The humble case report

Objective: There is negligible systematic information about case reports in the psychiatric literature, We aimed to describe case report articles publ ished in the Australian and New Zealand Journal of Psychiatry (ANZJP), to p rovide data about the quality of evidence they offer, to ascertain changes over time and to make recommendations, based on our findings, about these a rticles. Method: All articles describing cases which appeared in the ANZJP between 1 967 and 1999 were identified and examined. Results: 256 articles describing a total of 479 cases were published over t he study period. Fifty-five per cent of articles reported an unusual presen tation. Thirty-eight per cent of cases had a mood disorder and 24% had a ps ychosis. Seventy-six per cent of patients had a positive outcome. Cases pub lished in 1989-1999 were more likely to describe pharmacological treatments than cases published earlier. Conclusions: Clinical descriptions that lead to progress are undervalued. C ase reports should retain a place in the ANZJP, provided they convey inform ation that is new and useful (e.g. suggesting or refuting hypotheses) rathe r than simply document current practice or describe the unusual. Issues of patient consent and anonymity also warrant consideration.