The use of pain drawings in screening for psychological involvement in complaints of low-back pain.

The pain drawings of 54 low-back-pain patients were examined to find out if it is possible to use them as a brief screening test in order to assess the psychological impairment of the patients. We were using the scoring system of Ransford et al, which we slightly changed, and chose as a criterion variable the ERMSS (Erweiterte Revidierte Mehrdimensionale Schmerzskala) of Cziske. This test originates in the McGill Pain Questionnaire of Melzack and Torgerson; its scales describe four dimensions of pain perception: pain intensity, the sensory-discriminative dimension reflecting the somatic aspect of pain; the affective-motivational dimension, and the total number of words, both representing the psychological involvement of a pain patient. A correlation was found between pain drawing score and the sensory-discriminative dimension of pain perception, whereas there was no such correlation between drawing score and the affective dimension. These results indicate that the pain drawing score might not be a sufficiently valid instrument for assessing psychological disturbances in pain patients to allow it to be used for individual diagnosis without hesitation.