After receiving multiple spam e-mails through my installation of PFM ( http://developerkarma.com/projects/ ) I got around to integrating a CAPTCHA into forms using SecurImage v0.3 ( http://www.phpcaptcha.org/ ) in 2006.
Development of SecurImage has continued, and the way it works has changed so that it now uses PHP Sessions. Unfortunately this broke the original modification, and required a new modification to enable CAPTCHA input validation. The new version can make use of SecurImage v0.3 or SecurImage v1 and above, and remains backwardly compatible with the original PHPFormMail Classic v1.07.2.
You will find both the original modification and the new one on the respective pages linked above, along with instructions for installation and usage.
I hope these modifications help you all to reduce the influx of spam through your feedback form(s).