Les enjeux de la transition dans l’anorexie mentale vus par les professionnels : une étude qualitative

Abstract

IntroductionAnorexia nervosa (AN) is an eating disorder (ED) that emerges during adolescence and may be lasting several years, or even becoming chronic. For these patients, the transition to adult care is a period of high risk of instability, relapse, symptomatic re-aggravation and increased development of co-morbidities or eventually leading to care drop-out or medical nomadism. Professionals involved in the transition process with AN patients are often challenged with various difficulties, and confronted with the need to plan this care stage. This study sought to understand the pediatricians and (child) psychiatrists experience of this transition step and to identify national practices around the transition process for adolescents and young adults with anorexia nervosa. MethodA qualitative study was carried out on the basis of thirteen recorded individual interviews with physicians specialised in eating disorders working in hospital adolescent medicine units or in adult medicine units. The methodology used was IPA (Interpretative Phenomenological Analysis). ResultsVarious difficulties and obstacles to a successful transition emerged as well as perspectives to improve the transition to adulthood care: early identification of the target population, choice of the most adapted unit to the severity level of the disease, family support during the transition, identification of a coordinating physician and enhanced networking support. The opportunity of a transition program is discussed among physicians, who are consistent on the need for guidelines. ConclusionThis qualitative study allowed us to highlight the difficulties of specialized professionals faced to the transition period with AM patients but also to consider the need for specific tools and guidelines to promote continuity to adulthood care.