An overview of the rating scale literature reveals that the clinician now has many validated rating scales to choose from to assess his patient's condition. In general terms, it is the observer-rating scales that should be used as the principal outcome criterion in depressive disorders, both in general practice and in drug-related trials. However, self-rating scales can provide important additional information for therapy evaluation. They also provide a measure of the patient's perception of his own illness and recovery, which is not possible with observer ratings. Self-rating scales are designed for frequent use and to be sensitive to the change brought about by therapy and its time course. Observer ratings can also show sensitivity for change, and these compare well with the self-rating measures.

The multimethod approach, including both observer- and self-rating scales, and covering different domains such as psychopathological symptoms, social functioning, etc., is the preferred method for assessing patients. Using this approach, clinicians are able to build up complete profiles of their patients' illnesses and make full assessments of the efficacy of treatment and their return to normal social functioning.

The objective of the study was to evaluate the presence of psychopathology in fibromyalgia patients compared to a control group of rheumatic patients with pain. Forty-nine fibromyalgia patients and 33 controls were evaluated using established self-rating scales. Serotonin was determined using a radioenzymatic method. Fibromyalgia patients scored significantly higher than the controls on the majority of the subscales on the SCL-90, the two subscales on the Spielberger State and Trait Anxiety Inventory, the GHQ 12 scale and on a visual analogue pain scale. In a multivariate analysis the somatization dimension followed by the state anxiety accounted for the highest difference. Platelet-poor plasma serotonin, platelet serotonin and platelet uptake index were not significantly different between the groups. In conclusion, fibromyalgia patients presented quantitatively more psychopathology than the control group on a wide range of psychopathologic axes, and this cannot solely be accounted for by their higher level of pain.

A partir du concept de recherche de sensations, Zuckerman a créé l'échelle de recherche de sensations (Sensation Seeking Scale), composée de 72 items répartis en 5 facteurs. Nous l'avons traduite, et cette version française a été soumise à un échantillon de 102 sujets témoins issus de la population générale. Une retraduction indépendante a pu permettre de valider la version française de l'échelle. Les résultats sont répartis sur une distribution unimodale, avec une note moyenne légèrement supérieure à la médiane, et ils confirment l'existence de sujets obtenant un score élevé de recherche de sensations. Le facteur général se révèle un bon indice global pour évaluer la recherche de sensations du sujet. La recherche de sensations est inversement corrélée pour certains facteurs au sexe, et de manière très significative à l'âge, ce qui rejoint les postulats de Zuckerman et les résultats sur les études américaines antérieures. Ce concept opérationnel trouve actuellement un écho dans des descriptions phénoménologiques et sociales de tels sujets recherchant des sensations. D'autre part, il révèle son intérêt dans le camp de la psychopathologie. La structure de l'échelle est critiquée dans le sens d'un mélange entre plusieurs niveaux émotionnels non équivalents, et la discussion stimulation-sensation pourrait s'ouvrir sur un affinement du concept.