The relationship between pain drawings and the psychological state

Pain patients may be requested to complete pain charts as part of their evaluation at pain clinics. Inferences are made about the 'psychological content' of the patient's pain on the basis of the extent and distribution of the pain as illustrated in these drawings. In this study, the records of 328 patients from 4 distinct types of chronic pain service, were scored for how many body parts were included in the pain drawings and the percentage of body surface area involved. Four psychological instruments were used to quantify the psychological status of the patients. These included 2 measures of current psychological status (the General Health Questionnaire-28, and the Irritability/Depression and Anxiety Questionnaire), 1 measure of childhood quality (the Parental Bonding Index), and 1 measure of premorbid personality (the Hysteroid/Obsessoid Questionnaire). No significant correlation was found between the percentage of body surface area affected by pain, and the measures of childhood quality. Only very limited correlations were found between the percentage of the body surface area with pain and the measures of current psychological state and premorbid personality. Hence, strong emphasis should not be placed on the involvement of multiple areas as a sign of psychological illness.