The visual analogue scale (VAS) is a simple and frequently used method for the assessment of variations in intensity of pain. In clinical practice the percentage of pain relief, assessed by VAS, is often considered as a measure of the efficacy of treatment. However, as illustrated in the present study, the validity of VAS estimates performed by patients with chronic pain may be unsatisfactory. Two types of VAS, an absolute and a comparative scale, were compared with respect to factors influencing the reliability and validity of pain estimates. As shown in this study the absolute type of VAS seems to be less sensitive to bias than the comparative one and is therefore preferable for general clinical use. Moreover, the patients appear to differ considerably in their ability to use the VAS reliably. When assessing efficacy of treatment attention should therefore be paid to several complementary indices of pain relief as well as to the individual's tendency to bias his estimates.

The purpose of the present study was to compare intensity levels assessed on Borg's Category Scale for Ratings of Perceived Pain (BRPP) (1982) (a verbal scale using adjectives and adverbs combined with the numbers 0-10), with assessments on the Visual Analogue Scale (VAS) (a 10 cm horizontal line). Eight healthy subjects volunteered in an experimental study, where pain was provoked by load on passive soft tissue elbow joint structures. Each subject participated 4 times on different occasions in the same experimental set-up, which was divided into six 2 min periods; 3 periods with load induced by applied external weights causing load moments of 3.4 Nm, 4.5 Nm and 6.8 Nm plus that induced by the weight of the lower arm and hand (average 2.9 Nm), followed by 3 periods without external weights. Each series consisted of 12 assessments given during the last 10 sec period of each minute on either the BRPP or the VAS. No significant difference was found between the first and second time a scale was used by the same subject, and none between the assessments on the VAS and the BRPP. Intensity levels of pain increased with load and time and decreased after reduction of the load moments. It is concluded that both scales can be used to reliably assess intensity levels of perceived pain elicited by loading joint structures. Intensity levels, as assessed on both scales, are associated with applied external load and time for exposure.

Personality characteristics in patients with long-term patellofemoral pain were compared to those of matched controls and other groups both of non-patients and of psychiatric outpatients with character disorders. Personality was described using the self-administered dependency and alexithymia scales, the Karolinska Scales of Personality and the Rorschach inkblot method. The hypothesis was that the patellofemoral pain patients would have higher levels of anxiety, depression, helplessness, aggression and alexithymic characteristics than the matched controls. There were only a few significant differences between the knee patients and the matched controls. The Rorschach measures suggested significantly greater depression, hostility and passive attitude in the knee patients as compared to the reference data. There were no indications of the hypothesised alexithymic characteristics in the knee patients. If patellofemoral pain patients do not improve as expected, referral to a pain clinic with psychological expertise could be considered.

. The treatment comprised 15 mg of sibutramine administered daily and monthly dietary advice. Weight loss after 6 months of treatment was evaluated. For psychological assessment, the Rorschach method (Comprehensive System) and the Beck Depression Inventory were used. Results: A multiple linear regression model including the Rorschach predictors' physical demand states (animal movement, designated as FM) being intrusive or difficult to hold and a dependency orientation (food contents) could explain 47% of 6 months of weight loss. A model including initial weight loss in addition to the Rorschach predictors explained 58% of the 6-month weight loss. Discussion: The personality factors predicted greater weight loss. In particular, patients with difficulties concerning physical demand states, which would include hunger, could have reduced their eating behavior with enhanced satiety, resulting in greater weight loss. Enhanced satiety could also have helped patients with a dependent need for food to limit food intake. Being enrolled in a treatment program could also have provided essential support for patients with dependency needs. Furthermore, initial weight loss was a predictor of greater weight loss in sibutramine treatment, in accordance with prior research.

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