title: Prognostic value of early therapeutic alliance in weight recovery: a prospective cohort of 108 adolescents with anorexia nervosa.
abstract: OBJECTIVE
  To determine whether patients' perception of early therapeutic alliance (TA) could predict time to achieve a target weight among adolescents undergoing treatment for anorexia nervosa.
  
  
  METHODS
  TA was assessed in a prospective cohort recruited from both inpatient and outpatient settings by self-administered and validated questionnaires. Kaplan-Meier survival curves were compared by log rank test, and Cox regression was used to test whether patients' perception of early TA predicted time to achieve a target weight.
  
  
  RESULTS
  In total, 108 patients were included, and 79.6% achieved a target weight. Better patient perception of early TA increased the hazard ratio (HR) of achieving a target weight (HR = 2.7, 95% confidence interval: 1.7-4.4, p < .001) such as being in the inpatient setting by 6.7. Being very severely underweight at admission decreased the HR of achieving the target weight.
  
  
  CONCLUSIONS
  Patients' perception of early TA is a good predictor of achieving a target weight. Because TA is a modifiable construct, it could be a target for intervention.
authors.affiliation: Service médico-psychologique régional, Centre hospitalier Lorquin, Metz, France. steph_bedes@yahoo.fr
authors.forename: Stephanie
authors.initials: S
authors.lastname: Bourion-Bedes
authors.forename: Cedric
authors.initials: C
authors.lastname: Baumann
authors.forename: Solenn
authors.initials: S
authors.lastname: Kermarrec
authors.forename: Fabienne
authors.initials: F
authors.lastname: Ligier
authors.forename: François
authors.initials: F
authors.lastname: Feillet
authors.forename: Chrystele
authors.initials: C
authors.lastname: Bonnemains
authors.forename: Francis
authors.initials: F
authors.lastname: Guillemin
authors.forename: Bernard
authors.initials: B
authors.lastname: Kabuth
mesh_terms: D000293:Adolescent; D000856:Anorexia Nervosa / Q000523:psychology / Q000628:therapy*; D005260:Female; D005602:France; D006760:Hospitalization; D006801:Humans; D008297:Male; D010342:Patient Acceptance of Health Care; D011379:Prognosis; D016016:Proportional Hazards Models; D011446:Prospective Studies; D055502:Secondary Prevention; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D015430:Weight Gain