This single-center, retrospective, observational study combines quantitative and qualitative methodologies. The study will be conducted at the CHRU de Nancy and will include approximately 30 adults with chronic migraine treated with anti-CGRP monoclonal antibodies as part of routine clinical care.
At the study site, patients receiving anti-CGRP monoclonal antibody therapy routinely undergo a psychological interview at treatment initiation and follow-up psychological assessments during their care. Clinical and psychological data will be retrospectively collected from medical records, psychological interview reports, and standardized questionnaires administered at baseline (T0) and after 12 months of treatment (T1).
Quantitative assessment will include measures of anxiety and depressive symptoms using the Hospital Anxiety and Depression Scale (HADS), headache impact using the Headache Impact Test (HIT-6), and migraine-related disability using the Migraine Disability Assessment Scale (MIDAS).
The primary analysis will compare HADS total scores as well as HADS-Anxiety (HADS-A) and HADS-Depression (HADS-D) scores between two groups of participants defined according to their perceived treatment efficacy after 12 months of anti-CGRP therapy: a "Marked Improvement" group and a "No Perceived Efficacy" group. Secondary analyses will evaluate changes in HIT-6 and MIDAS scores between baseline and 12 months of follow-up.
Qualitative analysis will explore patients' psychological experiences of treatment, including emotional adjustment, coping strategies, adaptation to chronic pain, psychosocial functioning, expectations regarding treatment, changes in occupational, social, family, and leisure activities, and perceived needs for psychological support.
Comparative thematic analyses will be conducted between participants reporting marked improvement and those reporting no perceived efficacy in order to identify psychological factors, experiences, and coping processes associated with different treatment perceptions and adaptation trajectories.
The study aims to improve understanding of the psychological dimensions of chronic migraine treatment with anti-CGRP monoclonal antibodies and to identify factors that may inform the development of tailored psychological support for patients living with chronic migraine.
