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Therapeutic alliance in inpatients with severe anorexia nervosa
Author(s) -
Marzola Enrica,
Albini Erica,
Delsedime Nadia,
Fassino Secondo,
AbbateDaga Giovanni
Publication year - 2019
Publication title -
european eating disorders review
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.511
H-Index - 67
eISSN - 1099-0968
pISSN - 1072-4133
DOI - 10.1002/erv.2687
Subject(s) - anorexia nervosa , beck depression inventory , anxiety , psychology , eating disorders , depression (economics) , clinical psychology , visual analogue scale , body mass index , psychiatry , quality of life (healthcare) , bulimia nervosa , medicine , physical therapy , psychotherapist , economics , macroeconomics
Objective Therapeutic alliance (TA) is a relevant aspect in anorexia nervosa (AN), but data on inpatients are lacking. We aimed to evaluate the influence of motivation to change, diagnostic subtypes, and duration of illness on TA at hospital discharge; we also investigated if baseline clinical characteristics were associated with discharge TA, and the TA‐outcome association. Method We enrolled 137 adult inpatients with AN completing Eating Disorder Examination‐Questionnaire, Beck Depression Inventory, State–Trait Anxiety Inventory, Anorexia Nervosa Stages of Change‐Questionnaire, EuroQoL‐Quality of Life Scale‐Visual Analogue Scale, and Working Alliance Inventory‐Short Revised. Results Patients with different AN subtypes and duration of illness reported similar TA. Baseline depression, state anxiety, and motivation to change were statistically significantly associated with TA at discharge. After controlling for all these variables and duration of illness, only motivation to change remained statistically significant. Statistically significant correlations were also found between improvements in body mass index and quality of life and discharge TA. Conclusions Few data exist on TA in inpatients with AN and a long duration of illness. Our findings suggest that baseline motivation to change correlates with TA at discharge independently of other variables. Future studies should ascertain as to whether a causal link exists or not.