PSYCHIATRY AND CLINICAL NEUROSCIENCES (PCN) publishes a Case Report or a small case series on original clinical findings as a Letter to the Editor. A PCN letter must be written entirely within 500 words (with no abstract, no key words and no figures; if a table is included, it is counted as at least 250 words). This rule may appear quite stringent for an author who is planning to submit a Case Report to PCN. However, we believe this is the right way to publish a Case Report in PCN.
In older days, Case Reports were an important means to disseminate interesting clinical findings and experiences in every branch of medicine. However, a Case Report is quite limited as a scientific paper, because it describes findings in a particular case by particular authors and lacks generalizability in the findings. Such limitations are reasons that many major psychiatry journals do not publish Case Reports these days. In addition, PCN can not afford to publish a long Case Report as a regular article or even as a short communication for hard- pressed publication space thanks to the recent surge in submission of excellent Original Articles. For these reasons, PCN now deals with a Case Report only as a Letter to the Editor, except in quite rare instances, such as convincing reports of a new mental disorder and a significant breakthrough in the etiological research of a mental disorder.
In the years 2009–2010, PCN published a total of 64 Letters to the Editor. Of these 64, 43 (67.2%) were Case Reports. The vast majority of the themes of the 43 Case Reports are classified into two categories: treatments and adverse effects of treatments. Although all of the 43 Case Reports are quite readable, due to space limitations I would like to introduce only some of them below.
As for treatments, Mendhekar and Andrade reported a case of obsessive–compulsive disorder in a 22-year-old man who had suffered from the intrusive and anxiety-provoking experience of cell phone ring tones running repeatedly through his mind, which was successfully treated with a combination of fluvoxamine and clomipramine.1 Pae suggested the potential utility of aripiprazole monotherapy for comorbid major depressive disorder and obsessive–compulsive disorder in a 29-year-old man.2 Kobayashi and Kato reported a case of menstrual catatonia in an 18-year-old woman who presented catatonic symptoms from 7 days before to 10 days after menstruation and was successfully treated with lithium carbonate.3 Umehara et al. reported the first case of restless legs syndrome with initial symptoms of uncomfortable sensations in the back and chest in a 55-year-old man who was successfully treated with clonazepam.4 Fujita and Takebayashi reported the efficacy of low-dose donepezil for visual hallucinations in a 74-year-old woman with dementia with Lewy bodies.5 Nishihara et al. reported a case of delusional misidentification syndrome associated with subclinical hypothyroidism in a 29-year-old woman who attacked her father violently as she believed that he was an imposter of her real father but lost her delusion after taking levothyroxine.6 Chen et al. reported a case of Capgras syndrome in a 27-year-old man with the delusion that his uncle impersonated his father, had murdered his real father and grandfather, and then married his mother in whom the delusion refractory to antipsychotics was resolved soon after the DNA paternity test requested by the patient himself proved his father's paternity of him.7 Sugishita et al. reported a case of simple schizophrenia in a 44-year-old man who showed a reduction in the severity of negative symptoms following treatment of previously unrecognized obstructive sleep apnea with continuous positive airway pressure.8
As to adverse effects of treatments, Dan et al. reported a case of severe mental retardation in a 20-year-old man who had a fatal outcome of neuroleptic malignant syndrome caused by quetiapine used to control his frequent unprovoked aggression.9 Kato et al. reported a case of schizophrenia in a 24-year-old woman in whom tardive dystonia developed after risperidone administration was improved by switching risperidone to aripiprazole.10 Echizenya et al. noted that adolescents with free-running disorder (non-24-h sleep–wake syndrome) have a risk of developing a paradoxical reaction when they take hypnotics based on two such cases of 14-year-olds.11 Huang et al. reported a case of schizophrenia in a 35-year-old man in whom pica (i.e., eating garbage, sand and pebbles) emerged after olanzapine administration disappeared after its removal.12
These Case Reports present valuable suggestions not only for clinical practices but also for empirical studies. Well-written concise Case Reports are easier to read and may even be more interesting than lengthy Original Articles. We welcome submission of impressive Case Reports as Letters to the Editor.