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It has been well established that early adversity is a major risk factor for depression and for anxiety disorders in various populations and age groups. Few studies have considered the relative strength of these associations and the possible role of co-morbid depression/anxiety in understanding them. Using data from a large community sample of Ontario, Canada, we examined the relative strength of the associations between early physical abuse, sexual abuse, and/or parental strain with depression alone, anxiety alone, and co-morbid depression/anxiety. The current sample consisted of 6,597 individuals 15–64 years of age who were interviewed using the World Health Organization Composite International Diagnostic Interview (CIDI). Using a multivariate design, we compared early adversity scores across four diagnostic study groups including normal controls, individuals with major depression but no anxiety disorders, individuals with one or more anxiety disorders without major depression, and individuals with co-morbid major depression and anxiety. Individuals with past disorders were considered separately from those with current disorders. For both past and current disorders, highly significant differences in early adversity scores were found across the four study groups. A novel and robust finding, consistent across all analyses, was a marked association between early sexual abuse and co-morbid depression and anxiety but not the “pure” disorders. A strong association between early parental strain and major depression (independent of anxiety) was also found. The overall pattern of results suggest that there may be unique relationships linking particular adversities to particular manifestations of depression and anxiety disorders later in life. A particularly strong association between early sexual abuse and co-morbid depression/anxiety was found. Depression and Anxiety 17:34–42, 2003. © 2003 Wiley-Liss, Inc.

The Canadian Charter of Rights and Freedoms guarantees to all persons “freedom of conscience and religion.” The Charter, however, does not include any obvious equivalent to the Established Clause of the First amendment of the United States Bill of Rights. According to the Canadian courts, s. 2(a), the freedom of religion provision in the Charter, protects the individual from “coercion in matters of conscience.” It prohibits the state from either restricting or compelling religious practise. But it does not necessarily preclude state support for religion. State support for the practises of institutions of a particular religion will breach s.2(a) only if it coerces some members of the community, and interferes with their ability to practise their faith or compels them to practice the favoured religion.

OBJECTIVE: Mental health care reform has brought an increasing emphasis on community care, with concomitant reductions in inpatient psychiatric resources. Hospitalization remains a necessary and integral component of the mental health care system, but it is taking on a more specialized role. Examining the circumstances in which hospitalization is indicated can help clarify emergency psychiatric practices and determine whether patients' needs are being met within this changing environment. This pilot study examined the impact of selected patient and contextual characteristics on the decision to admit patients to inpatient psychiatric units and assessed the utility of the Severity of Psychiatric Illness (SPI) scale for monitoring clinical practice in emergency psychiatric services. METHODS: Crisis workers in two emergency psychiatric services crisis teams in Toronto, Canada, used the SPI in the assessment of 205 visitors to the services during the winter of 1998-1999. Contextual characteristics, including bed availability, service site, and the admitting physician's level of training, were recorded. Multivariate logistic regression was used to assess the relative contribution of patient and contextual variables in the admission decision. RESULTS: The severity of axis I symptoms and difficulties with self-care were significantly associated with the decision to admit. Site, bed availability, and the admitting physician's level of training did not appear to be associated with clinical decisions. CONCLUSIONS: Patients with the most need are being admitted to inpatient units despite significant systemic pressures on inpatient services. The SPI is a useful and discriminating tool for evaluating clinical practice in emergency services.

The Pathways Into Homelessness project in Toronto interviewed 300 unaccompanied adult users of homeless shelters to identify characteristics of individuals who are homeless for the first time. The sample reflected the total population of homeless shelter users in terms of age, sex, level of use, and type of shelter. Two fifths of the sample were homeless for the first time. There were more similarities than differences between those who were homeless for the first time and those who had been homeless previously. The prevalence of psychiatric and substance use disorders and the rate of previous hospitalization did not differ between first-time homeless persons and those who had been homeless before. The two groups were distinguished by some childhood experiences related to housing. Both groups had multiple indicators of serious problems, suggesting that the need for intervention is as pressing for persons who are homeless for the first time as it is for the larger population of homeless persons.

This Article identifies and explores the justifications or rationales offered by national court judges in support of their references to international human rights law. It does not analyze the extent to which judges invoke international law; rather, it examines the reasons offered by judges to explain their references to international law. The focus is on leading decisions rendered by higher courts in the United States and Commonwealth jurisdictions where the international norms do not bind decision-makers because they have not been made part of domestic law through an act of incorporation, the relevant treaty has not been ratified, or the ratifying state has filed a reservation limiting a treaty's domestic effect.

Women’s pain and death blurs the distinction between war and peace. Women are disproportionately starved, attacked physically, emotionally and psychologically, and killed during both war and peace. This paper focuses on the sanctions imposed against Iraq by the United Nations Security Council (“Se- curity Council”) in response to Saddam Hussein’s invasion of Kuwait in 1990 and the on-going purported threat posed to international peace and security by the Iraqi regime. Intended as a humane alternative to war, the sanctions have nonetheless lead to such high levels of death and suffering, particularly among women and children, that commentators have labeled them “genocide,” a “medieval military siege,” and “a humanitarian disaster comparable to the worst catastrophes of the past decades.”

This paper presents a particular reading of Truth and Method, Hans-Georg Gadamer's landmark text, as a lens through which to consider the meaning of international texts in domestic contexts. Gadamer's thoughts have been the subject of inquiry and controversy across legal lines; yet, they remain virtually unknown within international human rights law. His absence within this circle is unfortunate because Gadamer takes up questions concerning culture, perspective, difference, and authority - issues that no international human rights scholar can hope to ignore. More importantly, however, Gadamer addresses these issues within a theory of language that proves relevant to the very structure of international human rights law itself, given that it lacks a third party arbitrator authorized to pronounce on meaning. The judicial use of international law within domestic courts brings this feature of the international regime into stark relief because the rising judicial reliance on international law has the potential to generate as many meanings of international texts as there are courts willing to engage those texts. Truth and Method expounds a theory of language that recognizes the authority of international texts and international law's governance ambitions while still accommodating variations in interpretation between national jurisdictions.