"This is my place of reference": transition from adolescent to adult care in a qualitative study of patients with anorexia nervosa.

Background: Anorexia nervosa (AN) is a polyfactorial, long-term condition with an important risk of chronicity, that mainly emerges in adolescence. The transition to adulthood care is a delicate step at high risk of reaggravation and drop-out of treatment. This qualitative study aimed to explore the subjective experiences of adolescents and young adults with AN confronted with the transition process.

Methods: Semi-structured video conference interviews were conducted with AN patients recruited from a specialized multidisciplinary department for adolescents. Interpretative phenomenological analysis (IPA) was applied to analyze the data.

Results: Thirteen female patients were interviewed with an average age of 22 years and a standard deviation of 4.2 years Four themes emerged from the IPA: (I) Intense emotional experience, (II) Transition as a reflection of symptom severity, (III) Adapted and personalized transition, and (IV) the need of preparation of the transition.

Conclusions: The transition process from adolescent to adult care appeared challenging for most AN patients. Our study identified several internal barriers to transition, some of which are common to chronic diseases, whereas others are more specific to anorexia nervosa, such as individual psychic structure, psychopathology or associated psychiatric comorbidities. Hence, it seems essential to build personalized transition programs that consider individual developmental trajectories, the specificities of AN psychiatric comorbidities and the unknown long-term prognosis of this complex condition.