The Simplified Pain Catastrophizing Scale (PCS-S): A Pilot Study of a Screening Tool for Orofacial Pain

Introduction: The management of orofacial pain (OFP) and temporomandibular disorders (TMD) is based on the biopsychosocial model, where pain catastrophizing is a critical predictor of worse clinical outcomes. Although the 13-item Pain Catastrophizing Scale (PCS) is considered the gold standard, it is impractical in high-volume clinics, creating a gap between research and practice. Objective: To develop and test the Simplified Pain Catastrophizing Scale (PCS-S), a three-item tool for rapid psychosocial screening in patients with OFP and TMD. Methodology: The PCS-S was developed through a literature review, item selection, and cultural adaptation and was subsequently applied in a pilot study involving 78 patients at a public hospital in Rio de Janeiro, Brazil. Administration took an average of 1.8 minutes, with scores greater than 7 indicating high catastrophizing. A subsample (n = 50) compared the PCS-S with the full PCS, calculating agreement percentages. Results: Of the 78 patients, 22% (n = 17) exhibited high catastrophizing. The PCS-S demonstrated 85% overall agreement with the full PCS, with item-level agreement ranging from 86-90%. Psychological comorbidities were identified in 65% of high-catastrophizing cases. Conclusion: The PCS-S is a feasible tool for screening catastrophizing, promoting multidisciplinary referrals, and aligning clinical practice with the biopsychosocial model within Brazil's Unified Health System (SUS).