The impact of psychological treatment on catastrophization and pharmacological response in chronic migraine: A single-center experience

A bstract Background We aimed to assess the impact of pain catastrophizing, measured using the Italian version of the Pain Catastrophizing Scale (PCS), on the clinical response of patients with chronic migraine to anti-CGRP monoclonal antibodies combined with a multidisciplinary approach, including psychological treatment. Methods 25 Outpatients from SS. Antonio e Biagio e Cesare Arrigo headache clinic randomly assigned to receive Galcanezumab, Erenumab, or Fremanezumab. Their clinical response was evaluated over six months using various measures, including reducing the number of days with migraine per month, and quality of life using Headache Impact Test (HIT 6), MIgraine Disability Assessment Score questionnaire (MIDAS), and Beck’s Inventory Scale (BDI II) scales to assess comorbid depression. Results We established a strong correlation between HIT 6 and PCS, with coefficients of 0.81 and 0.88 at T 1 and T 2 , respectively. Furthermore, we found no significant correlation between PCS and the other scales, such as MIDAS, as with any pharmacological therapies. Conclusion This study aims to clearly define the impact of a multidisciplinary approach including a psychological follow-up on a particular clinical phenotype of chronic migraines and their tendency to catastrophize, but more extended data are needed.