Comments to “reporting guidelines for case reports in mental health and psychiatry (CRIMP)”

Dear Editor, We read the article by Sarkar et al.[1] on the development of case reports in mental health and psychiatry (CRIMP), with great interest. We agree that, despite a decline in writing and readership, case reports remain essential in early research, and require clear guidance to be scientifically rigorous and engaging. The CRIMP guidelines were developed through expert review and consensus; however, the expert recruitment process is not clearly established and do not clearly follow widely accepted guideline development methods, such as the Conducting and Reporting of Delphi Studies (CREDS).[2] Unaddressed issues include the sampling strategy and recruitment process, specifically the demographic and professional composition of the expert panel (e.g., gender, geography, career stage), whose absence may limit transparency, methodological rigor, and representativeness, as highlighted in a recent article.[3] Although CRIMP is described as useful for authors, reviewers, and editors, it does not clearly address gaps relative to established reporting standards, such as the Case Report CARE checklist[4] and others. By criticizing SCRIBE for not covering adverse events, CRIMP also fails to adequately address this issue. It would have been a good idea if the recommendations for using the Naranjo Adverse Drug Reaction Probability Scale had been made somewhere to supplement CRIMP (often asked by reviewers and editors in psychiatry).[5] These limitations hinder broader acceptance beyond specific journals and reflect the minimal novelty of CRIMP. Many journals limit case reports to short formats, often as letters with strict word limits, yet the article does not address these practical constraints in psychiatry for which CRIMP is designed. Without this clarification, the claim of broad usability remains unsupported. The authors’ call for uniform minimum reporting standards seems unjustified based on CRIMP alone, especially when compared to existing standards. Additionally, the CRIMP is an acronym for case report, but the authors mention a case series of 3 to 10 cases, creating confusion for readers. Finally, the assertion that ethics approval or oversight was unnecessary could have been stated as an ethical exemption or waiver to allow the generous use of CRIMP, given the involvement of human participants. Given that many psychiatry journals already have their own specific guidelines for reporting case reports, such as requirements regarding word length, level of detail, use of figures, and, in the case of psychotherapy reports, inclusion of verbatim material (e.g., BMJ Case Reports), a systematic content analysis of existing journal-specific guidelines could have been reported, while developing the consensus. Furthermore, the CRIMP is limited to a single country, without involvement from contributors outside the region, which limits its generalizability and broader applicability, as it does not address the gaps in existing standards. To summarize, introducing another guideline for case reports risks adding more noise than clarity. This raises concerns regarding the generalizability and broader applicability of such recommendations, particularly when existing guidelines already provide comprehensive frameworks with little added novelty by CRIMP. Moreover, the broader utility of CRIMP appears limited by its failure to address the step-by-step reporting of adverse drug reactions, which further constrains its practical utility compared to existing general and journal frameworks. Financial support and sponsorship Nil. Conflicts of interest There are no conflicts of interest.