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Clinical Journal of Pain:
doi: 10.1097/AJP.0000000000000113
Original Article: PDF Only

Ability of the Central Sensitization Inventory to Identify Central Sensitivity Syndromes in an Outpatient Chronic Pain Sample.

Neblett, Randy MA, LPC, BCB; Hartzell, Meredith M. MS, PhD Candidate; Cohen, Howard MD; Mayer, Tom G. MD; Williams, Mark PhD; Choi, YunHee MA, PhD; Gatchel, Robert J. PhD, ABPP

Published Ahead-of-Print
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Abstract

Objectives: To determine the ability of the Central Sensitization Inventory (CSI), a new screening instrument, to assist clinicians in identifying patients with Central Sensitivity Syndromes (CSSs).

Methods: Patients from a psychiatric medical practice (N=161), which specialized in the assessment and treatment of complex pain and psychophysiological disorders, were assessed for the presence of a CSS. CSI scores, using a previously determined cutoff of "40" out of "100," were compared between the CSS patient group (n=99) and the non-CSS patient group (n=62). Information on false positives, false negatives, true positives, and true negatives were analyzed, and sensitivity and specificity analyses were conducted. Additionally, CSS-relevant variables such as depression, abuse, and substance abuse were examined.

Results: A large percentage of CSS patients had comorbid major depressive disorder (80%) and abuse history (43%), which was higher than rates for the patients without a CSS (55% and 24%, respectively). The CSI correctly identified 82.8% (n=82) of CSS patients as having a CSS (i.e., sensitivity) and 54.8% (n=28) of non-CSS patients as not having a CSS (i.e., specificity). False-positive patients (not diagnosed with a CSS, but scoring greater than 40 on the CSI) reported more severe pain, interference in daily functioning, and abuse history, compared to the non-CSS patients who scored below 40 (i.e., true negatives).

Conclusions: The CSI is a useful and valid instrument for screening patients for the possibility of a CSS, although the chances of false-positives are relatively high when evaluating patients with complex pain and psychophysiological disorders.

(C) 2014 Wolters Kluwer Health, Inc. All rights reserved.

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