PRISM: Pictorial representation of illness and self measure - A brief nonverbal measure of illness impact and therapeutic aid in psychosomatic medicine

The burden of illness is important for patients but complex and difficult t o describe, let alone measure. A novel instrument is described that, accord ing to preliminary data, measures what in German is termed Leidensdruck- th e perceived burden of suffering due to illness. The measure-Pictorial Repre sentation of illness and Self Measure (PRISM)-takes less than 5 minutes to complete and is unusual in relying only minimally, on language. The PRISM i s being developed as a research tool and has been used effectively in routi ne clinical practice. To illustrate the latter application, three case vign ettes are presented, demonstrating how the PRISM carl enhance the patient's description and understanding of his/her illness and circumstances, facili tate patient-clinician communication, and help to monitor salient changes w ith treatment.