Relapse Prevention Anorexia Nervosa

Anorexia nervosa (AN) is a severe mental disorder characterized by (the drive for) thinness, a low body weight for one’s age and height combined with a disturbed body image. Patients often see and experience themselves as fat while they are in fact very underweight, and do not consider themselves ill, which contrasts with their physical status. Relapse is common, 31% of the patients experiences a relapse after successful treatment. One major problem was the lack of methodological support in implementing relapse prevention strategies in practice. We have addressed this issue by developing the Guideline Relapse Prevention Anorexia Nervosa (www.relapse-an.com), an evidence-based tool that offers a structured approach to applying relapse prevention strategies. The aim of this thesis is twofold; 1) to build evidence for the use of the Guideline Relapse Prevention Anorexia Nervosa, and 2) to gain more insight into the different aspects of the process of relapse in order to improve and substantiate work on relapse prevention. It is based on qualitative and quantitative studies. The studies in this thesis provide insight in the process of relapse from the perspective of the “three legged stool” of evidence based practice; through the patient, professional and science. The guideline shows to be a useful instrument in daily practice. We advise all patients at the end of treatment, to set up a personalized relapse prevention plan. And that they will be monitored, low frequently, throughout a period of 18 months in which the risk of relapse appears to be high.