Background: Measuring the impact of illness is important for several reasons. Recently, a new instrument was introduced using a pictorial approach in measuring the perception of suffering caused by illness: the Pictorial Representation of Illness Measure (PRISM). The aim of the present study was to introduce a self-administered version of PRISM and to provide some first data on its validity. Method: A postal survey was conducted in subjects with the chronic depigmentation disorder vitiligo. Participants were members of the German vitiligo association. The response rate was 60.6%. Data of 333 respondents completing the PRISM were used for analysis. Besides illness-related measures, psychological variables were assessed with the following instruments: Satisfaction with Life Scale (SWLS), five-item version of the Mental Health Inventory, adaptation of the Skindex-29, a quality-of-life measure for skin diseases. Results: Only 2.9% did not fill in the PRISM. Self-illness separation correlated as predicted with some illness-related variables. The distance was significantly larger in subjects whose depigmentation was no longer spreading. Significant correlations were also found with mental health (0.50), satisfaction with life (–0.28), perceived impairment of outward appearance (–0.65), and the Skindex subscales ‘emotions’ (–0.66) and ‘functioning’ (–0.67). Conclusion: Data suggest that PRISM can be self-administered. Measures of convergent validity confirm the usefulness of the new measure.

Keywords:
Suffering, Assessment, PRISM, Validity, Vitiligo
1.
Ware JE, Sherbourne CD: The MOS 36-Item Short-Form Health Survey (SF-36): Conceptual framework and item selection. Med Care 1992;30:473–483.
2.
Bergner M, Bobbitt RA, Pollard WE, Martin DP, Gilson BS: The sickness impact profile: Validation of a health status measure. Med Care 1976;14:57–67.
3.
Zigmond AS, Snaith RP: The hospital anxiety and depression scale. Acta Psychiatr Scand 1983;67:361–370.
4.
Büchi S, Sensky T, Sharpe L, Timberlake N: Graphic representation of illness: A novel method of measuring patients’ perceptions of the impact of illness. Psychother Psychosom 1998;67:222–225.
5.
Büchi S, Buddeberg C, Klaghofer R, Russi EW, Brandli O, Schlosser C, Stoll T, Villiger PM, Sensky T: Preliminary validation of PRISM (Pictorial Representation of Illness and Self Measure) – A brief method to assess suffering. Psychother Psychosom 2002;71:333–341.
6.
Kent G, Al’Abadie M: Psychologic effects of vitiligo: A critical incident analysis. J Am Acad Dermatol 1996;35:895–898.
7.
Berwick DM, Murphy JM, Goldman PA, Ware JE, Barsky AJ, Weinstein MC: Performance of a five-item mental health screening test. Med Care 1991;29:169–176.
8.
Veit CT, Ware JEJ: The structure of psychological distress and well-being in general populations. J Consult Clin Psychol 1983;51:730–742.
9.
Rumpf H-J, Meyer C, Hapke U, John U: Screening for mental health: Validity of MHI-5 using DSM-IV Axis I psychiatric disorders as gold standard. Psychiatry Res 2002;105:243–253.
10.
Diener E, Emmons RA, Larsen RJ, Griffin S: The Satisfaction with Life Scale. J Pers Assess 1985;49:71–75.
11.
Pavot W, Diener E: Review of the satisfaction-with-life scale. Psychol Assess 1993;9:164–172.
12.
Manning WG, Newhouse JP, Ware JE: The Status of Health in Demand Estimating; or, Beyond Excellent, Good, Fair, and Poor. Santa Monica, Rand Corporation, 1981.
13.
Chren MM, Lasek RJ, Flocke SA, Zyzanski SJ: Improved discriminative and evaluative capability of a refined version of Skindex, a quality-of-life instrument for patients with skin diseases. Arch Dermatol 1997;133:1433–1440.
14.
Abeni D, Picardi A, Pasquini P, Melchi CF, Chren MM: Further evidence of the validity and reliability of the Skindex-29: An Italian study on 2,242 dermatological outpatients. Dermatology 2002;204:43–49.
15.
Uesseler S: Beeinträchtigung von Lebensqualität und seelischer Gesundheit bei Vitiligo. Lübeck, University of Lübeck, 2002.
16.
Porter J, Beuf AH, Nordlund JJ, Lerner AB: Psychological reaction to chronic skin disorders: A study of patients with vitiligo. Gen Hosp Psychiatry 1979;1:73–77.
17.
Mangelli L, Gribbin N, Büchi S, Allard S, Sensky T: Psychological well-being in rheumatoid arthritis: Relationship to ‘disease’ variance and affective disturbance. Psychother Psychosom 2002;71:112–116.
© 2004 S. Karger AG, Basel
2003
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
You do not currently have access to this content.