Pain drawings in somatoform-functional pain

BMC Musculoskelet Disord. 2012 Dec 20:13:257. doi: 10.1186/1471-2474-13-257.

Abstract

Background: Pain drawings are a diagnostic adjunct to history taking, clinical examinations, and biomedical tests in evaluating pain. We hypothesized that somatoform-functional pain, is mirrored in distinctive graphic patterns of pain drawings. Our aim was to identify the most sensitive and specific graphic criteria as a tool to help identifying somatoform-functional pain.

Methods: We compared 62 patients with somatoform-functional pain with a control group of 49 patients with somatic-nociceptive pain type. All patients were asked to mark their pain on a pre-printed body diagram. An investigator, blinded with regard to the patients' diagnoses, analyzed the drawings according to a set of numeric or binary criteria.

Results: We identified 13 drawing criteria pointing with significance to a somatoform-functional pain disorder (all p-values ≤ 0.001). The most specific and most sensitive criteria combination for detecting somatoform-functional pain included the total number of marks, the length of the longest mark, and the presence of symmetric patterns. The area under the ROC-curve was 96.3% for this criteria combination.

Conclusion: Pain drawings are an easy-to-administer supplementary technique which helps to identify somatoform-functional pain in comparison to somatic-nociceptive pain.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Aged
  • Art*
  • Case-Control Studies
  • Chi-Square Distribution
  • Diagnosis, Differential
  • Female
  • Humans
  • Logistic Models
  • Male
  • Middle Aged
  • Nociceptive Pain / diagnosis*
  • Nociceptive Pain / psychology
  • Odds Ratio
  • Pain Measurement / methods*
  • Predictive Value of Tests
  • ROC Curve
  • Sensitivity and Specificity
  • Somatoform Disorders / diagnosis*
  • Somatoform Disorders / psychology
  • Young Adult