Alright, First-Hand account, given to me from my girlfriend (from Hokkaido, so I'm not sure if there's a difference)
Mainly used between women, although not necessarily limited to it (most of her friends are girls, so it makes sense).
The best example that she gave went like this:
Take my friend Itsumi-chan. We graduated together, and no matter how close of friends we become, I will never take off the -chan. But, if she started working at the same place that I do (sort of as a kouhai), then it would be weird to say "-chan," but I wouldn't want to just say "Itsumi" either. In this case, I would say "Itsumi-shi"
I ask, "so it's kind of used in formal situations between friends?"
She replies "yeah, it can be used like that, but not always"
Me, "So, can you use it when just hanging out? Like out drinking or something?"
Her, "Yeah, there's times like that, too. But you don't do it with people with weird names"
Me, "What are weird names?"
Her, "Well, you know your friend, Casey. It would be weird to say Casey-shi, ケーシーシ, wouldn't it?"
She had no problem saying "yes, his happens," but had a difficult time trying to explain how, when, and the situations.
I think it's just instead of -chan in situations where you can't say -chan, like work, perhaps.