Validity of rapid cycling as a modifier for bipolar disorder in DSM‐IV

Data are reviewed regarding the validity of rapid cycling as a modifier for Bipolar Disorder, as defined by the Dunner‐Fieve criterion of at least four affective episodes in 12 months. This formulation is evaluated in light of the criteria for validity suggested by Robins and Guze and by Kendell. While available data support recognition of rapid cycling as a modifier, a number of issues remain. These include particularly the optimal cut‐off for rapid cycling in terms of number of episodes per year, and whether brief but severe episodes should be counted towards that criterion. Several options for operational zed criteria sets are discussed. Depression 1:11–19 (1993). Published 1993 by Wiley‐Liss, Inc.