Determination of the optimal cutoff point for the chemsex inventory (CSI) to assess chemsex-related mental health risk in men who have sex with men

Background: Chemsex poses growing psychological and behavioural risks among men who have sex with men (MSM). Although the Chemsex Inventory (CSI) was developed to assess these risks, clinical cutoff points distinguishing recreational use from pathological patterns remain undefined. This study aimed...

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Autores: Del Pozo-Herce, Pablo, Martínez-Sabater, Antonio, Elena Chover-Sierra, Elena, Czapla, Michal, Sanchez Hernando, Beatriz, Navas-Echazarreta, Noelia, Juárez-Vela, Raúl
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2026
País:España
Institución:Universidad de Zaragoza
Repositorio:Zaguán. Repositorio Digital de la Universidad de Zaragoza
OAI Identifier:oai:dnet:zaguan______::b78654b7fe5fcde41ffe9624a91942c5
Acceso en línea:http://zaguan.unizar.es/record/170168
Access Level:acceso abierto
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spelling Determination of the optimal cutoff point for the chemsex inventory (CSI) to assess chemsex-related mental health risk in men who have sex with menDel Pozo-Herce, PabloMartínez-Sabater, AntonioElena Chover-Sierra, ElenaCzapla, MichalSanchez Hernando, BeatrizNavas-Echazarreta, NoeliaJuárez-Vela, RaúlBackground: Chemsex poses growing psychological and behavioural risks among men who have sex with men (MSM). Although the Chemsex Inventory (CSI) was developed to assess these risks, clinical cutoff points distinguishing recreational use from pathological patterns remain undefined. This study aimed to determine optimal CSI cutoff points to identify profiles of increased psychological and behavioral vulnerability associated with chemsex. Methods: A cross-sectional study was conducted in Spain between January and April 2023 with 563 MSM who reported chemsex use within the previous 12 months. Psychometric analyses included principal component analysis (PCA) and confirmatory factor analysis (CFA) of a second-order model with four dimensions: emotional instability, risk of psychosis, altered body perception, and suicide risk. Cutoff points were determined using the percentile-based P-score method. Results: The CSI showed excellent internal reliability (Cronbach’s α=0.88; ω=0.88) and strong factorial validity (CFI=0.985, TLI=0.984, RMSEA=0.05). The second-order model fit significantly better than the first-order alternative (χ²diff=8.14; p=0.017). High-risk cutoffs were: emotional instability≥78.3, psychosis≥51.4, body-perception disturbance≥95.0, suicide risk≥75.0, and global≥66.4. About 5% of participants exceeded these thresholds, indicating elevated psychological vulnerability. Conclusions: CSI cutoff points provide a reliable and sensitive tool for early detection of mental-health risks related to chemsex. Policy Implications: Incorporating the CSI into sexual-health, primary-care, and mental-health services may enhance early detection of at-risk individuals and support evidence-based prevention and harm-reduction strategies.2026info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionapplication/pdfhttp://zaguan.unizar.es/record/170168reponame:Zaguán. Repositorio Digital de la Universidad de Zaragozainstname:Universidad de ZaragozaInglésinfo:eu-repo/semantics/openAccessoai:dnet:zaguan______::b78654b7fe5fcde41ffe9624a91942c52026-05-29T13:59:51Z
dc.title.none.fl_str_mv Determination of the optimal cutoff point for the chemsex inventory (CSI) to assess chemsex-related mental health risk in men who have sex with men
title Determination of the optimal cutoff point for the chemsex inventory (CSI) to assess chemsex-related mental health risk in men who have sex with men
spellingShingle Determination of the optimal cutoff point for the chemsex inventory (CSI) to assess chemsex-related mental health risk in men who have sex with men
Del Pozo-Herce, Pablo
title_short Determination of the optimal cutoff point for the chemsex inventory (CSI) to assess chemsex-related mental health risk in men who have sex with men
title_full Determination of the optimal cutoff point for the chemsex inventory (CSI) to assess chemsex-related mental health risk in men who have sex with men
title_fullStr Determination of the optimal cutoff point for the chemsex inventory (CSI) to assess chemsex-related mental health risk in men who have sex with men
title_full_unstemmed Determination of the optimal cutoff point for the chemsex inventory (CSI) to assess chemsex-related mental health risk in men who have sex with men
title_sort Determination of the optimal cutoff point for the chemsex inventory (CSI) to assess chemsex-related mental health risk in men who have sex with men
dc.creator.none.fl_str_mv Del Pozo-Herce, Pablo
Martínez-Sabater, Antonio
Elena Chover-Sierra, Elena
Czapla, Michal
Sanchez Hernando, Beatriz
Navas-Echazarreta, Noelia
Juárez-Vela, Raúl
author Del Pozo-Herce, Pablo
author_facet Del Pozo-Herce, Pablo
Martínez-Sabater, Antonio
Elena Chover-Sierra, Elena
Czapla, Michal
Sanchez Hernando, Beatriz
Navas-Echazarreta, Noelia
Juárez-Vela, Raúl
author_role author
author2 Martínez-Sabater, Antonio
Elena Chover-Sierra, Elena
Czapla, Michal
Sanchez Hernando, Beatriz
Navas-Echazarreta, Noelia
Juárez-Vela, Raúl
author2_role author
author
author
author
author
author
description Background: Chemsex poses growing psychological and behavioural risks among men who have sex with men (MSM). Although the Chemsex Inventory (CSI) was developed to assess these risks, clinical cutoff points distinguishing recreational use from pathological patterns remain undefined. This study aimed to determine optimal CSI cutoff points to identify profiles of increased psychological and behavioral vulnerability associated with chemsex. Methods: A cross-sectional study was conducted in Spain between January and April 2023 with 563 MSM who reported chemsex use within the previous 12 months. Psychometric analyses included principal component analysis (PCA) and confirmatory factor analysis (CFA) of a second-order model with four dimensions: emotional instability, risk of psychosis, altered body perception, and suicide risk. Cutoff points were determined using the percentile-based P-score method. Results: The CSI showed excellent internal reliability (Cronbach’s α=0.88; ω=0.88) and strong factorial validity (CFI=0.985, TLI=0.984, RMSEA=0.05). The second-order model fit significantly better than the first-order alternative (χ²diff=8.14; p=0.017). High-risk cutoffs were: emotional instability≥78.3, psychosis≥51.4, body-perception disturbance≥95.0, suicide risk≥75.0, and global≥66.4. About 5% of participants exceeded these thresholds, indicating elevated psychological vulnerability. Conclusions: CSI cutoff points provide a reliable and sensitive tool for early detection of mental-health risks related to chemsex. Policy Implications: Incorporating the CSI into sexual-health, primary-care, and mental-health services may enhance early detection of at-risk individuals and support evidence-based prevention and harm-reduction strategies.
publishDate 2026
dc.date.none.fl_str_mv 2026
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
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dc.identifier.none.fl_str_mv http://zaguan.unizar.es/record/170168
url http://zaguan.unizar.es/record/170168
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.rights.none.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
dc.publisher.none.fl_str_mv
publisher.none.fl_str_mv
dc.source.none.fl_str_mv reponame:Zaguán. Repositorio Digital de la Universidad de Zaragoza
instname:Universidad de Zaragoza
instname_str Universidad de Zaragoza
reponame_str Zaguán. Repositorio Digital de la Universidad de Zaragoza
collection Zaguán. Repositorio Digital de la Universidad de Zaragoza
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