Development of a Taiwanese computerized database for psychiatric consultation in a general hospital.

OBJECTIVE: The aim of this study was to evaluate the applicability of a modified questionnaire in psychiatric consultation and a new computerized software at one general hospital in Taiwan. METHOD: The Micro-Cares Clinical Information System for Consultation/Liaison Psychiatry (CISCL), an English language-based patient management application, has multiple clinical variables that were translated into Mandarin Chinese. The Mandarin Chinese version of the Micro-Cares Questionnaire (MCMQ) was further modified after extensive testing and clinical use by two staff psychiatrists and eight senior resident doctors. In addition, the structure of the Mandarin Chinese version of the Micro-Cares CISCL Program (MCMP) was created for direct information entry through a specialized Microsoft Access-based support module. RESULTS: The MCMQ has been adapted to regular medical practice. Up to 66% of the consultation cases (618/913 patients) were recorded in 2003. Among those registered, 519 (84%) received psychiatric diagnoses. Eight of the 10 participants evaluated agreed that the MCMQ was clinically applicable. CONCLUSION: MCMQ and MCMP have been routinely applied in the clinical, administrative, research and educational services of our psychiatric consultation.

Mindfulness meditation training combined with eye movement desensitization and reprocessing in psychotherapy of an elderly patient.

We present our experiences with an elderly patient with depression that was attributed to a surge of physical ailments who also had trauma-derived fear of having to undergo a tracheotomy. He refused pharmacotherapy and was offered intensive training in Mindfulness Meditation (MM) plus Eye Movement Desensitization and Reprocessing (EMDR) therapy during the 2 weeks of hospitalization. This treatment combination had not been used previously. We suggest that EMDR eliminated his fear of surgery, whereas MM relieved his depression and attendant anxiety. However, the two techniques appeared to work synergistically. Following his discharge, he continued to practice MM, which prevented the recurrence of emotional distress, and even helped to reduce its causative physical symptoms. We offer an explanation for the success of our combined treatments and discuss the potential usefulness in specific psychotherapeutic situations. We also propose a place for MM within general geriatric care, and point out the reluctance to consider the therapeutic value of meditation.

Mindfulness meditation in the control of severe headache.

In the West, the use of the methods of alternative medicine, including meditation, has been on the rise. In the US, Kabat-Zinn and associates have pioneered the extensive use of mindfulness meditation (MM) for the treatment of people facing pain and illness. Among the essentials of MM is the observation of bodily sensations, including pain. In Taiwan, despite the deep cultural roots of meditation, its therapeutic use has received little attention from institutionalized medicine. We report on the case of a man who was prone to developing severe headaches due to activities requiring extreme concentration. He learned to control his pain and discomfort through mindfulness meditation, although this practice in fact induced headaches initially. It is suggested that training in MM may be a medically superior and cost-effective alternative to pain medication for the control of headaches with no underlying organic causes in highly motivated patients.