The humble case report.

Abstract

OBJECTIVE: There is negligible systematic information about case reports in the psychiatric literature. We aimed to describe case report articles published in the Australian and New Zealand Journal of Psychiatry (ANZJP), to provide data about the quality of evidence they offer, to ascertain changes over time and to make recommendations, based on our findings, about these articles. METHOD: All articles describing cases which appeared in the ANZJP between 1967 and 1999 were identified and examined. RESULTS: 256 articles describing a total of 479 cases were published over the study period. Fifty-five per cent of articles reported an unusual presentation. Thirty-eight per cent of cases had a mood disorder and 24% had a psychosis. Seventy-six per cent of patients had a positive outcome. Cases published in 1989-1999 were more likely to describe pharmacological treatments than cases published earlier. CONCLUSIONS: Clinical descriptions that lead to progress are undervalued. Case reports should retain a place in the ANZJP, provided they convey information that is new and useful (e.g. suggesting or refuting hypotheses) rather than simply document current practice or describe the unusual. Issues of patient consent and anonymity also warrant consideration.