The Long-term Course of Rapid-Cycling Bipolar Disorder

Abstract
SEVERAL CONSIDERATIONS give importance to the phenomenon of rapid cycling.1 In accord with the kindling hypothesis evoked to explain it, rapid cycling may reflect a sensitization produced by repeated episodes.2,3 If, as suspected, such sensitization is often an enduring change,3 the prognostic significance of rapid cycling should be long lasting as well. Some follow-up studies have supported this view,4,5 but others have shown rapid cycling to be time limited.6