Clinical Case Reports in mental health : the need for nuance and context

Sharing an interesting clinical case report with a colleague recently elicited the remark, “... sounds like one of my clinical supervision sessions!” The comment got us reflecting on the value of clinical case reports. Research regulators such as Australia’s National Health and Medical Research Council [1] place “case reports” alongside “case studies” as the lowest ranked type of credible research design. Apparently, this is because replication and generalization of case reports are normally either difficult or impossible – but is not that just the point? Clinical case reports are vitally important because, like precious gems, they often represent difference, describing cases and insights that are out of the ordinary and challenge current assumptions. Surprisingly, however, there has been negligible formal study of case reports and not infrequently there have been calls to cease publishing them.