Symptomatology long-term evolution after hospitalization for anorexia nervosa: Drive for thinness to explain effects of body dissatisfaction on type of outcome.

Anorexia nervosa (AN) is a serious psychiatric disorder associated with the highest mortality rate. Body dissatisfaction (BD) is now considered as an important risk factor for AN onset and relapse. Recent results lead to the hypothesis according to which AN and drive for thinness (DT) are related to body dissatisfaction. The primary aim of this current study was to identify whether DT mediated the relationship between BD and AN symptoms several years after hospitalization. As a secondary aim, self-reported Body Shape Questionnaire, Eating Attitude Test, Eating Disorder Inventory and Beck Depression Inventory scores were compared between the 48 women with a history of severe AN and 73 matched controls. A mediation analysis didn't show evidence of a direct effect of BD on eating disorder symptomatology after controlling for DT suggesting a full mediation of DT on the association between BD and eating disorders symptomatology. Results also showed that patients with a bad outcome had a higher score of DT than controls, which was not the case of patients with a good outcome. These findings highlight the potential importance of DT and the usefulness of targeting this dimension in therapeutic interventions for AN patients if further research confirm these results.