Bipolar affective disorder (BD) is often a chronic and disabling illness that negatively impacts the quality life, functioning, and life expectancy of those affected (Whiteford et al., 2013). It mainly comprises recurrent pathological mood fluctuations ranging from manic to depressive episodes and the admixture of these, usually referred to as mixed states (Grande et al., 2016). Beyond these frank clinical episodes, many patients affected by BD are symptomatic, albeit subsyndromally, during almost half of their lifetime producing a high degree of functional and cognitive impairment (Martínez-Arán et al., 2004; Judd et al., 2002). As a consequence, the societal and economic burden of the disorder is highly challenging for any healthcare system due to high associated healthcare costs (Fajutrao et al., 2009).