The European Union and global governance:a handbook

The role of the European Union in global politics has been of growing interest over the past decade. The EU is a key player in global institutions such as the World Trade Organization (WTO) and NATO. It continues to construct an emerging identity and project its values and interests throughout contemporary international relations. The capacity of the EU to both formulate and realise its goals, however, remains contested. Some scholars claim the EU’s `soft power’ attitude rivals that of the USA’s `hard power’ approach to international relations. Others view the EU as insufficiently able to produce a co-ordinated position to project upon global politics. Regardless of the position taken within this debate, the EU’s relationship with its external partners has an increasingly important impact upon economic, political and security concerns on an international level. Trade negotiations, military interventions, democracy promotion, international development and responses to the global economic crisis have all witnessed the EU playing a central role. This has seen the EU become both a major force in contemporary institutions of global governance and a template for supranational governance that might influence other attempts to construct regional and global institutions. This volume brings together a collection of leading EU scholars to provide a state-of-the-art overview covering these and other debates relating to the EU’s role in contemporary global governance. The Handbook is divided into four main sections: Part I: European studies and global governance – provides an overview and critical assessment of the leading theoretical approaches through which the EU’s role in global governance has been addressed within the literature. Part II: Institutions – examines the role played by the key EU institutions in pursuing a role for the EU in contemporary international relations. Part III: Policy and issue areas – explores developments within particular policy sectors, assessing the different impact that the EU has had in different issue areas, including foreign and security policy, environmental policy, common commercial policy, the Common Agricultural Policy, development policy, accession policy, the Neighbourhood Policy and conflict transformation. Part IV: The global multilevel governance complex and the EU – focuses on the relationship between the EU and the institutions, regions and countries with which it forms a global multilevel governance complex, including chapters on the EU’s relationship with the WTO, United Nations, East Asia, Africa and the USA.

Introduction

The role of the European Union in global politics has been of growing interest over the past decade. The EU is a key player in global institutions such as the World Trade Organization (WTO) and NATO. It continues to construct an emerging identity and project its values and interests throughout contemporary international relations. The capacity of the EU to both formulate and realise its goals, however, remains contested. Some scholars claim the EU’s `soft power’ attitude rivals that of the USA’s `hard power’ approach to international relations. Others view the EU as insufficiently able to produce a co-ordinated position to project upon global politics. Regardless of the position taken within this debate, the EU’s relationship with its external partners has an increasingly important impact upon economic, political and security concerns on an international level. Trade negotiations, military interventions, democracy promotion, international development and responses to the global economic crisis have all witnessed the EU playing a central role. This has seen the EU become both a major force in contemporary institutions of global governance and a template for supranational governance that might influence other attempts to construct regional and global institutions.

Psychotic symptoms are associated with physical health problems independently of a mental disorder diagnosis:results from the WHO World Health Survey

This study explored whether physical health problems are related to psychotic symptoms independently of a mental disorder diagnosis. A total of 224,254 subjects recruited for the World Health Organization World Health Survey were subdivided into those with both a lifetime diagnosis of psychosis and at least one psychotic symptom in the 12 months prior to the evaluation, those with at least one psychotic symptom in the past 12 months but no lifetime diagnosis of psychosis, and those without psychotic symptoms in the past 12 months and without a lifetime diagnosis of psychosis. The three groups were compared for the presence of medical conditions, health problems, and access to health care. Medical conditions and health problems (angina, asthma, arthritis, tuberculosis, vision or hearing problems, mouth/teeth problems, alcohol consumption, smoking, and accidents), medication consumption, and hospital admissions (but not regular health care visits) were more frequent in individuals with psychotic symptoms but no psychosis diagnosis, compared to those with no symptoms and no diagnosis. The number of medical conditions increased with the number of psychotic symptoms. Given the sample analyzed, this trend seems to be independent from the socio-economic development of the country or the specific health care system.

Increased risk of diabetes mellitus among persons with psychotic symptoms:results from the WHO World Health Survey

OBJECTIVE: To analyze with a symptom-based approach the relationship between psychosis and diabetes mellitus in the general population. METHOD: Nationally representative samples from the World Health Organization (WHO) World Health Survey, totaling 224,743 randomly selected adults 18 years and older from 52 countries worldwide, were interviewed to establish the presence of psychotic symptoms and diabetes mellitus. Presence of psychotic symptoms was established using questions pertaining to positive symptoms from the psychosis screening module of the Composite International Diagnostic Interview. Presence of diabetes was established with a response of "yes" to the question, "Have you ever been diagnosed with diabetes (high blood sugar)?" The World Health Survey was conducted between 2002 and 2004. RESULTS: An increasing number of psychotic symptoms was related to increasing likelihood of diabetes mellitus (OR = 1.27; 95% CI, 1.24-1.30). As compared to no symptoms, at least 1 psychotic symptom substantially elevated the risk (OR = 1.71; 95% CI, 1.61-1.81). In people with a lifetime diagnosis of schizophrenia or psychosis, the prevalence of diabetes was higher in those with current psychotic symptoms (7.3% vs 5.2%; OR = 1.65; 95% CI, 1.21-2.26), suggesting that the persistence of symptoms over time could play a central role. After controlling for different potential confounders, there was a clear increase in the probability of having diabetes as the number of psychotic symptoms increased. The relationship between psychotic symptoms and diabetes was tested with multiple mediation models and path analyses for categorical outcomes. Only body mass index appeared as a relevant mediator in a model with a good fit (ie, χ21 = 3.2, P = .0742; comparative fit index = 0.999). CONCLUSIONS: Psychotic symptoms are related to increased rates of diabetes mellitus in nonclinical samples, independent of several potential confounders-including a clinical diagnosis of psychosis or schizophrenia, previous antipsychotic treatment, depression, lifestyle, and individual or country socioeconomic status. The findings highlight the worldwide relevance of the problem and the importance of identifying the specific paths of this association.