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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*; Cohen, Howard MD; Mayer, Tom G. MD; Williams, Mark PhD*; Choi, YunHee MA, PhD*; Gatchel, Robert J. PhD, ABPP§

doi: 10.1097/AJP.0000000000000113
Original Articles

Objectives: The aim of this study was 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” 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. In addition, 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 (ie, sensitivity) and 54.8% (n=28) of non-CSS patients as not having a CSS (ie, specificity). False-positive patients (not diagnosed with a CSS, but scoring >40 on the CSI) reported more severe pain, interference in daily functioning, and abuse history, compared with the non-CSS patients who scored below 40 (ie, 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.

*PRIDE Research Foundation

Department of Orthopedic Surgery, University of Texas Southwestern Medical Center at Dallas

Graduate School of Nursing

§Department of Psychology, University of Texas at Arlington, Arlington, TX

The authors declare no conflict of interest.

Reprints: Tom G. Mayer, MD, 5701 Maple Ave. #100, Dallas, TX 75235 (e-mail:

Received November 18, 2013

Received in revised form May 23, 2014

Accepted April 18, 2014

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