Problematic internet use is common, functionally impairing, and in need of further study. Its relationship with obsessive-compulsive and impulsive disorders is unclear. Our objective was to evaluate whether problematic internet use can be predicted from recognised forms of impulsive and compulsive traits and symptomatology. We recruited volunteers aged 18 and older using media advertisements at two sites (Chicago USA, and Stellenbosch, South Africa) to complete an extensive online survey. State-of-the-art out-of-sample evaluation of machine learning predictive models was used, which included Logistic Regression, Random Forests and Naïve Bayes. Problematic internet use was identified using the Internet Addiction Test (IAT). 2006 complete cases were analysed, of whom 181 (9.0%) had moderate/severe problematic internet use. Using Logistic Regression and Naïve Bayes we produced a classification prediction with a receiver operating characteristic area under the curve (ROC-AUC) of 0.83 (SD 0.03) whereas using a Random Forests algorithm the prediction ROC-AUC was 0.84 (SD 0.03) [all three models superior to baseline models p < 0.0001]. The models showed robust transfer between the study sites in all validation sets [p < 0.0001]. Prediction of problematic internet use was possible using specific measures of impulsivity and compulsivity in a population of volunteers. Moreover, this study offers proof-of-concept in support of using machine learning in psychiatry to demonstrate replicability of results across geographically and culturally distinct settings.

&lt;p&gt;&lt;strong&gt;List of Abstract Titles and authors:&lt;br /&gt;&lt;/strong&gt;&lt;/p&gt;&lt;p&gt;&lt;strong&gt;1. Psychosis: A matter of mental effort?&lt;/strong&gt;&lt;/p&gt;&lt;p&gt;M Borg, Y Y van der Zee, J H Hsieh, H Temmingh, D J Stein, F M Howells&lt;/p&gt;&lt;p&gt;&lt;strong&gt;2.In search of an affordable, effective post-discharge intervention: A randomised control trial assessing the influence of a telephone-based intervention on readmissions for patients with severe mental illness in a developing country&lt;/strong&gt;&lt;/p&gt;&lt;p&gt;&lt;strong&gt;&lt;/strong&gt;U A Botha, L Koen, M Mazinu, E Jordaan, D J H Niehaus&lt;/p&gt;&lt;p&gt;&lt;strong&gt;3. The effect of early abstinence from long-term methamphetamine use on brain metabolism using 1H-magnetic resonance spectro-scopy (1H-MRS)&lt;/strong&gt;&lt;/p&gt;&lt;p&gt;A Burger, S Brooks, D J Stein, F M Howells&lt;/p&gt;&lt;p&gt;&lt;strong&gt;4. The effect of &lt;em&gt;in utero exposure &lt;/em&gt;to methamphetamine on brain metabolism in childhood using 1H-magnetic resonance spectroscopy (1H-MRS)&lt;/strong&gt;&lt;/p&gt;&lt;p&gt;A Burger, A Roos, M Kwiatkowski, D J Stein, K A Donald, F M Howells&lt;/p&gt;&lt;p&gt;&lt;strong&gt;5. A prospective study of clinical, biological and functional aspects of outcome in first-episode psychosis: The EONKCS Study&lt;/strong&gt;&lt;/p&gt;&lt;p&gt;&lt;strong&gt;&lt;/strong&gt;B Chiliza, L Asmal, R Emsley&lt;/p&gt;&lt;p&gt;&lt;strong&gt;6. Stimulants as cognitive enhancers - perceptions v. evidence in a very real world&lt;/strong&gt;&lt;/p&gt;&lt;p&gt;&lt;strong&gt;&lt;/strong&gt;H M Clark&lt;/p&gt;&lt;p&gt;&lt;strong&gt;7. Pharmacogenomics in antipsychotic drugs&lt;/strong&gt;&lt;/p&gt;&lt;p&gt;&lt;strong&gt;&lt;/strong&gt;Ilse du Plessis&lt;/p&gt;&lt;p&gt;&lt;strong&gt;8. Serotonin in anxiety disorders and beyond&lt;/strong&gt;&lt;/p&gt;&lt;p&gt;&lt;strong&gt;&lt;/strong&gt;Ilse du Plessis&lt;/p&gt;&lt;p&gt;&lt;strong&gt;9. HIV infection results in ventral-striatal reward system hypo-activation during cue processing&lt;/strong&gt;&lt;/p&gt;&lt;p&gt;&lt;strong&gt;&lt;/strong&gt;S du Plessis, M Vink, J A Joska, E Koutsilieri, A Bagadia, D J Stein, R Emsley&lt;/p&gt;&lt;p&gt;&lt;strong&gt;10. Disease progression in schizophrenia: Is the illness or the treatment to blame?&lt;/strong&gt;&lt;/p&gt;&lt;p&gt;R Emsley, M J Sian&lt;/p&gt;&lt;p&gt;&lt;strong&gt;11. Serotonin transporter variants play a role in anxiety sensitivity in South African adolescents&lt;/strong&gt;&lt;/p&gt;&lt;p&gt; S M J Hemmings, L I Martin, L van der Merwe, R Benecke, K Domschke, S Seedat&lt;/p&gt;&lt;p&gt;&lt;strong&gt;12. Iron deficiency in two children diagnosed with multiple sclerosis: Report on whole exom sequencing&lt;/strong&gt;&lt;/p&gt;&lt;p&gt;&lt;strong&gt;&lt;/strong&gt;S Janse van Rensburg, R van Toorn, J F Schoeman, A Peeters, L R Fisher, K Moremi, M J Kotze&lt;/p&gt;&lt;p&gt;&lt;strong&gt;13. Benzodiazepines: Practical pharmacokinetics&lt;/strong&gt;&lt;/p&gt;&lt;p&gt;&lt;strong&gt;&lt;/strong&gt;P Joubert&lt;/p&gt;&lt;p&gt;&lt;strong&gt;14. What to consider when prescribing psychotropic medications&lt;/strong&gt;&lt;/p&gt;&lt;p&gt;&lt;strong&gt;&lt;/strong&gt;G Lippi&lt;/p&gt;&lt;p&gt;&lt;strong&gt;15. Current prescribing practices for obsessive-compulsive disorder in South Africa: Controversies and consensus&lt;/strong&gt;&lt;/p&gt;&lt;p&gt;&lt;strong&gt;&lt;/strong&gt;C Lochner, L Taljaard, D J Stein&lt;/p&gt;&lt;p&gt;&lt;strong&gt;16. Correlates of emotional and behavioural problems in children with preinatally acquired HIV in Cape Town, South Africa&lt;/strong&gt;&lt;/p&gt;&lt;p&gt;&lt;strong&gt;&lt;/strong&gt;K-A Louw, N Phillips, JIpser, J Hoare&lt;/p&gt;&lt;p&gt;&lt;strong&gt;17. The role of non-coding RNAs in fear extinction&lt;/strong&gt;&lt;/p&gt;&lt;p&gt;&lt;strong&gt;&lt;/strong&gt;S Malan-Muller, L Fairbairn, W M U Daniels, M J S Dashti, E J Oakleley, M Altorfer, J Harvey, S Seedat, J Gamieldien, S M J Hemmings&lt;/p&gt;&lt;p&gt;&lt;strong&gt;18. An analysis of the management og HIV-mental illness comorbidity at the psychiatric unit of the Dr George Mukhari Academic Hospital&lt;/strong&gt;&lt;/p&gt;&lt;p&gt;&lt;strong&gt;&lt;/strong&gt;M L Maodi, S T Rataemane, T Kyaw&lt;/p&gt;&lt;p&gt;&lt;strong&gt;19. The identification of novel genes in anxiety disorders: A gene X environment correlation and interaction study&lt;/strong&gt;&lt;/p&gt;&lt;p&gt;&lt;strong&gt;&lt;/strong&gt;N W McGregor, J Dimatelis, S M J Hemmings, C J Kinnear, D J Stein, V Russel, C Lochner&lt;/p&gt;&lt;p&gt;&lt;strong&gt;20. Collaborations between conventional medicine and traditional healers: Obstacles and possibilities&lt;/strong&gt;&lt;/p&gt;&lt;p&gt;&lt;strong&gt;&lt;/strong&gt;G Nortje, S Seedat, O Gureje&lt;/p&gt;&lt;p&gt;&lt;strong&gt;21. Thought disorder and form perception: Relationships with symptoms and cognitive function in first-episode schizophrenia&lt;/strong&gt;&lt;/p&gt;&lt;p&gt;M R Olivier, R Emsley&lt;/p&gt;&lt;p&gt;&lt;strong&gt;22. Investigating the functional significance of genome-wide variants associated with antipsychotic treatment response&lt;/strong&gt;&lt;/p&gt;&lt;p&gt;&lt;strong&gt;&lt;/strong&gt;E Ovenden, B Drogemoller, L van der Merwe, R Emsley, L Warnich&lt;/p&gt;&lt;p&gt;&lt;strong&gt;23. The moral and bioethical determinants of "futility" in psychiatry&lt;/strong&gt;&lt;/p&gt;&lt;p&gt;&lt;strong&gt;&lt;/strong&gt;W P Pienaar&lt;/p&gt;&lt;p&gt;&lt;strong&gt;24. Single voxel proton magnetic resonance spectroscopy (1H-MRS) and volumetry of the amylgdala in social anxiety disorder in the context of early developmental trauma&lt;/strong&gt;&lt;/p&gt;&lt;p&gt;D Rosenstein, A T Hess, J Zwart, F Ahmed-Leitao, E Meintjies, S Seedat&lt;/p&gt;&lt;p&gt;&lt;strong&gt;25. Schizoaffective disorder in an acute psychiatric unit: Profile of users and agreement with Operational Criteria (OPCRIT)&lt;/strong&gt;&lt;/p&gt;&lt;p&gt;&lt;strong&gt;&lt;/strong&gt;R R Singh, U Subramaney&lt;/p&gt;&lt;p&gt;&lt;strong&gt;26. The right to privacy and confidentiality: The ethics of expert diagnosis in the public media and the Oscar Pistorius trial&lt;/strong&gt;&lt;/p&gt;&lt;p&gt;&lt;strong&gt;&lt;/strong&gt;C Smith&lt;/p&gt;&lt;p&gt;&lt;strong&gt;27. A birth cohort study in South Africa: A psychiatric perspective&lt;/strong&gt;&lt;/p&gt;&lt;p&gt;D J Stein&lt;/p&gt;&lt;p&gt;&lt;strong&gt;28. 'Womb Raiders': Women referred for observation in terms of the Criminal Procedures Act (CPA) charged with fetal abduction and murder&lt;/strong&gt;&lt;/p&gt;&lt;p&gt;&lt;strong&gt;&lt;/strong&gt;U Subramaney&lt;/p&gt;&lt;p&gt;&lt;strong&gt;29. Psycho-pharmacology of sleep wake disorders: An update&lt;/strong&gt;&lt;/p&gt;&lt;p&gt;R Sykes&lt;/p&gt;&lt;p&gt;&lt;strong&gt;30. Refugee post-settlement in South Africa: Role of adjustment challenges and family in mental health outcomes&lt;/strong&gt;&lt;/p&gt;&lt;p&gt;&lt;strong&gt;&lt;/strong&gt;L Thela, A Tomita, V Maharaj, M Mhlongo, K Jonathan&lt;/p&gt;&lt;p&gt;&lt;strong&gt;31. Dstinguishing ADHD symptoms in psychotic disorders: A new insight in the adult ADHD questionnaire&lt;/strong&gt;&lt;/p&gt;&lt;p&gt;Y van der Zee, M Borg, J H Hsieh, H Temmingh, D J Stein, F M Howells&lt;/p&gt;&lt;p&gt;&lt;strong&gt;32. Oscar Pistorius ethical dilemmas in a trial by media: Does this include psychiatric evaluation by media?&lt;/strong&gt;&lt;/p&gt;&lt;p&gt;M Vorster&lt;/p&gt;&lt;p&gt;&lt;strong&gt;33. Genetic investigation of apetite aggression in South African former young offenders: The involvement of serotonin transporter gene&lt;/strong&gt;&lt;/p&gt;&lt;p&gt;K Xulu, J Somer, M Hinsberger, R Weierstall, T Elbert, S Seedat, S Hemmings&lt;/p&gt;&lt;p&gt;&lt;strong&gt;34. Effects of HIV and childhood trauma on brain morphemtry and neurocognitive function&lt;/strong&gt;&lt;/p&gt;&lt;p&gt;G Spies, F Ahmed-Leitao, C Fennema-Notestine, M Cherner, S Seedat&lt;/p&gt;&lt;p&gt;&lt;strong&gt;35. Measuring intentional behaviour normative data of a newly developed motor task battery&lt;/strong&gt;&lt;/p&gt;&lt;p&gt;&lt;strong&gt;&lt;/strong&gt;S Bakelaar, J Blampain, S Seedat, J van Hoof, Y Delevoye-Turrel&lt;/p&gt;&lt;p&gt;&lt;strong&gt;36. Resilience in social anxiety disorder and post-traumatic stress disorder in the context of childhood trauma&lt;/strong&gt;&lt;/p&gt;&lt;p&gt;M Bship, S Bakelaar, D Rosenstein, S Seedat&lt;/p&gt;&lt;p&gt;&lt;strong&gt;37. The ethical dilemma of seclusion practices in psychiatry&lt;/strong&gt;&lt;/p&gt;&lt;p&gt;G Chiba, U Subramaney&lt;/p&gt;&lt;p&gt;&lt;strong&gt;38. Physical activity and neurological soft signs in patients with schizophrenia&lt;/strong&gt;&lt;/p&gt;&lt;p&gt;O Esan, C Osunbote, I Oladele, S Fakunle, C Ehindero&lt;/p&gt;&lt;p&gt;&lt;strong&gt;39. A retrospective study of completed suicides in the Nelson Mandela Bay Metropolitan Area from 2008 to 2013 - preliminary results&lt;/strong&gt;&lt;/p&gt;&lt;p&gt;&lt;strong&gt;&lt;/strong&gt;C Grobler, J Strumpher, R Jacobs&lt;/p&gt;&lt;p&gt;&lt;strong&gt;40. Serotonin transporter variants play a role in anxiety sensitivity in South African adolescents&lt;/strong&gt;&lt;/p&gt;&lt;p&gt;&lt;strong&gt;&lt;/strong&gt;S M J Hemmings, L I Martin, L van der Merwe, R Benecke, K Domschke, S Seedat&lt;/p&gt;&lt;p&gt;&lt;strong&gt;41. Investigation of variants within antipsychotic candidate pharmacogenes associated with treatment outcome&lt;/strong&gt;&lt;/p&gt;&lt;p&gt;F Higgins, B Drogmoller, G Wright, L van der Merwe, N McGregor, B Chiliza, L Asmal, L Koen, D Niehaus, R Emsley, L Warnich&lt;/p&gt;&lt;p&gt;&lt;strong&gt;42. Effects of diet, smoking and alcohol consumption on disability (EDSS) in people diagnosed with multiple sclerosis&lt;/strong&gt;&lt;/p&gt;&lt;p&gt;S Janse van Rensburg, W Davis, D Geiger, F J Cronje, L Whati, M Kidd, M J Kotze&lt;/p&gt;&lt;p&gt;&lt;strong&gt;43. The clinical utility of neuroimaging in an acute adolescnet psychiatric inpatient population&lt;/strong&gt;&lt;/p&gt;&lt;p&gt;&lt;strong&gt;&lt;/str

The high prevalence and meaningful risk of PTSD make UD a major public health issue. This study provides novel insights into predictors of PTSD after this experience and suggests that screening assessments might be useful in identifying high-risk individuals for preventive interventions.

The successful implementation of prevention programs for mother-to-child human immunodeficiency virus (HIV) transmission has dramatically reduced the prevalence of infants infected with HIV while increasing that of HIV-exposed uninfected (HEU) children. Neuropsychological assessments indicate that HEU children may exhibit differences in neurodevelopment compared to unexposed children (HUU). Pathological mechanisms leading to such neurodevelopmental delays are not clear. In this observational birth cohort study we explored the integrity of regional white matter microstructure in HEU infants, shortly after birth. Microstructural changes in white matter associated with prenatal HIV exposure were evaluated in HEU infants (n = 15) and matched controls (n = 22) using diffusion tensor imaging and tract-based spatial statistics. Additionally, diffusion values were extracted and compared for white matter tracts of interest, and associations with clinical outcomes from the Dubowitz neonatal neurobehavioral tool were investigated. Higher fractional anisotropy in the middle cerebellar peduncles of HEU compared to HUU neonates was found after correction for age and gender. Scores on the Dubowitz abnormal neurological signs subscale were positively correlated with FA (r = 0.58, P = 0.038) in the left uncinate fasciculus in HEU infants. This is the first study to present data suggesting that prenatal HIV exposure without infection is associated with altered white matter microstructural integrity in the neonatal period. Longitudinal studies of HEU infants as their brains mature are necessary to understand further the significance of prenatal HIV and antiretroviral treatment exposure on white matter integrity and neurodevelopmental outcomes.

Chronic musculoskeletal disorders were common in the general population, with higher prevalence among women compared to men, and increasing prevalence with age. Musculoskeletal disorders had considerable impact on the use of primary and specialist health services in Norway. The use of register data on health service utilization may be a useful source for monitoring population trends, and for estimating the burden in terms of health and health service use.

A wide range of medications have been studied for posttraumatic stress disorder (PTSD) and a number are registered for this indication. Nevertheless, current pharmacotherapies are only partially effective in some patients, and are minimally effective in others. Thus novel treatment avenues need to be explored. Areas covered: In considering novel pharmacological agents for the treatment of PTSD, this paper takes a translational approach. We outline how advances in our understanding of the underlying neurobiology of PTSD may inform the identification of potential new treatment targets, including glutamatergic, noradrenergic and opioid pathways. Expert commentary: Continued investigation of the neural substrates and signalling pathways involved in responses to trauma may inform the development of novel treatment targets for future drug development for PTSD. However, the translation of preclinical findings to clinical practice is likely to be complex and gradual.

Obsessive compulsive disorder (OCD) showed a lower prevalence of cigarette smoking compared to other psychiatric disorders in previous and recent reports. We assessed the prevalence and clinical correlates of the phenomenon in an international sample of 504 OCD patients recruited through the International College of Obsessive Compulsive Spectrum Disorders (ICOCS) network. Cigarette smoking showed a cross-sectional prevalence of 24.4% in the sample, with significant differences across countries. Females were more represented among smoking patients (16% vs 7%; p<.001). Patients with comorbid Tourette's syndrome (p<.05) and tic disorder (p<.05) were also more represented among smoking subjects. Former smokers reported a higher number of suicide attempts (p<.05). We found a lower cross-sectional prevalence of smoking among OCD patients compared to findings from previous studies in patients with other psychiatric disorders but higher compared to previous and more recent OCD studies. Geographic differences were found and smoking was more common in females and comorbid Tourette's syndrome/tic disorder.

We observed an inverse association between educational level and risk of HF. More efforts in preventing this severe complication of AMI among less educated patients may help to reduce the socioeconomic gap in survival following coronary events.

The amygdala is a complex structure that plays its role in perception and threat-related behaviour by activity of its specific nuclei and their separate networks. In the present functional magnetic resonance imaging study, we investigated the role of the basolateral amygdala in face and context processing. Five individuals with focal basolateral amygdala damage and 12 matched controls viewed fearful or neutral faces in a threatening or neutral context. We tested the hypothesis that basolateral amygdala damage modifies the relation between face and threatening context, triggering threat-related activation in the dorsal stream. The findings supported this hypothesis. First, activation was increased in the right precentral gyrus for threatening versus neutral scenes in the basolateral amygdala damage group compared with the control group. Second, activity in the bilateral middle frontal gyrus, and left anterior inferior parietal lobule was enhanced for neutral faces presented in a threatening versus neutral scene in the group with basolateral amygdala damage compared with controls. These findings provide the first evidence for the neural consequences of basolateral amygdala damage during the processing of complex emotional situations.

The aim of the present study was to investigate the effect of HIV infection on cortical and subcortical regions of the frontal-striatal system involved in the inhibition of voluntary movement. Functional MRI (fMRI) studies suggest that human immunodeficiency virus (HIV) infection is associated with frontostriatal dysfunction. While frontostriatal systems play a key role in behavioral inhibition, there are to our knowledge no fMRI studies investigating the potential impact of HIV on systems involved during the inhibition of voluntary movement. A total of 17 combined antiretroviral therapy (cART) naïve HIV+ participants as well as 18 age, gender, ethnic, education matched healthy controls performed a modified version of the stop-signal paradigm. This paradigm assessed behavior as well as functional brain activity associated with motor execution, reactive inhibition (outright stopping) and proactive inhibition (anticipatory response slowing before stopping). HIV+ participants showed significantly slower responses during motor execution compared to healthy controls, whereas they had normal proactive response slowing. Putamen hypoactivation was evident in the HIV+ participants based on successful stopping, indicating subcortical dysfunction during reactive inhibition. HIV+ participants showed normal cortical functioning during proactive inhibition. Our data provide evidence that HIV infection is associated with subcortical dysfunction during reactive inhibition, accompanied by relatively normal higher cortical functioning during proactive inhibition. This suggests that HIV infection may primarily involve basic striatal-mediated control processes in cART naïve participants.