The hallmark of bipolar disorder is hypomania or mania, and the predominant phase of illness is depression. Affecting approximately 40 million individuals worldwide, bipolar disorder is associated with a substantial psychosocial, medical, and financial burden and increased mortality from suicide and other causes. Diagnosis can be challenging due to symptom overlap with attention-deficit hyperactivity disorder, major depressive disorder, psychotic spectrum disorders, and personality disorders, which often leads to a delay in diagnosis. Recent advancements in understanding disease risk and pathophysiology have identified multigene risk and possible infectious and mitochondrial causes. Treatment approaches include pharmacotherapy, psychotherapy, and lifestyle modifications, which should always be patient-centred and aligned with individual goals and priorities. Future directions for bipolar disorder care include increasing the availability of psychosocial interventions aimed at self-management, addressing treatment-resistant bipolar depression, deepening the understanding of pathophysiology, and exploring novel interventions, such as ketamine, esketamine, other rapid-acting antidepressants, and various neuromodulation approaches.

Epilepsies that present during childhood pose unique challenges and include developmental and epileptic encephalopathies, specific distinctive constellations, and epilepsies with seizure subtypes, such as epileptic spasms, myoclonic-atonic seizures, and myoclonic absences. Self-limited focal epilepsies and genetic generalised epilepsy phenotypes are also evident during childhood. However, determining the cause-whether structural, genetic, metabolic, infectious, or autoimmune-is increasingly relevant. Although history and clinical examination form the fundamental basis of diagnosis, exclusion of epilepsy mimics in childhood can prove challenging, requiring specialist input and supportive electrophysiology. With crucial evidence-based medicine emerging on the treatment of infantile epileptic spasm syndrome, Dravet syndrome, and Lennox-Gastaut syndrome, with a focus on improving outcomes, early identification of surgically remediable epilepsies is crucial for neurodevelopmental outcomes. Practical questions remain regarding pathophysiology, the effects of causative factors and interictal epileptiform activity on cognition, and the efficacy of precision medicine-based approaches based on insights from epilepsy genetics.

Despite the availability of biological therapies, suboptimal disease control remains a problem for patients with Crohn's disease. We report the results of the GALAXI-2 and GALAXI-3 studies, which aimed to assess the efficacy and safety of intravenous induction followed by subcutaneous maintenance therapy with guselkumab over 48 weeks in adults with moderately to severely active Crohn's disease.