Evidence for the early clinical relevance of hallucinatory-delusional states in the general population

OBJECTIVE: To analyze, in a general population sample, clustering of delusional and hallucinatory experiences in relation to environmental exposures and clinical parameters. METHOD: General population-based household surveys of randomly selected adults between 18 and 65 years of age were carried out. SETTING: 52 countries participating in the World Health Organization's World Health Survey were included. PARTICIPANTS: 225 842 subjects (55.6% women), from nationally representative samples, with an individual response rate of 98.5% within households participated. RESULTS: Compared with isolated delusions and hallucinations, co-occurrence of the two phenomena was associated with poorer outcome including worse general health and functioning status (OR = 0.93; 95% CI: 0.92-0.93), greater severity of symptoms (OR = 2.5 95% CI: 2.0-3.0), higher probability of lifetime diagnosis of psychotic disorder (OR = 12.9; 95% CI: 11.5-14.4), lifetime treatment for psychotic disorder (OR = 19.7; 95% CI: 17.3-22.5), and depression during the last 12 months (OR = 11.6; 95% CI: 10.9-12.4). Co-occurrence was also associated with adversity and hearing problems (OR = 2.0; 95% CI: 1.8-2.3). CONCLUSION: The results suggest that the co-occurrence of hallucinations and delusions in populations is not random but instead can be seen, compared with either phenomenon in isolation, as the result of more etiologic loading leading to a more severe clinical state.

The influence of newer member states in the European Union:the case of Poland and the Eastern partnership

This article seeks to examine and assess the role of Poland in the early stages of the making of the Eastern Partnership of the European Union. First, it briefly reviews Poland's aims and ambitions with regard to the European Union's policy towards its eastern neighbours, both before and since it joined the European Union in 2004. Second, it describes and analyses the Eastern Partnership, including its added value for the European Neighbourhood Policy. Third, it draws on a range of interviews carried out by the authors in Brussels and Warsaw on Poland's role in the initial formation of the Eastern Partnership, as seen by its partners in the other member states and European institutions. In addition, it seeks to unpack some of the early stage lessons learnt by the Polish government about how best to achieve its ambitions in the European Union, and notes the remaining weaknesses of the Polish administration, particularly in the area of administrative capacity. © 2013 University of Glasgow.