The frequency of social dysfunctions in a general population sample and in different diagnostic groups was investigated by using the Social Interview Schedule (SIS). Based on the results of the general population sample, several of the a priori derived cut-off scores of the SIS were modified. The analysis of the general population sample revealed sex-specific relationships between age and different aspects of social functioning. Especially for younger women significantly more objective social restrictions, were found due to the burden of multiple role responsibilities. With regard to different diagnostic subgroups including patients and mostly untreated cases from the community sample with Affective Disorders and Anxiety Disorders, results indicate that the degree of social impairment and dysfunctions and the degree of satisfaction with different role areas are strongly dependent on type of disorder and on former treatment status. Specific findings are: (1) The highest number of social impairments and dysfunctions were found in cases and patients with affective syndromes and in schizophrenic patients, but not in schizoaffective patients. (2) Management difficulties and dissatisfaction in intimate relationships were primarily found in depressed women. (3) Unlike anxiety patients, anxiety cases, although mostly chronically ill, had significantly less objective impairments and a lower rate of dissatisfaction than depressed cases. The results are discussed with special reference to the possible key role of depression for the development of social dysfunctions, as measured by the SIS. (4) Problems were, however, acknowledged concerning the use of the SIS with severely disturbed chronic schizophrenic patients.

The study examines to what degree well-documented present and life-time psychotic symptoms in a group of former psychiatric inpatients are ascertained when using the Diagnostic Interview Schedule (DIS). The Inpatient Multidimensional Psychiatric Scale (IMPS) and the Manual for the Assessment and Documentation of Psychopathology/Diagnostische Sichtlochkartei (AMDP/DiaSika) Interview-Checklist approach were used for the “clinical” evaluations of symptoms. The results indicate fair concordance between the two clinical approaches and the DIS with regard to the presence of any delusional or hallucination symptoms. Low to poor agreement was found in the assessment of many of the rather specific hallucinations and delusions. Generally, the concordance found was higher when compared to the more clinical AMDP/DiaSiKa approach than to the IMPS. More detailed comparisons with diagnostic subgroups of schizophrenic and schizoaffective patients substantiated the findings in the overall sample. Overall it was reconfirmed that the DIS approach is limited to those patients who are cooperative and at least partly remitted.

The frequency of social dysfunctions in a general population sample and in different diagnostic groups was investigated by using the Social Interview Schedule (SIS). Based on the results of the general population sample, several of the a priori derived cut-off scores of the SIS were modified. The analysis of the general population sample revealed sex-specific relationships between age and different aspects of social functioning. Especially for younger women significantly more objective social restrictions, were found due to the burden of multiple role responsibilities. With regard to different diagnostic subgroups including patients and mostly untreated cases from the community sample with Affective Disorders and Anxiety Disorders, results indicate that the degree of social impairment and dysfunctions and the degree of satisfaction with different role areas are strongly dependent on type of disorder and on former treatment status. Specific findings are: (1) The highest number of social impairments and dysfunctions were found in cases and patients with affective syndromes and in schizophrenic patients, but not in schizoaffective patients. (2) Management difficulties and dissatisfaction in intimate relationships were primarily found in depressed women. (3) Unlike anxiety patients, anxiety cases, although mostly chronically ill, had significantly less objective impairments and a lower rate of dissatisfaction than depressed cases. The results are discussed with special reference to the possible key role of depression for the development of social dysfunctions, as measured by the SIS. (4) Problems were, however, acknowledged concerning the use of the SIS with severely disturbed chronic schizophrenic patients.

The study examines to what degree well-documented present and life-time psychotic symptoms in a group of former psychiatric inpatients are ascertained when using the Diagnostic Interview Schedule (DIS). The Inpatient Multidimensional Psychiatric Scale (IMPS) and the Manual for the Assessment and Documentation of Psychopathology/Diagnostische Sichtlochkartei (AMDP/DiaSika) Interview-Checklist approach were used for the “clinical” evaluations of symptoms. The results indicate fair concordance between the two clinical approaches and the DIS with regard to the presence of any delusional or hallucination symptoms. Low to poor agreement was found in the assessment of many of the rather specific hallucinations and delusions. Generally, the concordance found was higher when compared to the more clinical AMDP/DiaSiKa approach than to the IMPS. More detailed comparisons with diagnostic subgroups of schizophrenic and schizoaffective patients substantiated the findings in the overall sample. Overall it was reconfirmed that the DIS approach is limited to those patients who are cooperative and at least partly remitted.

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This research provides a comparative study of the Japanese and German nursing home sectors. Faced with aging populations, both countries share similar long-term care policies based on social insurance. However, descriptive statistics indicate significant differences in the outcomes and costs in their respective nursing home sectors. This research aims to identify the reasons for this state of affairs by examining demographic and policy differences between the two countries. To shed light on the subject from multiple angles, we conduct three types of empirical analysis—regression, the Blinder-Oaxaca decomposition, and data envelopment analysis—on regional data from the past decade. Our findings indicate that the different outcomes are driven by both demographic and policy differences where policy relates to long-term care as well as to additional welfare aid. In terms of policy, a key difference is found in the designs of the welfare programs for low-income elders. In Germany, our results are consistent with moral hazard due to the generous design of the welfare program, while in Japan, our results do not indicate moral hazard, which may be due to strict nursing home admission rules for welfare recipients.