Purpose Patients with eating disorders (ED) pose a high-risk group regarding relapse. The understanding of factors contributing to a better outcome is much-needed. Therapeutic alliance (TA) is one important, pantheoretical variable in the treatment process, which has shown to be connected with outcome. This review looks into a possible predictive effect of TA on outcome as well as related variables. Methods A systematic review with pre-determined inclusion criteria following the PRISMA guidelines was conducted for studies published since 2014. Three previous reviews including studies up until 2014 were analyzed for studies matching our inclusion criteria. A total of 26 studies were included. Results The results were heterogeneous between different patient groups. Regarding the predictive effect of TA, in adolescent samples, the TA of either the patients or their parents seems to impact outcome as well as completion. For adults, results are mixed, with a tendency to a greater impact of TA for anorexia nervosa (AN) patients, while some samples of adult bulimia nervosa (BN) patients did not find any relation between TA and outcome. Conclusion The effect of TA on clinical outcome depends on the patient group. TA has a greater impact on adolescents, irrespective of diagnosis, and on adults with AN. The examined studies have different limitations which include small sample sizes and questionable study design. The examination of motivation as a potential influencing factor is recommended. Level of evidence Level I, systematic review.

Anorexia nervosa is a common psychiatric disorder in adolescents and young adults and is often associated with high rates of comorbidities and a chronic course of the disease. Additionally, it still shows the highest rates of mortality among all psychiatric disorders. The case presented describes a female patient with severe and enduring anorexia nervosa who achieved remission after strict adherence to inpatient treatment and showed a full recovery in the 3‑year follow-up. Shortly after achieving a minimum weight of 25 kg (171 cm, body mass index 8.5 kg/m) the 21-year-old, chronically ill patient was admitted to an intensive care unit. After a phase of stabilization and achieving a BMI of 10 kg/m, she was transferred to a hospital specialized in treating eating disorders. It came to a full recovery of the patient including full weight restoration during regular follow-ups (BMI 20.0 kg/m) and normalization of the psychopathology of the eating disorder. In a 3-year follow-up, the patient presented with an enduring and complete remission of all symptoms, which were extremely expressed during the illness.

Patienten mit akuter einseitiger Hörminderung kann neben einer systemischen Steroidtherapie eine intratympanale Kortisoninjektion (ITC) angeboten werden. Oft gilt die ITC als Rettungsversuch nach ausbleibendem Ansprechen auf die primäre systemische Steroidtherapie. Sie kann dieser auch vorgezogen werden, wenn durch das Nebenwirkungsprofil der systemischen Steroidtherapie eine Entgleisung bestehender Vorerkrankungen zu befürchten ist.