A dissemination and education programme to improve the clinical behaviours of psychiatrists in accordance with treatment guidelines for schizophrenia and major depressive disorders: the Effectiveness of Guidelines for Dissemination and Education in Psychiatric Treatment (EGUIDE) project

Background Clinical practice guidelines for schizophrenia and major depressive disorder have been published. However, these have not had sufficient penetration in clinical settings. We developed the Effectiveness of Guidelines for Dissemination and Education in Psychiatric Treatment (EGUIDE) projec...

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Main Authors: Hisashi Yamada, Mikuni Motoyama, Naomi Hasegawa, Kenichiro Miura, Junya Matsumoto, Kazutaka Ohi, Norio Yasui-Furukori, Shusuke Numata, Masahiro Takeshima, Nobuhiro Sugiyama, Tatsuya Nagasawa, Chika Kubota, Kiyokazu Atake, Takashi Tsuboi, Kayo Ichihashi, Naoki Hashimoto, Takahiko Inagaki, Yoshikazu Takaesu, Jun-ichi Iga, Hikaru Hori, Toshiaki Onitsuka, Hiroshi Komatsu, Akitoyo Hishimoto, Kentaro Fukumoto, Michiko Fujimoto, Toshinori Nakamura, Kiyotaka Nemoto, Ryuji Furihata, Satoshi Yamamura, Hirotaka Yamagata, Kazuyoshi Ogasawara, Eiichi Katsumoto, Atsunobu Murata, Hitoshi Iida, Shinichiro Ochi, Manabu Makinodan, Mikio Kido, Taishiro Kishimoto, Yuka Yasuda, Masahide Usami, Taro Suwa, Ken Inada, Koichiro Watanabe, Ryota Hashimoto
Format: Article
Language:English
Published: Cambridge University Press 2022-05-01
Series:BJPsych Open
Subjects:
Online Access:https://www.cambridge.org/core/product/identifier/S2056472422000448/type/journal_article
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author Hisashi Yamada
Mikuni Motoyama
Naomi Hasegawa
Kenichiro Miura
Junya Matsumoto
Kazutaka Ohi
Norio Yasui-Furukori
Shusuke Numata
Masahiro Takeshima
Nobuhiro Sugiyama
Tatsuya Nagasawa
Chika Kubota
Kiyokazu Atake
Takashi Tsuboi
Kayo Ichihashi
Naoki Hashimoto
Takahiko Inagaki
Yoshikazu Takaesu
Jun-ichi Iga
Hikaru Hori
Toshiaki Onitsuka
Hiroshi Komatsu
Akitoyo Hishimoto
Kentaro Fukumoto
Michiko Fujimoto
Toshinori Nakamura
Kiyotaka Nemoto
Ryuji Furihata
Satoshi Yamamura
Hirotaka Yamagata
Kazuyoshi Ogasawara
Eiichi Katsumoto
Atsunobu Murata
Hitoshi Iida
Shinichiro Ochi
Manabu Makinodan
Mikio Kido
Taishiro Kishimoto
Yuka Yasuda
Masahide Usami
Taro Suwa
Ken Inada
Koichiro Watanabe
Ryota Hashimoto
author_facet Hisashi Yamada
Mikuni Motoyama
Naomi Hasegawa
Kenichiro Miura
Junya Matsumoto
Kazutaka Ohi
Norio Yasui-Furukori
Shusuke Numata
Masahiro Takeshima
Nobuhiro Sugiyama
Tatsuya Nagasawa
Chika Kubota
Kiyokazu Atake
Takashi Tsuboi
Kayo Ichihashi
Naoki Hashimoto
Takahiko Inagaki
Yoshikazu Takaesu
Jun-ichi Iga
Hikaru Hori
Toshiaki Onitsuka
Hiroshi Komatsu
Akitoyo Hishimoto
Kentaro Fukumoto
Michiko Fujimoto
Toshinori Nakamura
Kiyotaka Nemoto
Ryuji Furihata
Satoshi Yamamura
Hirotaka Yamagata
Kazuyoshi Ogasawara
Eiichi Katsumoto
Atsunobu Murata
Hitoshi Iida
Shinichiro Ochi
Manabu Makinodan
Mikio Kido
Taishiro Kishimoto
Yuka Yasuda
Masahide Usami
Taro Suwa
Ken Inada
Koichiro Watanabe
Ryota Hashimoto
author_sort Hisashi Yamada
collection DOAJ
description Background Clinical practice guidelines for schizophrenia and major depressive disorder have been published. However, these have not had sufficient penetration in clinical settings. We developed the Effectiveness of Guidelines for Dissemination and Education in Psychiatric Treatment (EGUIDE) project as a dissemination and education programme for psychiatrists. Aims The aim of this study is to assess the effectiveness of the EGUIDE project on the subjective clinical behaviour of psychiatrists in accordance with clinical practice guidelines before and 1 and 2 years after participation in the programmes. Method A total of 607 psychiatrists participated in this study during October 2016 and March 2019. They attended both 1-day educational programmes based on the clinical practice guidelines for schizophrenia and major depressive disorder, and answered web questionnaires about their clinical behaviours before and 1 and 2 years after attending the programmes. We evaluated the changes in clinical behaviours in accordance with the clinical practice guidelines between before and 2 years after the programme. Results All of the scores for clinical behaviours in accordance with clinical practice guidelines were significantly improved after 1 and 2 years compared with before attending the programmes. There were no significant changes in any of the scores between 1 and 2 years after attending. Conclusions All clinical behaviours in accordance with clinical practice guidelines improved after attending the EGUIDE programme, and were maintained for at least 2 years. The EGUIDE project could contribute to improved guideline-based clinical behaviour among psychiatrists.
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spelling doaj.art-1528f26d5d06466ca56d12f5544fc8d32023-03-09T12:29:19ZengCambridge University PressBJPsych Open2056-47242022-05-01810.1192/bjo.2022.44A dissemination and education programme to improve the clinical behaviours of psychiatrists in accordance with treatment guidelines for schizophrenia and major depressive disorders: the Effectiveness of Guidelines for Dissemination and Education in Psychiatric Treatment (EGUIDE) projectHisashi Yamada0https://orcid.org/0000-0002-0933-2330Mikuni Motoyama1Naomi Hasegawa2Kenichiro Miura3Junya Matsumoto4Kazutaka Ohi5https://orcid.org/0000-0001-9577-9640Norio Yasui-Furukori6Shusuke Numata7Masahiro Takeshima8Nobuhiro Sugiyama9Tatsuya Nagasawa10Chika Kubota11Kiyokazu Atake12Takashi Tsuboi13Kayo Ichihashi14Naoki Hashimoto15Takahiko Inagaki16Yoshikazu Takaesu17Jun-ichi Iga18Hikaru Hori19Toshiaki Onitsuka20Hiroshi Komatsu21Akitoyo Hishimoto22Kentaro Fukumoto23Michiko Fujimoto24Toshinori Nakamura25Kiyotaka Nemoto26Ryuji Furihata27Satoshi Yamamura28Hirotaka Yamagata29Kazuyoshi Ogasawara30Eiichi Katsumoto31Atsunobu Murata32Hitoshi Iida33Shinichiro Ochi34Manabu Makinodan35Mikio Kido36Taishiro Kishimoto37Yuka Yasuda38Masahide Usami39Taro Suwa40Ken Inada41Koichiro Watanabe42Ryota Hashimoto43Department of Neuropsychiatry, Hyogo College of Medicine, Japan; and Department of Pathology of Mental Diseases, National Institute of Mental Health, National Center of Neurology and Psychiatry, JapanDepartment of Neuropsychiatry, Hyogo College of Medicine, JapanDepartment of Pathology of Mental Diseases, National Institute of Mental Health, National Center of Neurology and Psychiatry, JapanDepartment of Pathology of Mental Diseases, National Institute of Mental Health, National Center of Neurology and Psychiatry, JapanDepartment of Pathology of Mental Diseases, National Institute of Mental Health, National Center of Neurology and Psychiatry, JapanDepartment of Psychiatry, Gifu University Graduate School of Medicine, JapanDepartment of Psychiatry, Dokkyo Medical University School of Medicine, JapanDepartment of Psychiatry, Graduate School of Biomedical Science, Tokushima University, JapanDepartment of Neuropsychiatry Section of Neuro and Locomotor Science, Akita University Graduate School of Medicine, JapanDepartment of Psychiatry, Shinshu University School of Medicine, Japan; and Department of Applied Occupational Therapy, Shinshu University School of Health Sciences, JapanDepartment of Neuropsychiatry, Kanazawa Medical University, JapanDepartment of Pathology of Mental Diseases, National Institute of Mental Health, National Center of Neurology and Psychiatry, JapanKyushu Health Administration Center, Nippon Telegraph and Telephone West Corporation, JapanDepartment of Neuropsychiatry, Kyorin University School of Medicine, JapanDepartment of Neuropsychiatry, University of Tokyo Hospital, JapanDepartment of Psychiatry, Hokkaido University Graduate School of Medicine, JapanAdolescent Mental Health Service, Biwako Hospital, Japan; and Department of Psychiatry, Shiga University of Medical Science, JapanDepartment of Neuropsychiatry, Graduate School of Medicine, University of the Ryukyus, JapanDepartment of Neuropsychiatry, Molecules and Function, Ehime University Graduate School of Medicine, JapanDepartment of Psychiatry, Faculty of Medicine, Fukuoka University, JapanDepartment of Neuroimaging Psychiatry, Graduate School of Medical Sciences, Kyushu University, JapanDepartment of Psychiatry, Tohoku University Hospital, JapanDepartment of Psychiatry, Yokohama City University Graduate School of Medicine, JapanDepartment of Neuropsychiatry, Iwate Medical University School of Medicine, JapanDepartment of Pathology of Mental Diseases, National Institute of Mental Health, National Center of Neurology and Psychiatry, Japan; and Department of Psychiatry, Osaka University Graduate School of Medicine, JapanDepartment of Psychiatry, Shinshu University School of Medicine, JapanDepartment of Psychiatry, Faculty of Medicine, University of Tsukuba, JapanKyoto University Health Service, JapanSuzuka Kosei Hospital, JapanDivision of Neuropsychiatry, Department of Neuroscience, Yamaguchi University School of Medicine, JapanCenter for Postgraduate Clinical Training and Career Development, Nagoya University Hospital, JapanKatsumoto Mental Clinic, JapanDepartment of Pathology of Mental Diseases, National Institute of Mental Health, National Center of Neurology and Psychiatry, JapanDepartment of Psychiatry, Faculty of Medicine, Fukuoka University, JapanDepartment of Neuropsychiatry, Molecules and Function, Ehime University Graduate School of Medicine, JapanDepartment of Psychiatry, Faculty of Medicine, Nara Medical University, JapanDepartment of Psychiatry, Toyama City Hospital, Japan; and Department of Neuropsychiatry, University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, JapanDepartment of Neuropsychiatry, Keio University School of Medicine, JapanDepartment of Pathology of Mental Diseases, National Institute of Mental Health, National Center of Neurology and Psychiatry, Japan; and Life Grow Brilliant Mental Clinic, Medical Corporation Foster, JapanDepartment of Child and Adolescent Psychiatry, Kohnodai Hospital, National Center for Global Health and Medicine, JapanDepartment of Psychiatry, Graduate School of Medicine, Kyoto University, JapanDepartment of Psychiatry, Tokyo Women's Medical University, JapanDepartment of Neuropsychiatry, Kyorin University School of Medicine, JapanDepartment of Pathology of Mental Diseases, National Institute of Mental Health, National Center of Neurology and Psychiatry, Japan Background Clinical practice guidelines for schizophrenia and major depressive disorder have been published. However, these have not had sufficient penetration in clinical settings. We developed the Effectiveness of Guidelines for Dissemination and Education in Psychiatric Treatment (EGUIDE) project as a dissemination and education programme for psychiatrists. Aims The aim of this study is to assess the effectiveness of the EGUIDE project on the subjective clinical behaviour of psychiatrists in accordance with clinical practice guidelines before and 1 and 2 years after participation in the programmes. Method A total of 607 psychiatrists participated in this study during October 2016 and March 2019. They attended both 1-day educational programmes based on the clinical practice guidelines for schizophrenia and major depressive disorder, and answered web questionnaires about their clinical behaviours before and 1 and 2 years after attending the programmes. We evaluated the changes in clinical behaviours in accordance with the clinical practice guidelines between before and 2 years after the programme. Results All of the scores for clinical behaviours in accordance with clinical practice guidelines were significantly improved after 1 and 2 years compared with before attending the programmes. There were no significant changes in any of the scores between 1 and 2 years after attending. Conclusions All clinical behaviours in accordance with clinical practice guidelines improved after attending the EGUIDE programme, and were maintained for at least 2 years. The EGUIDE project could contribute to improved guideline-based clinical behaviour among psychiatrists. https://www.cambridge.org/core/product/identifier/S2056472422000448/type/journal_articleClinical practice guidelineseducational programmeschizophreniamajor depressive disorderEGUIDE project
spellingShingle Hisashi Yamada
Mikuni Motoyama
Naomi Hasegawa
Kenichiro Miura
Junya Matsumoto
Kazutaka Ohi
Norio Yasui-Furukori
Shusuke Numata
Masahiro Takeshima
Nobuhiro Sugiyama
Tatsuya Nagasawa
Chika Kubota
Kiyokazu Atake
Takashi Tsuboi
Kayo Ichihashi
Naoki Hashimoto
Takahiko Inagaki
Yoshikazu Takaesu
Jun-ichi Iga
Hikaru Hori
Toshiaki Onitsuka
Hiroshi Komatsu
Akitoyo Hishimoto
Kentaro Fukumoto
Michiko Fujimoto
Toshinori Nakamura
Kiyotaka Nemoto
Ryuji Furihata
Satoshi Yamamura
Hirotaka Yamagata
Kazuyoshi Ogasawara
Eiichi Katsumoto
Atsunobu Murata
Hitoshi Iida
Shinichiro Ochi
Manabu Makinodan
Mikio Kido
Taishiro Kishimoto
Yuka Yasuda
Masahide Usami
Taro Suwa
Ken Inada
Koichiro Watanabe
Ryota Hashimoto
A dissemination and education programme to improve the clinical behaviours of psychiatrists in accordance with treatment guidelines for schizophrenia and major depressive disorders: the Effectiveness of Guidelines for Dissemination and Education in Psychiatric Treatment (EGUIDE) project
BJPsych Open
Clinical practice guidelines
educational programme
schizophrenia
major depressive disorder
EGUIDE project
title A dissemination and education programme to improve the clinical behaviours of psychiatrists in accordance with treatment guidelines for schizophrenia and major depressive disorders: the Effectiveness of Guidelines for Dissemination and Education in Psychiatric Treatment (EGUIDE) project
title_full A dissemination and education programme to improve the clinical behaviours of psychiatrists in accordance with treatment guidelines for schizophrenia and major depressive disorders: the Effectiveness of Guidelines for Dissemination and Education in Psychiatric Treatment (EGUIDE) project
title_fullStr A dissemination and education programme to improve the clinical behaviours of psychiatrists in accordance with treatment guidelines for schizophrenia and major depressive disorders: the Effectiveness of Guidelines for Dissemination and Education in Psychiatric Treatment (EGUIDE) project
title_full_unstemmed A dissemination and education programme to improve the clinical behaviours of psychiatrists in accordance with treatment guidelines for schizophrenia and major depressive disorders: the Effectiveness of Guidelines for Dissemination and Education in Psychiatric Treatment (EGUIDE) project
title_short A dissemination and education programme to improve the clinical behaviours of psychiatrists in accordance with treatment guidelines for schizophrenia and major depressive disorders: the Effectiveness of Guidelines for Dissemination and Education in Psychiatric Treatment (EGUIDE) project
title_sort dissemination and education programme to improve the clinical behaviours of psychiatrists in accordance with treatment guidelines for schizophrenia and major depressive disorders the effectiveness of guidelines for dissemination and education in psychiatric treatment eguide project
topic Clinical practice guidelines
educational programme
schizophrenia
major depressive disorder
EGUIDE project
url https://www.cambridge.org/core/product/identifier/S2056472422000448/type/journal_article
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AT kayoichihashi disseminationandeducationprogrammetoimprovetheclinicalbehavioursofpsychiatristsinaccordancewithtreatmentguidelinesforschizophreniaandmajordepressivedisorderstheeffectivenessofguidelinesfordisseminationandeducationinpsychiatrictreatmenteguideproject
AT naokihashimoto disseminationandeducationprogrammetoimprovetheclinicalbehavioursofpsychiatristsinaccordancewithtreatmentguidelinesforschizophreniaandmajordepressivedisorderstheeffectivenessofguidelinesfordisseminationandeducationinpsychiatrictreatmenteguideproject
AT takahikoinagaki disseminationandeducationprogrammetoimprovetheclinicalbehavioursofpsychiatristsinaccordancewithtreatmentguidelinesforschizophreniaandmajordepressivedisorderstheeffectivenessofguidelinesfordisseminationandeducationinpsychiatrictreatmenteguideproject
AT yoshikazutakaesu disseminationandeducationprogrammetoimprovetheclinicalbehavioursofpsychiatristsinaccordancewithtreatmentguidelinesforschizophreniaandmajordepressivedisorderstheeffectivenessofguidelinesfordisseminationandeducationinpsychiatrictreatmenteguideproject
AT junichiiga disseminationandeducationprogrammetoimprovetheclinicalbehavioursofpsychiatristsinaccordancewithtreatmentguidelinesforschizophreniaandmajordepressivedisorderstheeffectivenessofguidelinesfordisseminationandeducationinpsychiatrictreatmenteguideproject
AT hikaruhori disseminationandeducationprogrammetoimprovetheclinicalbehavioursofpsychiatristsinaccordancewithtreatmentguidelinesforschizophreniaandmajordepressivedisorderstheeffectivenessofguidelinesfordisseminationandeducationinpsychiatrictreatmenteguideproject
AT toshiakionitsuka disseminationandeducationprogrammetoimprovetheclinicalbehavioursofpsychiatristsinaccordancewithtreatmentguidelinesforschizophreniaandmajordepressivedisorderstheeffectivenessofguidelinesfordisseminationandeducationinpsychiatrictreatmenteguideproject
AT hiroshikomatsu disseminationandeducationprogrammetoimprovetheclinicalbehavioursofpsychiatristsinaccordancewithtreatmentguidelinesforschizophreniaandmajordepressivedisorderstheeffectivenessofguidelinesfordisseminationandeducationinpsychiatrictreatmenteguideproject
AT akitoyohishimoto disseminationandeducationprogrammetoimprovetheclinicalbehavioursofpsychiatristsinaccordancewithtreatmentguidelinesforschizophreniaandmajordepressivedisorderstheeffectivenessofguidelinesfordisseminationandeducationinpsychiatrictreatmenteguideproject
AT kentarofukumoto disseminationandeducationprogrammetoimprovetheclinicalbehavioursofpsychiatristsinaccordancewithtreatmentguidelinesforschizophreniaandmajordepressivedisorderstheeffectivenessofguidelinesfordisseminationandeducationinpsychiatrictreatmenteguideproject
AT michikofujimoto disseminationandeducationprogrammetoimprovetheclinicalbehavioursofpsychiatristsinaccordancewithtreatmentguidelinesforschizophreniaandmajordepressivedisorderstheeffectivenessofguidelinesfordisseminationandeducationinpsychiatrictreatmenteguideproject
AT toshinorinakamura disseminationandeducationprogrammetoimprovetheclinicalbehavioursofpsychiatristsinaccordancewithtreatmentguidelinesforschizophreniaandmajordepressivedisorderstheeffectivenessofguidelinesfordisseminationandeducationinpsychiatrictreatmenteguideproject
AT kiyotakanemoto disseminationandeducationprogrammetoimprovetheclinicalbehavioursofpsychiatristsinaccordancewithtreatmentguidelinesforschizophreniaandmajordepressivedisorderstheeffectivenessofguidelinesfordisseminationandeducationinpsychiatrictreatmenteguideproject
AT ryujifurihata disseminationandeducationprogrammetoimprovetheclinicalbehavioursofpsychiatristsinaccordancewithtreatmentguidelinesforschizophreniaandmajordepressivedisorderstheeffectivenessofguidelinesfordisseminationandeducationinpsychiatrictreatmenteguideproject
AT satoshiyamamura disseminationandeducationprogrammetoimprovetheclinicalbehavioursofpsychiatristsinaccordancewithtreatmentguidelinesforschizophreniaandmajordepressivedisorderstheeffectivenessofguidelinesfordisseminationandeducationinpsychiatrictreatmenteguideproject
AT hirotakayamagata disseminationandeducationprogrammetoimprovetheclinicalbehavioursofpsychiatristsinaccordancewithtreatmentguidelinesforschizophreniaandmajordepressivedisorderstheeffectivenessofguidelinesfordisseminationandeducationinpsychiatrictreatmenteguideproject
AT kazuyoshiogasawara disseminationandeducationprogrammetoimprovetheclinicalbehavioursofpsychiatristsinaccordancewithtreatmentguidelinesforschizophreniaandmajordepressivedisorderstheeffectivenessofguidelinesfordisseminationandeducationinpsychiatrictreatmenteguideproject
AT eiichikatsumoto disseminationandeducationprogrammetoimprovetheclinicalbehavioursofpsychiatristsinaccordancewithtreatmentguidelinesforschizophreniaandmajordepressivedisorderstheeffectivenessofguidelinesfordisseminationandeducationinpsychiatrictreatmenteguideproject
AT atsunobumurata disseminationandeducationprogrammetoimprovetheclinicalbehavioursofpsychiatristsinaccordancewithtreatmentguidelinesforschizophreniaandmajordepressivedisorderstheeffectivenessofguidelinesfordisseminationandeducationinpsychiatrictreatmenteguideproject
AT hitoshiiida disseminationandeducationprogrammetoimprovetheclinicalbehavioursofpsychiatristsinaccordancewithtreatmentguidelinesforschizophreniaandmajordepressivedisorderstheeffectivenessofguidelinesfordisseminationandeducationinpsychiatrictreatmenteguideproject
AT shinichiroochi disseminationandeducationprogrammetoimprovetheclinicalbehavioursofpsychiatristsinaccordancewithtreatmentguidelinesforschizophreniaandmajordepressivedisorderstheeffectivenessofguidelinesfordisseminationandeducationinpsychiatrictreatmenteguideproject
AT manabumakinodan disseminationandeducationprogrammetoimprovetheclinicalbehavioursofpsychiatristsinaccordancewithtreatmentguidelinesforschizophreniaandmajordepressivedisorderstheeffectivenessofguidelinesfordisseminationandeducationinpsychiatrictreatmenteguideproject
AT mikiokido disseminationandeducationprogrammetoimprovetheclinicalbehavioursofpsychiatristsinaccordancewithtreatmentguidelinesforschizophreniaandmajordepressivedisorderstheeffectivenessofguidelinesfordisseminationandeducationinpsychiatrictreatmenteguideproject
AT taishirokishimoto disseminationandeducationprogrammetoimprovetheclinicalbehavioursofpsychiatristsinaccordancewithtreatmentguidelinesforschizophreniaandmajordepressivedisorderstheeffectivenessofguidelinesfordisseminationandeducationinpsychiatrictreatmenteguideproject
AT yukayasuda disseminationandeducationprogrammetoimprovetheclinicalbehavioursofpsychiatristsinaccordancewithtreatmentguidelinesforschizophreniaandmajordepressivedisorderstheeffectivenessofguidelinesfordisseminationandeducationinpsychiatrictreatmenteguideproject
AT masahideusami disseminationandeducationprogrammetoimprovetheclinicalbehavioursofpsychiatristsinaccordancewithtreatmentguidelinesforschizophreniaandmajordepressivedisorderstheeffectivenessofguidelinesfordisseminationandeducationinpsychiatrictreatmenteguideproject
AT tarosuwa disseminationandeducationprogrammetoimprovetheclinicalbehavioursofpsychiatristsinaccordancewithtreatmentguidelinesforschizophreniaandmajordepressivedisorderstheeffectivenessofguidelinesfordisseminationandeducationinpsychiatrictreatmenteguideproject
AT keninada disseminationandeducationprogrammetoimprovetheclinicalbehavioursofpsychiatristsinaccordancewithtreatmentguidelinesforschizophreniaandmajordepressivedisorderstheeffectivenessofguidelinesfordisseminationandeducationinpsychiatrictreatmenteguideproject
AT koichirowatanabe disseminationandeducationprogrammetoimprovetheclinicalbehavioursofpsychiatristsinaccordancewithtreatmentguidelinesforschizophreniaandmajordepressivedisorderstheeffectivenessofguidelinesfordisseminationandeducationinpsychiatrictreatmenteguideproject
AT ryotahashimoto disseminationandeducationprogrammetoimprovetheclinicalbehavioursofpsychiatristsinaccordancewithtreatmentguidelinesforschizophreniaandmajordepressivedisorderstheeffectivenessofguidelinesfordisseminationandeducationinpsychiatrictreatmenteguideproject