title: Predicting premature termination of hospitalised treatment for anorexia nervosa: the roles of therapeutic alliance, motivation, and behaviour change.
abstract: OBJECTIVE
  This study aims to investigate treatment drop-out, and the associated roles of motivation, alliance, and behaviour change exhibited over the first four weeks of hospitalised treatment for anorexia.
  
  
  METHODS
  90 participants meeting DSM-IV criteria for anorexia nervosa completed questionnaires at admission, and four weeks into treatment. Weight data was collected over this same time period. At the end of treatment, participants were categorised into completer or premature termination groups.
  
  
  RESULTS
  The overall rate of premature termination was 57.8%. Those who prematurely terminated treatment demonstrated lower discharge BMI (p<.0005), and weight gain (p<.0005) than those who completed. Therapeutic alliance proved significantly different between outcome groups at admission (p=.004).
  
  
  CONCLUSIONS
  End-of-treatment outcomes for those who do not complete treatment are invariably poor. Therapeutic alliance appears to be a particularly important factor in this area.
authors.affiliation: Population Health Sciences and Education, St. George's University of London, London, UK. r.sly@uea.ac.uk
authors.forename: Richard
authors.initials: R
authors.lastname: Sly
authors.forename: John F
authors.initials: JF
authors.lastname: Morgan
authors.forename: Victoria A
authors.initials: VA
authors.lastname: Mountford
authors.forename: J Hubert
authors.initials: JH
authors.lastname: Lacey
mesh_terms: D000293:Adolescent; D000328:Adult; D000856:Anorexia Nervosa / Q000523:psychology / Q000628:therapy*; D003068:Coercion; D015331:Cohort Studies; D005260:Female; D006760:Hospitalization; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009042:Motivation; D010352:Patient Dropouts / Q000523:psychology*; D011369:Professional-Patient Relations; D011446:Prospective Studies; D013811:Psychotherapeutic Processes; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D055815:Young Adult