Writing a clinical case study: a methodological conundrum

Journal title RIVISTA SPERIMENTALE DI FRENIATRIA
Author/s Paolo Vistoli, Eleonora Montagner
Publishing Year 2015 Issue 2015/2
Language Italian Pages 24 P. 67-90 File size 261 KB
DOI 10.3280/RSF2015-002007
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Currently, quantitative research in psychiatry neglects clinical case studies in favour of large scale surveys based on impersonal descriptions. Moreover, clinical case studies, in qualitative psychiatry, tend to overemphasize the patients’ abnormal features and often present a caricatural and incomplete narrative. The authors reexamine the methodology employed to draft a clinical case study and highlight the heuristic and scientific relevance of clinical narratives in psychiatry. They then propose an innovative method for drafting a clinical case study - based on the preliminary analysis of some well-known clinical cases - that not only describes the patient’s acute pathological features, but also the person’s "background" context of life from which the pathological features surface. Their method is appraised presenting the study of a long-term psychotic patient in community psychiatry. The patient’s life experience is analysed through an extensive and longitudinal approach that brings to light the patient’s psychotic world, but also the person’s and environment’s "normal" traits: i.e. coping strategies, quality of life, meaningful relationships, and the feelings the patient arouses in others. The authors suggest that participant observation of long-term patients, in ever-changing healthcare environments and personnel, draws attention towards unusual courses of illness and calls for renewed descriptive tools to capture the more recent forms of subjectivity.

Keywords: Clinical case study, recovery, coping strategies, post-and-in-between Psychosis

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Paolo Vistoli, Eleonora Montagner, La stesura di un racconto clinico come rompicapo metodologico in "RIVISTA SPERIMENTALE DI FRENIATRIA" 2/2015, pp 67-90, DOI: 10.3280/RSF2015-002007