Evaluating psychiatry journals' adherence to informed consent guidelines for case reports.

Background: Case reports are valuable tools that illustrate and analyze practical scenarios, novel problems, and the effectiveness of interventions. In psychiatry they often explore unique and potentially stigmatizing aspects of mental health, underscoring the importance of confidentiality and informed consent. However, journals' guidance on consent and confidentiality for case reports varies. In 2013, an international expert group developed the CAse REports (CARE) Guidelines for best practices in case reports, which include guidelines for informed consent and de-identification. In 2016, the Committee on Publication Ethics (COPE) issued ethical standards for publishing case reports, calling for written informed consent from featured patients.

Methods: Using a cross-sectional approach, we assessed the instructions for authors of 253 indexed psychiatry journals, of which 129 had published English-language case reports in the prior five years. Our research identified and evaluated journals' use of COPE and CARE guidelines on informed consent and de-identification in case reports.

Results: Among these 129 journals, 84 (65%) referred to COPE guidelines, and 59 (46%) referenced CARE guidelines. Furthermore, 46 (36%) required informed consent without de-identification, 7 (5%) required only de-identification, and 21 (16%) required both, specifying consent for identifying information. Notably, 40 (31%) lacked informed consent instructions. Of the 82 journals that required informed consent, 69 (85%) required documentation of consent.

Conclusion: A decade after the publication of expert guidance, psychiatry journals remain inconsistent in their adherence to ethical guidelines for informed consent in case reports. More attention to clear instructions from journals on informed consent-a notable topic across different fields-would provide an important educational message about both publication ethics and fundamental respect for patients' confidentiality.