PO-49 | Distress perception and mutuality in caregivers of migraine patients with depressive symptoms.: baseline evaluation of the observational prospective real-life MiDEAR study to evaluate the effectiveness of fremanezumab for reducing the caregivers’ burden a

C. Altamura,¹ L. Fofi,¹ R. Ornello,² G. Ceccardi,³ C. Aurilia,⁴ A. Montisano,⁵ I. Orologio,⁶ D. Mascarella,⁷ G. Viticchi,⁸ M. Marcosano,¹ N. Brunelli,¹ G. Del Mastro,¹ A. Onofri,² A. Lanfranchi,³ G. Fiorentini,⁴ M. Silvestro,⁶ V. Favoni,⁷ G. Egeo,⁴ M. Silvestrini,⁸ M. Peresson,⁹ S. Cevoli,⁷ A. Russo,⁶ R. Rao,³ L. Grazzi,⁵ S. Sacco,² F. Vernieri¹ | ¹Fondazione Policlinico Universitario Campus Bio-Medico, Rome; ²University of L'Aquila, L’Aquila; ³ASST Spedali Civili di Brescia, Brescia; ⁴IRCCS San Raffaele, Rome; ⁵IRCCS Fondazione istituto Neurologico Carlo Besta, Milan; ⁷IRCCS Istituto Delle Scienze Neurologiche di Bologna, Bologna; ⁶University of Campania; Caserta; ⁸Marche Polytechnic University, Ancona; ⁹San Pietro Fatebenefratelli Hospital, Rome, Italy

Abstract

Background: Migraine is a very disabling disease that negatively impacts not only patients’ but also their family members’ daily life. While the role (figure) of the caregiver is central to various neurological pathologies, it has scarcely been taken into consideration in migraine. The aim of the present study is to evaluate distress perception and mutuality in caregivers of migraine patients with depressive symptoms.

Methods: This is a multicenter, observational, study involving adult patients with migraine receiving fremanezumab with symptoms of depression (PHQ-9 ≥5) and their caregivers. At baseline, monthly migraine days (MMDs), acute medications (MAMs), pain intensity (NRS), migraine-related disability (MIDAS; HIT6), and depressive symptoms (PHQ-9) were evaluated in migraine patients, while perceived stress (Relatives Stress Scale -RSS) was measured in caregivers and reciprocity in the dyad (Mutuality Scale MS).

Results: The MI-DEAR study has been ongoing since October 2024, and currently 116 dyads have been enrolled (patients: 83.2% females, 43.9 ys, SD 1.2; caregivers: 34.5% females, 48.7 ys, SD 1.1). Of these, 38 dyads completed the 6-month follow-up. Caregivers were the patients’ partners in 80.5% of cases, parents in 12.4%, daughters in 2.7%, and sisters in 1.8%.  At baseline, patients reported 15 SD 6.9 MMDs with a severe disability (HIT-6 65.5 SD 8.5, and MIDAS 66.8 SD 51.7), and moderate symptoms of depression (PHQ-9 11 SD 5 SD5.1). Caregivers presented moderate distress (RSS 20.37, SD 11.3). Mutuality scales scores were high in patients (3.0, SD 0.6) and caregivers. (3.2 SD 0.5). At baseline, MMDs were related to PHQ scores (p = 0.009) but not directly to MS in patients and caregivers, or to RRS scores (p consistently > 0.1). Conversely, RRS scores were associated with PHQ-9 scores (p=0.004), MIDAS (p=0.021), and inversely related to MS in patients (p=0.009) and caregivers (p< 0.001).

Conclusion: Caregivers of patients with disabling migraine present a moderate burden of perceived stress, which is associated with patients' depressive symptoms and negatively affects mutuality in the couple.

Keywords

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