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Background <p>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.</p> Methods <p>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.</p> Results <p>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; <i>p</i> = 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.</p> Conclusions <p>CSI cutoff points provide a reliable and sensitive tool for early detection of mental-health risks related to chemsex.</p> Policy Implications <p>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.</p>

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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

  • 期刊论文

  • 出版模式：

    开放获取

  • 发表日期：

    2026年3月11日

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  • Pablo Del Pozo-Herce,
  • Antonio Martínez-Sabater,
  • Elena Elena Chover-Sierra,
  • Michał Czapla,
  • Beatriz Sanchez Hernado,
  • Noelia Navas-Echazarreta,
  • Raúl Juárez-Vela

摘要

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.