• In the DSM-5, the diagnosis of mania or hypomania requires the presence of increase in energy or goal-directed activities compared with the habitual in the subject along with mood elevation. This change will contribute to increasing diagnostic reliability.
• In the DSM-5, the term mixed feature is a course specifier and can be applied to depressive, manic, and hypomanic episodes. Seasonal patterns can now be used for all types of mood episodes. These changes will lead to alterations in study designs and data analysis and potentially advance mental health research.
• There is increasing evidence of the thinning of cortical gray matter in the brains of patients with bipolar disorder when compared with healthy controls. The greatest deficits were found in parts of the brain that control inhibition and emotion, such as the frontal and temporal regions. This finding clarifies aspects of the mechanisms underlying the developments and maintenance of bipolar symptoms.
• Neuroimaging studies showed that lithium treatment was associated with reduced thinning of gray matter, which suggests a protective effect of this medication on the brain.
• Combining pharmacotherapy and psychotherapy can reduce the rate of recurrence mood episodes and medication adherence in bipolar patients. Electroconvulsive therapy is highly effective and can be beneficial in treatment-resistant patients.

• Neurostimulation offers the opportunity to impact neuronal functioning to treat severe psychiatric illness as an adjunct or alternative to pharmacotherapy.
• Transcranial magnetic stimulation offers a clear and compelling evidence base for the treatment of moderate-to-severe depression.
• Vagal nerve stimulation has shown significant efficacy in the most severe treatment-resistant depressions (TRD) in naturalistic studies, but wide adoption has been hampered by difficulties in randomized controlled trials.
• Low intensity transcranial electrical stimulation has varied delivery systems with numerous stimulation arrays, which have hampered professional and regulatory acceptance.
• Deep brain stimulation as the most expensive and invasive of the neurostimulation modalities has failed two sham-controlled trials and awaits more conclusive evidence before becoming part of the TRD options.

A number of subjective and objective tools have been developed recently to assess cough severity. An encouraging development to aid in the assessment of new antitussives is the automated cough counter. Researchers will now be able to make objective measurements of cough frequency rather than relying exclusively on reported cough symptoms such as recorded in cough diaries and visual analogue scales describing cough severity. Approved devices are available that appear to accurately distinguish cough from throat clearing, snoring, and ambient background noises. They are compact and noninvasive, with a long battery life for extended recording times. Their role is currently limited to cough research rather than clinical practice.

When investigating malnutrition and weight loss in older patients, clinicians should screen for physiologic, psychological, and social risk factors. Malnutrition may be caused by social isolation and lack of awareness regarding healthy eating and may be associated with depression, bereavement, dementia, or alcohol use. Patients with malignancy, nonmalignant gastrointestinal diseases, psychiatric conditions, and diseases that become more common with aging (such as diabetes mellitus and cancer) should be considered high risk for unintentional weight loss.

• Increasing adoption of risk calculators to assess operative risks
• Use of regional anesthesia approaches to decrease narcotic usage
• Impact of ERAS pathways on approaches to perioperative management

• Caloric reduction is more important than macronutrient distribution for weight loss
• Frequent provider contact by a trained health professional is beneficial for successful weight management. 
• Exercise is is highly essential for maintaining weight loss and achieving general health improvements.
• An individualized approach toward weight loss is important to take into account food, cultural, and lifestyle preferences. 
• Weight management clinicians are the leaders in representing science-based approaches toward weight loss