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In a randomised multicentre study, the prophylactic efficacy of lithium and carbamazepine was compared in schizoaffective disorder. A total of 90 ICD-9 schizoaffective patients were included in the maintenance phase (2.5 years). They were also diagnosed according to RDC and DSM-III-R and classified into subgroups. Mean serum levels were 0.58 +/- 0.12 mmol/l for lithium and 6.4 +/- 1.5 micrograms/ml for carbamazepine (mean dose 643 +/- 179 mg/d). Outcome criteria were hospitalisation, recurrence, concomitant psychotropic medication and adverse effects leading to discontinuation. There were more non-completers under carbamazepine than under lithium (p = 0.02). Survival analyses demonstrated no significant differences between lithium and carbamazepine in treatment outcome. Patient's ratings of side effects (p = 0.003) and treatment satisfaction (p = 0.02) favoured carbamazepine. Following the RDC criteria, patients of the schizodepressive and non-classifiable type did better under carbamazepine (p = 0.055 for recurrence), whereas in the schizomanic patients equipotency of both drugs was found. Applying DSM-III-R, carbamazepine demonstrated a superiority in the patient group with more schizophrenia-like or depressive disorders (p = 0.040 for recurrence), but not in patients fulfilling the DSM-III-R criteria of bipolar disorder. Lithium and carbamazepine seem to be equipotent alternatives in the maintenance treatment of broadly defined schizoaffective disorders. However, in subgroups with depressive or schizophrenia-like features and regarding its long-term tolerability carbamazepine seems to be superior.

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Building on the notion of the ‘social nature’ of money, this article investigates how dual-earner couples in Germany, Spain, Sweden and the US handle money in their everyday lives. We analysed in-depth, open-ended interviews conducted with 45 couples in these four countries to determine whether they define money as ‘joint’ or ‘separate’ and to investigate the consequences such definitions have for couple relationships. The concept of the convertibility of money helped us to spell out these consequences in detail. In addition, we explore whether the meaning of ‘joint’ or ‘separate’ money might relate to institutionalized cultural frameworks embodied in welfare policies that vary between countries. Couples in Spain and in Sweden seem to practise a low degree of convertibility of money into other resources, but they do so for different reasons: in Spain, money tends to be considered ‘joint money’ from the outset, whereas in Sweden it is often kept ‘separate’ and outside the relationship. In contrast, in the US and Germany, money, while often classified as ‘joint’ by the couples, is more likely to be seen as each partner’s individual contribution to the relationship. Thus it can be, and often is, converted into resources such as domestic work or recognition.

This article fills a gap in the existing literature by investigating how public employment service (PES) staff actually deal with their clients under a continental regime of activation. The results reported here are based on interviews both with PES staff and their unemployed clients in Germany. We argue that due to its Bismarckian origins as an insurance-based system of 'unemployment protection', Germany's system of unemployment compensation is attractive not only for the marginalized, but also for core workers. As a result, PES staff deal with clients from very heterogeneous class backgrounds. We demonstrate that social class is a significant factor in client outcomes, and that earlier research has perhaps overemphasized the role of frontline staff as 'street-level bureaucrats'. While staff do have considerable power, the result of the encounters between the administration and clients also depends on the capabilities of the clients, which, in turn, are strongly related to social class.

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