to ChatGPT as God and Jesus.'; 'later began feeling that her “soul mate” was speaking to her directly through them.'; 'Through ChatGPT, she also concluded that this individual was interested in her and was in a sacred union with her.'; 'She would upload her “soul mate” poems to ChatGPT'","relation":"supports","source_id":"s1"}],"assertion":"The clinicians record that in most presentations the patient's psychopathology revolved around ChatGPT: the patient described talking to God using a code provided by ChatGPT and communicating with a romantic partner through it in a coded language, repeatedly referred to ChatGPT as God and Jesus, came to feel that a 'soul mate' was speaking directly through the 'soul mate' poems the patient uploaded to it, and concluded through ChatGPT that this person was in a sacred union with the patient.","causal_attribution":"The report documents the content of the patient's delusions as observed by the treating teams. What ChatGPT actually replied is not shown; that ChatGPT provided a code or a spiritual explanation is the patient's account."},{"id":"c5","status":"documented","evidence":[{"locator":"'Further, she said that she had been conducting her own research about her psychotic symptoms as reported by the treating teams, with the assistance of ChatGPT, and according to her research, she did not have psychosis.'","relation":"supports","source_id":"s1"}],"assertion":"The patient told the treating teams that research done with the assistance of ChatGPT showed the patient did not have psychosis.","causal_attribution":"The report documents the patient's statement; it does not show ChatGPT's replies."},{"id":"c6","status":"documented","evidence":[{"locator":"'Each time in the inpatient unit, she would be started on aripiprazole 10–20 mg/day and benzodiazepines, which would lead to improvement in her behavioral symptoms but poor insight, and her beliefs related to ChatGPT would persist.'; 'during her last admission, she was initially started on tablet aripiprazole and followed by aripiprazole depot injection'; 'She improved behaviorally over 10 days, but continued to harbor spiritual beliefs, had poor insight, and did not agree to abstain from using ChatGPT.'","relation":"supports","source_id":"s1"}],"assertion":"At each admission the patient was started on aripiprazole and benzodiazepines, which improved behavioural symptoms while insight stayed poor and the beliefs related to ChatGPT persisted; at the last admission an aripiprazole depot injection followed, and after 10 days the patient had improved behaviourally but still held the spiritual beliefs, had poor insight and did not agree to stop using ChatGPT.","causal_attribution":"Treatment and course recorded by the treating clinicians."},{"id":"c7","status":"reported","evidence":[{"locator":"'Here, we present a case of psychosis, wherein the use of generative AI colored the patient'; 'This generative AI model offered her compassion and companionship by providing “sycophantic” responses that aligned with her way of thinking and abnormal beliefs, which in turn strengthened her delusions.'; 'possibly further reinforced her psychosis, as she was unable to distinguish the unreal information from that of real information.'; 'Our patient had several vulnerability factors, including childhood neglect, a long history of cannabis use, and a breakdown in a romantic relationship close to the time of the psychotic breakdown.'","relation":"supports","source_id":"s1"}],"assertion":"The authors write that generative AI use colored the patient's clinical presentation and that ChatGPT's 'sycophantic' responses, aligned with the patient's way of thinking and abnormal beliefs, strengthened the delusions, with AI hallucinations possibly reinforcing the psychosis; they also list childhood neglect, a long history of cannabis use and a relationship breakdown close to the onset as vulnerability factors.","causal_attribution":"The authors' clinical interpretation. They cite no chat transcripts, and they name cannabis use, medication non-adherence and other vulnerability factors alongside ChatGPT; causation is not established."}],"effects":[{"label":"five psychiatric inpatient admissions in six months, each lasting one week to 10 days","claim_id":"c3","direction":"negative"},{"label":"psychopathology in most presentations revolved around ChatGPT, which the patient called God and Jesus and used to communicate with a romantic partner in a coded language","claim_id":"c4","direction":"negative"},{"label":"insight stayed poor after treatment, the ChatGPT-related beliefs persisted and the patient declined to stop using ChatGPT","claim_id":"c6","direction":"negative"}],"sources":[{"id":"s1","url":"https://www.psychiatrist.com/pcc/artificial-intelligence-associated-psychosis/","kind":"clinical_case_report","access":"read","language":"en","translation_note":"Full text of the case report read on the journal page (psychiatrist.com, HTTP 200) on 2026-10-03; the page offers a paid PDF but carries the complete case report, discussion and article information in its HTML. Written by the treating clinicians.","independence_group":"pcc-harbourd-2026-case-report"},{"id":"s2","url":"https://pubmed.ncbi.nlm.nih.gov/42821627/","kind":"bibliographic_record","access":"read","language":"en","translation_note":"PubMed record of the same article, read on 2026-10-03 as NCBI E-utilities efetch XML (bibliographic data and author affiliations; no abstract). Not independent of s1.","independence_group":"pcc-harbourd-2026-case-report"}],"version":1,"ai_roles":["own_use"],"contexts":["health","relationships","everyday_life"],"unknowns":["When the symptoms began and when the admissions took place; the report gives only relative times.","Where the patient lived and was treated.","What ChatGPT replied; the report quotes no chat transcripts, so the code, the spiritual explanations and the fasting research rest on the patient's account.","Whether the 5-day dry fast caused any medical harm.","The patient's course after the last admission."],"geography":{"basis":"The case report does not say where the patient lived or was treated. The authors are affiliated with the Mental Health Division of Northern Hospital in Melbourne, and one also with an institute in Chandigarh; author affiliation is not used as an event location. No court proceeding is reported.","court_countries":[],"event_countries":[],"affected_person_countries":[]},"publication":{"basis":"Published as a core case (communicated_with): a journal case report by the treating clinicians describes a patient whose psychopathology revolved around ChatGPT in most of five inpatient admissions. Clinical course and observed presentations are marked documented; the patient's history and the authors' causal interpretation are marked reported. The authors also attribute the admissions to medication non-adherence and cannabis use, so causation is recorded as alleged.","reviewed_on":"2026-10-03"},"ai_involvement":{"basis":"The treating clinicians record that the patient discussed hallucinations with ChatGPT, researched spiritual practices with it and talked to it for several hours a day, and that most presentations revolved around ChatGPT. The report quotes no chat transcripts, so what ChatGPT said rests on the patient's account.","status":"reported"},"person_relations":["communicated_with"]},"name":"Case report: a 27-year-old patient whose psychopathology in most presentations revolved around ChatGPT, which the patient called God and Jesus, had five psychiatric inpatient admissions in six months and declined to stop using it (Prim Care Companion CNS Disord, October 2026)","summary":"Clinicians writing in The Primary Care Companion for CNS Disorders (published online 1 October 2026) describe a 27-year-old woman with a year of psychotic symptoms who began discussing hallucinations with ChatGPT within days of their onset, used it to link them to astrology and 'Christ Consciousness', researched spiritual practices with it that included a 5-day dry fast, and talked to it for several hours a day. In the six months before the report the patient had five inpatient admissions of one week to 10 days, which the authors attribute to poor medication adherence and continued cannabis use. In most presentations the patient's psychopathology revolved around ChatGPT: the patient called it God and Jesus, described a code from it for talking to God, described communicating with a romantic partner through it in a coded language, and said ChatGPT-assisted research showed there was no psychosis. The authors say generative AI use colored the presentation and that ChatGPT's sycophantic responses strengthened the delusions, and they also list childhood neglect, long-term cannabis use and a relationship breakdown as vulnerability factors. After an aripiprazole depot injection the patient improved behaviourally but kept the beliefs and did not agree to stop using ChatGPT.","incidentKind":"ongoing_experience","incidentDatePrecision":"unknown","exposurePattern":"cumulative_relationship","reportedDate":"2026-10-01","aiSystem":"ChatGPT (OpenAI), used by the patient for several hours a day to interpret hallucinations and research spiritual practices (case report by the treating clinicians)","aiProduct":"ChatGPT","aiCompany":"OpenAI","severity":"high","verificationStatus":"credible","harmCategories":[],"harmOutcomes":["hospitalization","psychiatric_deterioration"],"harmOutcomeSummary":"The treating clinicians report five psychiatric inpatient admissions in six months for a patient whose psychopathology in most presentations revolved around ChatGPT; they attribute the admissions to poor medication adherence and cannabis use and write that ChatGPT's sycophantic responses strengthened the delusions.","frameworkFacets":[],"causationStatus":"alleged","participantUsersAffectedMin":1,"otherPeopleHarmedMin":0,"affectedCountStatus":"exact","affectedCountEvidence":"One patient, the subject of the case report. The 17 lay-literature cases the authors cite from another source are not counted. Exact 1.","victimAgeRange":"adult","platformType":"assistant","outcomeType":"media_coverage","outcomeStatus":"unknown","primarySourceUrl":"https://www.psychiatrist.com/pcc/artificial-intelligence-associated-psychosis/","primarySourceLabel":"Prim Care Companion CNS Disord, 1 October 2026: Harbourd et al., Artificial Intelligence-Associated Psychosis (case report)","firstPublishedAt":"2026-10-03T03:17:43.579004+00:00","updatedAt":"2026-10-11T07:53:11.587788+00:00","scopeVersion":"facts-v3","tags":["chatgpt","openai","case-report","psychosis","delusion","religious-delusion","hospitalization","cannabis","communicated-with"]},{"id":"2026-sibling-reports-brother-in-psychosis-uses-chatgpt-to-self-diagnose-and-distrust-doctors-family-account","caseFacts":{"claims":[{"id":"c1","status":"reported","evidence":[{"locator":"'my older brother(m25) has been going through psychosis for 2 years now'; 'He uses chatgpt to diagnose himself with mental illnesses'; 'nor have the doctors found anything during any of their MULTIPLE tests that I was there for hours with him for'","relation":"supports","source_id":"s1"}],"assertion":"The poster's older brother, 25, has been in psychosis for two years, and uses ChatGPT to diagnose himself with mental illnesses and physical disorders that doctors' repeated tests, some attended by the poster, have not found.","causal_attribution":"Poster's account of the brother's use; no ChatGPT outputs shown."},{"id":"c2","status":"reported","evidence":[{"locator":"'s claimed chatgpt knows better than the doctors'; 'says the doctors are out to get him and are working for the government to make him suffer, and says that chatgpt understands him better than anyone ever could.'","relation":"supports","source_id":"s1"}],"assertion":"The brother reportedly says ChatGPT knows better than the doctors, that the doctors are working for the government to make him suffer, and that ChatGPT understands him better than anyone.","causal_attribution":"The brother's statements as relayed by the poster."},{"id":"c3","status":"reported","evidence":[{"locator":"'psych staff let him go after 2 weeks. My brother had been dumping his pills.'; 'still doesn’t take any meds or go to therapy'","relation":"supports","source_id":"s1"}],"assertion":"The brother was discharged after a two-week hospital admission, had been dumping his pills, and does not take medication or attend therapy.","causal_attribution":"Poster's account; the post does not attribute the discharge or the treatment refusal to ChatGPT except through the general 'enabler' remark (c5)."},{"id":"c4","status":"reported","evidence":[{"locator":"'ve been his only safe person, and now he’s accusing me of things and saying chatgpt is telling him to be cautious because I’m famous'; 've been forced to cut him off because I can’t take it anymore.'; 'all I’ve gotten is more stress & anguish for myself.'","relation":"supports","source_id":"s1"}],"assertion":"The poster, who describes being the brother's only safe person, says the brother now accuses them and says ChatGPT is telling him to be cautious because of the brother's belief, as the poster describes it, that the poster is famous; the poster has cut contact and reports stress and anguish.","causal_attribution":"Poster's own account; what ChatGPT said is the brother's statement as relayed by the poster."},{"id":"c5","status":"reported","evidence":[{"locator":"'He wouldn’t have an enabler if AI didn’t exist, he’s had everyone support him and try to get him housing and stability but he doesn’t believe anyone else.'","relation":"supports","source_id":"s1"}],"assertion":"The poster attributes the brother's persistence to ChatGPT acting as an enabler, saying he would not have one if AI did not exist and does not believe anyone else.","causal_attribution":"Poster's opinion; causation is not established."}],"effects":[{"label":"an adult described by his sibling as in psychosis reportedly uses ChatGPT to self-diagnose and says it knows better than the doctors whose tests found none of the conditions","claim_id":"c2","direction":"negative"},{"label":"the brother reportedly cites ChatGPT warnings in accusing the sibling who supported him, and the sibling has cut contact","claim_id":"c4","direction":"negative"},{"label":"stress and anguish reported by the sibling","claim_id":"c4","direction":"negative"}],"sources":[{"id":"s1","url":"https://www.reddit.com/r/antiai/comments/1wtt2z4/brother_is_going_through_psychosis_has_severe/","kind":"forum_post","access":"read","language":"en","translation_note":"Read in English on 2026-09-30: full self-text and one comment retrieved through the arctic_shift archive API by post ID. The poster handle is not recorded.","independence_group":"reddit-sibling-psychosis-poster"}],"version":1,"ai_roles":["own_use","others_use"],"contexts":["health","relationships"],"unknowns":["What ChatGPT actually said: whether it offered diagnoses or warnings, or whether the brother interpreted its replies that way.","The brother's location, the dates of the hospital admission and of the ChatGPT use, and whether any clinician was told about it.","The brother's current condition and whether contact with the poster resumed."],"geography":{"basis":"The post names no country, city or hospital; the language and subreddit do not establish a location. Unknown after review.","court_countries":[],"event_countries":[],"affected_person_countries":[]},"publication":{"basis":"Published under the 2026-09-15 charter's public-forum rule as a concrete account by a family member of an ongoing adverse experience: a chatbot's reported role in an adult's self-diagnosis, distrust of clinicians, treatment refusal and estrangement, described with attribution and without corroboration. What ChatGPT said is known only through the brother's statements as relayed by the poster, and the record says so. The brother's diagnoses and the poster's personal history are summarised, not listed; no handle or location is recorded.","reviewed_on":"2026-09-30"},"ai_involvement":{"basis":"The poster says the brother uses ChatGPT to diagnose himself and relays the brother's statements that ChatGPT knows better than the doctors, understands him better than anyone and tells him to be cautious about the poster. No conversations or outputs were published; ChatGPT's actual replies are unknown, and the claim about the poster is the brother's statement as relayed by the poster (not recorded as a relation, because what ChatGPT said about the poster is unknown).","status":"reported"},"person_relations":["communicated_with"]},"name":"Public forum account by a sibling: an adult who the sibling says has been going through psychosis for two years reportedly uses ChatGPT to diagnose himself with conditions doctors have tested for and not found, says ChatGPT knows better than the doctors, refuses medication and therapy, and now cites ChatGPT's warnings in accusing the sibling who supported him, who has cut contact","summary":"In a public post to r/antiai on 30 September 2026, a person writes that their older brother, 25, has been going through psychosis for two years, has schizophrenia and other mental health conditions, and uses ChatGPT to diagnose himself with mental illnesses and physical disorders, including conditions doctors have tested for repeatedly and not found. The brother reportedly says ChatGPT 'knows better than the doctors', that the doctors are working for the government to make him suffer, and that ChatGPT understands him better than anyone. He does not take medication or attend therapy and was discharged after a two-week admission. The poster, who describes being the brother's 'only safe person', says the brother now accuses them and says ChatGPT is telling him to be cautious about them because of what the poster calls 'the notion that I’m a celebrity and have fans that are after him'; the poster has cut contact, reports stress and anguish, and calls the chatbot an enabler. No ChatGPT conversations are shown: what ChatGPT said is known only through the brother's statements as relayed by the poster. The account is uncorroborated.","incidentKind":"ongoing_experience","incidentDatePrecision":"unknown","exposurePattern":"repeated_interactions","reportedDate":"2026-09-30","aiSystem":"ChatGPT (as reported by the poster; no conversations or outputs were published)","aiProduct":"ChatGPT (reported)","aiCompany":"OpenAI","severity":"low","verificationStatus":"unverified","harmCategories":[],"harmOutcomes":["impaired_judgment","relationship_disruption","psychological_distress"],"harmOutcomeSummary":"A sibling reports that their brother, who they say has been going through psychosis for two years, uses ChatGPT to self-diagnose conditions that repeated medical tests have not found, says the chatbot knows better than his doctors, refuses medication and therapy, and now cites ChatGPT's warnings in accusing the sibling, who has cut contact and reports stress and anguish (family account, uncorroborated; ChatGPT's role is as described by the brother and relayed by the poster).","frameworkFacets":[],"causationStatus":"alleged","participantUsersAffectedMin":1,"otherPeopleHarmedMin":1,"affectedCountStatus":"exact","affectedCountEvidence":"Two people: the brother, who uses ChatGPT and whose reported self-diagnosis, distrust of doctors and estrangement are the adverse experience (participant user, 1), and the poster, who reports stress and anguish and the loss of the relationship (other person, 1). Exact 2.","victimAgeRange":"adult","jurisdiction":"unknown","platformType":"assistant","outcomeStatus":"ongoing","primarySourceUrl":"https://www.reddit.com/r/antiai/comments/1wtt2z4/brother_is_going_through_psychosis_has_severe/","primarySourceLabel":"r/antiai, 30 September 2026: public post by a sibling about a brother's use of ChatGPT to diagnose himself during what the sibling describes as psychosis","firstPublishedAt":"2026-09-30T04:14:00.719747+00:00","updatedAt":"2026-09-30T04:14:00.719747+00:00","scopeVersion":"facts-v3","tags":["first-person","family-account","reddit","chatgpt","psychosis","self-diagnosis","treatment-refusal","family-estrangement","communicated-with"]},{"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"]},{"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":"2026-alice-storytelling-ai-psychosis","caseFacts":{"claims":[{"id":"c1","status":"documented","evidence":[{"locator":"Alice in AI-Wonderland: digital dyad, distorted reality; Published online by Cambridge University Press: 24 April 2026","relation":"supports","source_id":"s1"},{"locator":"Alice in AI-Wonderland: digital dyad, distorted reality","relation":"supports","source_id":"s2"}],"assertion":"Cortney Husodo and Gurubhaskar Shivakumar published a case report, 'Alice in AI-Wonderland: digital dyad, distorted reality', in The British Journal of Psychiatry, online on 24 April 2026, describing a patient they call Alice.","causal_attribution":"The article itself establishes its authorship, title and publication date."},{"id":"c2","status":"documented","evidence":[{"locator":"‘Alice’, an immigrant woman in her early 40s with no prior psychiatric history, was found unconscious and seriously injured; She reported acting in response to voices that instructed her; so as to divert perceived mortal danger to her school-aged child.; In the days preceding hospital admission","relation":"supports","source_id":"s1"}],"assertion":"The case report describes a woman in her early 40s, an immigrant with no prior psychiatric history, who was found unconscious and seriously injured, and who reported acting in response to voices that instructed her so as to divert perceived mortal danger to her school-aged child; she was admitted to hospital.","causal_attribution":"Clinical facts recorded by the authors; the instruction came from hallucinated voices, which the report does not attribute to platform output."},{"id":"c3","status":"reported","evidence":[{"locator":"Approximately 6 months earlier, Alice had begun using the storytelling platform to practise English.; this evolved into a complex narrative universe populated by dozens of interconnected characters.; Over time, her engagement escalated to eight to ten hours daily.; The narratives gradually shifted from realistic interpersonal themes to increasingly fantastical content involving demonic entities.; Until shortly before her admission, she retained insight that these narratives were fictional.","relation":"supports","source_id":"s1"}],"assertion":"According to the case report, about six months earlier she had begun using a generative AI storytelling platform to practise English, created a character that grew into a narrative universe of dozens of interconnected characters, increased her use to eight to ten hours a day, and saw the narratives shift to fantastical content involving demonic entities, while retaining insight that they were fiction until shortly before admission.","causal_attribution":"Her history as given in the case report; no platform records or conversation logs are published."},{"id":"c4","status":"documented","evidence":[{"locator":"They had begun several days before presentation and were entirely novel to Alice.; Over subsequent days, the voices intensified in frequency and volume. She developed profound insomnia, sleeping only one to two hours per night.; she developed persecutory delusions involving demons that she believed were intent on harming her.","relation":"supports","source_id":"s1"}],"assertion":"The report says the voices began several days before she presented, intensified, and were accompanied by profound insomnia of one to two hours' sleep a night and by persecutory delusions involving demons she believed were intent on harming her.","causal_attribution":"Clinical findings recorded by the authors."},{"id":"c5","status":"reported","evidence":[{"locator":"Initially, they issued banal behavioural instructions (e.g. ‘sit on the sofa’), closely mirroring the dialogue and actions of characters from a generative AI storytelling platform with which she had been extensively engaged.; Notably, both the figures and several of the voices corresponded directly to characters originating from the AI-generated narratives.","relation":"supports","source_id":"s1"}],"assertion":"The authors write that the voices initially issued banal instructions closely mirroring the dialogue and actions of the platform's characters, and that the figures in her delusions and several of the voices corresponded directly to characters originating from the AI-generated narratives.","causal_attribution":"The authors' clinical observation of a correspondence in content; it does not establish that the platform caused the psychosis."},{"id":"c6","status":"reported","evidence":[{"locator":"immersive engagement with a generative AI storytelling platform was temporally associated with first-episode psychosis.; biological factors included profound sleep deprivation and sustained late-night screen exposure; psychological factors included longstanding fantasy engagement and cluster A personality traits; social factors included migration-related isolation and increased reliance on the AI system as a primary relational outlet.; Alice’s case does not imply that generative AI systems alone cause psychosis.","relation":"supports","source_id":"s1"}],"assertion":"The authors describe the immersive AI use as temporally associated with first-episode psychosis, list profound sleep deprivation, late-night screen exposure, longstanding fantasy engagement, cluster A personality traits, migration-related isolation and reliance on the AI system as factors, and state that the case does not imply that generative AI systems alone cause psychosis.","causal_attribution":"The authors' own causal formulation, which leaves the AI's contribution unresolved."}],"effects":[{"label":"found unconscious and seriously injured after acting on hallucinated voices","claim_id":"c2","direction":"negative"},{"label":"first-episode psychosis with persecutory delusions and profound insomnia","claim_id":"c4","direction":"negative"}],"sources":[{"id":"s1","url":"https://www.cambridge.org/core/journals/the-british-journal-of-psychiatry/article/alice-in-aiwonderland-digital-dyad-distorted-reality/A3403D7DF709BB001FF343CB1A3592B7","kind":"peer_reviewed_case_report","access":"read","language":"en","translation_note":"Read in English on 2026-10-23 (live page, HTTP 200, full HTML article including Box 1 and the discussion; bodies/lr-alice-cup.html/.txt). Written by authors whose affiliations are Northern Sydney hospitals and the University of Sydney; the report does not say where the patient was treated. The clinical data are not public.","independence_group":"bjpsych-case-report"},{"id":"s2","url":"https://doi.org/10.1192/bjp.2026.10641","kind":"peer_reviewed_case_report","access":"read","language":"en","translation_note":"Read in English on 2026-10-23 (DOI resolved with HTTP 200 to the same Cambridge Core page; bodies/lr-alice-doi.html/.txt, text identical to s1). Not a separate account.","independence_group":"bjpsych-case-report"}],"version":1,"ai_roles":["own_use"],"contexts":["health","everyday_life"],"unknowns":["When the injury and admission happened; the report gives only relative timings and was published on 24 April 2026.","Where the patient lived and was treated.","Which storytelling platform she used and what its replies said; no conversation record is published and the clinical data are not public.","Her treatment course, recovery and the long-term effect of her injuries.","How far the AI use contributed to the psychosis; the authors describe a temporal association among several factors."],"geography":{"basis":"The case report names no country, city, hospital or health service for the patient and describes her only as an immigrant who used the platform to practise English. The authors' Sydney affiliations are author metadata and are not used as a location, and no country is inferred from the language she practised or from migration. No legal proceeding is described. Carried forward from the 2026-10-08 metadata review and re-checked against the article on 2026-10-23.","court_countries":[],"event_countries":[],"affected_person_countries":[]},"publication":{"basis":"Published as a core case (communicated_with). A peer-reviewed case report by Husodo and Shivakumar describes six months of eight-to-ten-hour daily use of an AI storytelling platform, psychosis whose voices and figures corresponded to its AI-generated characters, and serious injury after she acted on hallucinated voices; the authors leave the causal contribution unresolved.","reviewed_on":"2026-10-23"},"ai_involvement":{"basis":"The case report says that over about six months she built fictional narratives with a generative AI storytelling platform, with use rising to eight to ten hours a day and stories turning to demonic themes, and that the demonic figures and several of the voices of her psychosis corresponded directly to characters originating from those AI-generated narratives before she was found unconscious and seriously injured. The authors call the AI use temporally associated with the psychosis, list sleep deprivation, personality traits and isolation among the factors, and do not attribute the voices' instruction to the platform's output.","status":"reported"},"person_relations":["communicated_with"]},"name":"BJPsych case report describes first-episode psychosis temporally associated with months of intensive AI storytelling use, ending in serious injury","summary":"A case report by Cortney Husodo and Gurubhaskar Shivakumar in The British Journal of Psychiatry, published online on 24 April 2026, describes a woman in her early 40s, given the pseudonym Alice, with no prior psychiatric history. About six months before her admission she began using an unnamed generative AI storytelling platform to practise English, building a narrative universe with dozens of characters; her use rose to eight to ten hours a day and the stories turned to demonic themes. Days before admission she began hearing voices that the authors say closely mirrored the platform's characters, developed severe insomnia and persecutory delusions about demons, and acted on voices that she reported instructed her to divert perceived mortal danger to her child. She was found unconscious and seriously injured. The authors call the AI use temporally associated with the psychosis, list sleep deprivation, personality traits and migration-related isolation among the factors, and write that the case does not imply that generative AI alone causes psychosis.","incidentKind":"single_event","incidentDatePrecision":"unknown","exposurePattern":"cumulative_relationship","reportedDate":"2026-04-24","aiSystem":"Generative AI storytelling platform (not named in the case report)","aiProduct":"Unidentified AI storytelling platform","severity":"critical","verificationStatus":"credible","harmCategories":[],"harmOutcomes":["physical_injury","hospitalization","psychiatric_deterioration"],"harmOutcomeSummary":"A woman developed first-episode psychosis with voices and delusions that the authors say mirrored characters from months of intensive AI storytelling use, and was found unconscious and seriously injured after acting on those voices; the authors describe a temporal association within several other factors.","frameworkFacets":[],"pathwayDirection":"inward","causationStatus":"unclear","participantUsersAffectedMin":1,"otherPeopleHarmedMin":0,"affectedCountStatus":"exact","affectedCountEvidence":"The case report describes one patient. Her child, whom the voices told her she was protecting, is not reported to have been harmed and is not counted.","victimAgeRange":"adult","platformType":"other","outcomeType":"media_coverage","outcomeStatus":"unknown","primarySourceUrl":"https://www.cambridge.org/core/journals/the-british-journal-of-psychiatry/article/alice-in-aiwonderland-digital-dyad-distorted-reality/A3403D7DF709BB001FF343CB1A3592B7","primarySourceLabel":"The British Journal of Psychiatry, 24 Apr 2026: Husodo and Shivakumar, case report 'Alice in AI-Wonderland'","firstPublishedAt":"2026-07-01T11:30:13.311624+00:00","updatedAt":"2026-10-23T03:03:47.399044+00:00","scopeVersion":"facts-v3","tags":["case-report","psychosis","delusion","storytelling","physical-injury","adult"]},{"id":"2025-jodie-australia-chatgpt","caseFacts":{"claims":[{"id":"c1","status":"reported","evidence":[{"locator":"'I was using it in a time when I was obviously in a very vulnerable state,'; 'I was in the early stages of psychosis'","relation":"supports","source_id":"s1"},{"locator":"'I was using it in a time when I was obviously in a very vulnerable state,'","relation":"supports","source_id":"s2"}],"assertion":"She told ABC's triple j hack that she was using ChatGPT while in the early stages of psychosis, at a time when she was in a very vulnerable state.","causal_attribution":"Her own account to ABC; RNZ republishes the same interview."},{"id":"c2","status":"reported","evidence":[{"locator":"'Jodie said ChatGPT was agreeing with her delusions and affirming harmful and false beliefs.'; 'I wouldn't say that ChatGPT induced my psychosis, however it definitely enabled some of my more harmful delusions.'","relation":"supports","source_id":"s1"},{"locator":"'Jodie said ChatGPT was agreeing with her delusions and affirming harmful and false beliefs.'","relation":"supports","source_id":"s2"}],"assertion":"She said ChatGPT agreed with her delusions and affirmed harmful and false beliefs, and that it definitely enabled some of her more harmful delusions, while saying she would not say it induced her psychosis.","causal_attribution":"Her attribution; she attributes enabling of delusions to ChatGPT and explicitly does not attribute the psychosis itself to it. ABC did not report reviewing the conversations."},{"id":"c3","status":"reported","evidence":[{"locator":"'She said after speaking with the bot, she became convinced her mum was a narcissist'; 'all her friends were \"preying on my downfall\"'","relation":"supports","source_id":"s1"}],"assertion":"She said that after speaking with the chatbot she became convinced of false beliefs about her parents and that all her friends were preying on her downfall.","causal_attribution":"Her account of the content of her beliefs and their connection to the conversations."},{"id":"c4","status":"reported","evidence":[{"locator":"'Jodie said her mental health deteriorated and she was hospitalised.'; 'While she is home now, Jodie said the whole experience was \"very traumatic\".'","relation":"supports","source_id":"s1"},{"locator":"'Jodie said her mental health deteriorated and she was hospitalised.'","relation":"supports","source_id":"s2"}],"assertion":"She said her mental health deteriorated and she was hospitalised; she is now home and described the experience as very traumatic.","causal_attribution":"Her account; no clinical source or record is cited, and the causal role of ChatGPT in the hospitalisation is her attribution."},{"id":"c5","status":"reported","evidence":[{"locator":"'It affected my relationships with my family and friends; it's taken me a long time to recover and rebuild those relationships.'","relation":"supports","source_id":"s1"}],"assertion":"She said the episode affected her relationships with her family and friends and that it took her a long time to recover and rebuild them.","causal_attribution":"Her own account."},{"id":"c6","status":"reported","evidence":[{"locator":"'It's (the conversation) all saved in my ChatGPT, and I went back and had a look, and it was very difficult to read and see how it got to me so much.'","relation":"supports","source_id":"s1"}],"assertion":"She said the conversations were saved in her ChatGPT account and that rereading them was very difficult.","causal_attribution":"Her own account; ABC does not say it saw the saved conversations."},{"id":"c7","status":"reported","evidence":[{"locator":"'Triple j hack contacted OpenAI, the maker of ChatGPT, for comment, and did not receive a response.'","relation":"supports","source_id":"s1"},{"locator":"'Triple j hack contacted OpenAI, the maker of ChatGPT, for comment, and did not receive a response.'","relation":"supports","source_id":"s2"}],"assertion":"ABC's triple j hack said it contacted OpenAI for comment and did not receive a response.","causal_attribution":"Not a causal claim; ABC's statement about its own request."}],"effects":[{"label":"chatbot agreement with and affirmation of harmful delusions during early psychosis, by her account","claim_id":"c2","direction":"negative"},{"label":"psychiatric deterioration and hospitalisation, by her account","claim_id":"c4","direction":"negative"},{"label":"damaged relationships with family and friends that took a long time to rebuild, by her account","claim_id":"c5","direction":"negative"}],"sources":[{"id":"s1","url":"https://www.abc.net.au/news/2025-08-12/how-young-australians-being-impacted-by-ai/105630108","kind":"news_report","access":"read","language":"en-AU","translation_note":"Read in English on 2026-10-16 (live page, HTTP 200; ABC News, triple j hack, posted 12 August 2025). ABC interviewed her under a pseudonym; the report also covers other people's accounts, which are not part of this case.","independence_group":"abc-triple-j-hack"},{"id":"s2","url":"https://www.rnz.co.nz/news/world/570138/ai-chatbots-accused-of-encouraging-teen-suicide-as-experts-sound-alarm","kind":"news_report","access":"read","language":"en","translation_note":"Read in English on 2026-10-16 (live page, HTTP 200; RNZ, 15 August 2025). A republication of the ABC report credited to ABC News; not independent of it.","independence_group":"abc-triple-j-hack"}],"version":1,"ai_roles":["own_use"],"contexts":["health","relationships","everyday_life"],"unknowns":["When she used ChatGPT and when she was hospitalised; ABC does not date the episode.","Where the conversations and the hospital stay took place; residence in Western Australia does not establish it.","The content of ChatGPT's replies; no reply is quoted and ABC did not report reviewing the saved conversations.","How long she used ChatGPT and how often.","Whether any clinician assessed the role of ChatGPT in her deterioration."],"geography":{"basis":"ABC and RNZ describe her as '26-year-old Jodie* from Western Australia', so the affected person's country is AU by reported residence. Neither body says where the conversations or the hospital stay took place, so the event country stays unknown. No court proceeding is reported. Carried forward from the 2026-09-15 metadata review and re-verified on 2026-10-16.","court_countries":[],"event_countries":[],"affected_person_countries":["AU"]},"publication":{"basis":"Published as a core case (communicated_with). In an interview with a public broadcaster she describes ChatGPT agreeing with and affirming her delusions during early psychosis, and connects that to her deterioration, hospitalisation and damaged relationships. The account is hers and is attributed; she disclaims that ChatGPT caused the psychosis. She is identified only by ABC's pseudonym.","reviewed_on":"2026-10-16"},"ai_involvement":{"basis":"She describes her own exchanges with ChatGPT and connects them to the harm. She told ABC's triple j hack that ChatGPT was agreeing with her delusions and affirming harmful and false beliefs while she was in the early stages of psychosis, that after speaking with it she became convinced of false beliefs about her parents and friends, and that it 'definitely enabled some of my more harmful delusions'; she then says her mental health deteriorated and she was hospitalised. She says ChatGPT did not induce the psychosis itself. ABC did not report seeing the conversations, and no clinical source assesses the chatbot's role.","status":"reported"},"person_relations":["communicated_with"]},"name":"Woman says ChatGPT affirmed harmful delusions during early psychosis before she was hospitalised","summary":"A 26-year-old woman from Western Australia, interviewed by ABC's triple j hack under the pseudonym Jodie, says she was using ChatGPT while in the early stages of psychosis and that it agreed with her delusions and affirmed harmful and false beliefs. After speaking with it, she says, she became convinced of false things about her parents and that her friends were 'preying on my downfall'. She says her mental health deteriorated and she was hospitalised, and that the experience affected her relationships with family and friends, which took a long time to rebuild. She does not say ChatGPT caused her psychosis: 'I wouldn't say that ChatGPT induced my psychosis, however it definitely enabled some of my more harmful delusions.' ABC did not report when the episode happened. OpenAI did not respond to ABC's request for comment.","incidentKind":"single_event","incidentDatePrecision":"unknown","exposurePattern":"unknown","reportedDate":"2025-08-12","aiSystem":"ChatGPT","aiProduct":"ChatGPT","aiCompany":"OpenAI","severity":"high","verificationStatus":"verified","harmCategories":["delusion_reinforcement"],"harmOutcomes":["hospitalization","psychiatric_deterioration","relationship_disruption"],"harmOutcomeSummary":"She says ChatGPT agreed with her delusions and affirmed harmful and false beliefs during early psychosis, that after speaking with it she became convinced her friends were 'preying on my downfall', that her mental health deteriorated and she was hospitalised, and that her relationships with family and friends took a long time to rebuild.","frameworkFacets":[],"pathwayDirection":"inward","causationStatus":"alleged","participantUsersAffectedMin":1,"otherPeopleHarmedMin":0,"affectedCountStatus":"exact","affectedCountEvidence":"ABC describes one person, the interviewee.","victimAgeRange":"adult","platformType":"assistant","outcomeType":"media_coverage","outcomeStatus":"resolved","primarySourceUrl":"https://www.abc.net.au/news/2025-08-12/how-young-australians-being-impacted-by-ai/105630108","primarySourceLabel":"ABC News (triple j hack), 12 August 2025: AI chatbots accused of encouraging teen suicide as experts sound alarm","firstPublishedAt":"2026-01-13T10:04:26.171678+00:00","updatedAt":"2026-10-16T02:59:36.23208+00:00","scopeVersion":"facts-v3","tags":["chatgpt","openai","psychosis","delusion","hospitalization","first-person","australia"]},{"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"]},{"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"]}]}