Sibeoni Jordan, Orri Massimiliano, Valentin Marie, Podlipski Marc-Antoine, Colin Stephanie, Pradere Jerome, Revah-Levy Anne
Service Universitaire de Psychiatrie de l'Adolescent, Argenteuil Hospital Centre, Argenteuil, France.
ECSTRA Team, UMR-1153, Inserm, Paris Diderot University, Sorbonne Paris Cite, Paris, France.
PLoS One. 2017 Jan 5;12(1):e0169493. doi: 10.1371/journal.pone.0169493. eCollection 2017.
Anorexia nervosa in adolescents can be a difficult-to-treat disease. Because qualitative research is a well-established method for deepening our understanding of subjective experiences, such as eating disorders and their treatment, we sought to perform a systematic review of qualitative studies to synthesize the views of adolescents with this disease, their parents, and their healthcare providers about its treatment.
We performed a thematic synthesis to develop the central themes that summarize all of the topics raised in the articles included in our review. The quality of the articles was assessed by the Critical Appraisal Skills Program.
We included 32 articles from seven different countries. Two central themes were inductively developed from the analysis: (1) the treatment targets (i.e., symptoms and patients in context), and (2) a therapeutic tool-a relationship, specifically the core concept of the therapeutic relationship.
Our results underline the difficulty in establishing a therapeutic alliance, the barriers to it, especially the risk that professionals, adolescents, and parents will not converse about treatment; although such a dialogue appears to be an essential component in the construction of a therapeutic alliance.
青少年神经性厌食症可能是一种难以治疗的疾病。由于定性研究是深化我们对主观体验（如饮食失调及其治疗）理解的成熟方法，我们试图对定性研究进行系统综述，以综合患有这种疾病的青少年、他们的父母以及他们的医疗服务提供者对其治疗的看法。
我们进行了主题综合分析，以形成总结我们综述中所纳入文章中提出的所有主题的核心主题。文章质量由批判性评估技能计划进行评估。
我们纳入了来自七个不同国家的32篇文章。通过分析归纳出两个核心主题：（1）治疗目标（即症状及具体情境中的患者），以及（2）一种治疗工具——一种关系，特别是治疗关系的核心概念。
我们的结果强调了建立治疗联盟的困难、其障碍，尤其是专业人员、青少年和父母之间不就治疗进行沟通的风险；尽管这种对话似乎是构建治疗联盟的一个重要组成部分。
