Furio MA, Popovic D, Vieta E, et al. - Via performing the “Bipolar Disorders: Improving Diagnosis, Guidance, and Education” (BRIDGE-II-Mix) study, researchers investigated the frequency of mixed states in patients with a major depressive episode (MDE) according to different definitions. In addition, they compared their clinical validity, considering specific features such as rapid cycling (RC). They assessed a sample of 2,811 MDE patients, 726 of which (25.8%) were diagnosed with bipolar disorder (BD). Among patients with BD, 159 (21.9%) met DSM-5 criteria for RC. A higher number of lifetime depressive episodes with shorter duration of depressive episodes, and more psychiatric comorbidities, as well as higher rates of atypical features and concomitant (hypo)manic symptoms (irritable mood; risky behavior; impulsivity; and psychomotor agitation) were the important clinical differences observed between bipolar patients with and without a RC. In addition, worse functioning, more obesity, and significantly more likelihood to be treated with three or more drugs were recorded for patients with RC.