Polycystic ovarian morphology and bulimia nervosa: a 9-year follow-up study

Objective: To examine long-term changes in polycystic ovarian morphology in women with polycystic ovaries and bulimia nervosa after treatment of the latter condition. Design: Longitudinal follow-up study. Setting: Eating disorder unit of a university hospital. Patient(s): Eight women originally treated for bulimia nervosa (T 0) who underwent ultrasonography up to 2 years after treatment (T 1) and had a second ultrasonographic scan 9 years later (T 2). Intervention(s): Treatment of bulimia nervosa that combined cognitive behavioral therapy with insight-orientated psychotherapy. Main Outcome Measure(s): Ovarian morphology evaluated by ultrasonography, using the criteria of Adams to define polycystic ovaries; Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition diagnosis of eating disorders. Result(s): At T 1, 7 women had recent bulimia and 1 was quiescent. The woman with quiescent disease had normal ovaries. Of the 7 bulimic women, 6 had polycystic ovaries and 1 had multifollicular morphology. At T 2, 5 women were bulimic, all of whom had polycystic ovaries. Three women had normal eating patterns and normal ovarian morphology. Conclusion(s): This study clearly shows a strong association between resolution of bulimia and changes in ovarian morphology, suggesting that changes in the former mirror changes in the latter. It also demonstrates normalization of ovarian morphology in previously polycystic ovaries.