title: Pain drawings in somatoform-functional pain.
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.
  
  
  CONCLUSIONS
  Pain drawings are an easy-to-administer supplementary technique which helps to identify somatoform-functional pain in comparison to somatic-nociceptive pain.
authors.affiliation: Division of Psychosomatic Medicine, Department of General Internal Medicine, Inselspital, Bern University Hospital and University of Bern, Bern, Switzerland. niklaus.egloff@insel.ch
authors.forename: Niklaus
authors.initials: N
authors.lastname: Egloff
authors.forename: Rafael J A
authors.initials: RJ
authors.lastname: Cámara
authors.forename: Roland
authors.initials: R
authors.lastname: von Känel
authors.forename: Nicole
authors.initials: N
authors.lastname: Klingler
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Marti
authors.forename: Marie-Louise Gander
authors.initials: ML
authors.lastname: Ferrari
mesh_terms: D000328:Adult; D000368:Aged; D001154:Art; D016022:Case-Control Studies; D016009:Chi-Square Distribution; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D059226:Nociceptive Pain / Q000175:diagnosis* / Q000523:psychology; D016017:Odds Ratio; D010147:Pain Measurement / Q000379:methods*; D011237:Predictive Value of Tests; D012372:ROC Curve; D012680:Sensitivity and Specificity; D013001:Somatoform Disorders / Q000175:diagnosis* / Q000523:psychology; D055815:Young Adult