This section is an overview of psychodermatology in Japan. Because skin locates at the interface of the body and environment, it holds strong psychosomatic correlation. The relationship between skin disorders and psychology will be categorized as follows ; psychosomatic diseases, psychological abnormalities caused by disfiguring skin diseases, skin disorders induced by psychological diseases, and others. The history of the psychosomatic dermatology in Japan and the development of Japanese Society of Psychosomatic Dermatology are noted and the future task of the society is discussed.

Skin diseases affect patients’ life quality in a various aspect of their life. Pruritus and appearance, which affect patients’ body image, are serious problems that influence patients’ life quality. To estimate the quality of life and body image of dermatology patients, a variety of questionnaires have been developed including those for family members of the patients and children suffering from skin diseases.

There have been many studies about the impact of skin diseases on patients’ quality of life. In addition, quality of life is becoming a marker of patients’ outcome in interventional studies of medical treatment. Researchers should consider clinically significant changes of patients’ life quality. Recently QALY has been applied to evaluate the cost effectiveness of medical treatment for skin diseases.

In daily practice, the author provides psychological care for the patients with dermatological disorders applying Morita therapy as a principal method while combining various techniques such as reframing. The author understands Morita’s theory as a guide for life rather than psychotherapy, and believes it to be useful for the patients who live in difficult situations holding anxiety and conflicts. In order to have the patients engage seriously in the therapist’s instructions, the therapist needs to stay fully present to what they are feeling. It is important to note empathic capabilities, reflections, and positive sides. It is also important that the therapist himself engages in the treatment with the attitude to aspire for the arugamama way of life.

While learning various techniques of brief psychotherapy and making their clinical applications, now the author thinks that he has come to structure his psychosomatic medical therapy for dermatology by adopting their essences for his own clinic without paying particular attention to one method. In addition, the author introduced the framework of our treatment and reported on a patient of atopic dermatitis who was treated by a systems approach considering his father who did not visit the hospital.

In psychodermatology, psychotropics are used in addition to ordinary dermatological therapy. These medicines are used not only in psychosomatic state but also in primary psychiatric disorder, secondary psychiatric disorder and mucocutaneous dysesthesia. Besides these conditions, psychotropics are useful in case of intractable itch and scratch. In most cases, sedatives, hypnotics and antidepressants are used. But in some other disorders, antipsychotics and anticonvulsants are used. Pharmacological therapy does not need a special technique and time as in psychotherapy. It is a simple and useful therapy for general dermatologists. It should be much more distributed to dermatologists.

Psychologists play multiple roles in dermatology. For example, it is thought that the support to dermatology treatment and a psychological problem that upset the everyday life is important. There are multiple dermatological diseases that require psychological support. From the perspective of psychosomatic medicine, it is necessary to think about providing psychological support to the skin diseases based on the mind-body correlation.

This report describes the psychological problem of atopic dermatitis and acne that are related to a state of mind and a symptom. From the psychologist’s perspective, the reporter comments on the need and concrete contents of the psychological support required for patients with atopic dermatitis and acne.

Objective : Psychosocial stress can result in various physical symptoms. Fever is one such symptom ; however, fever can also be an important indicator of a serious disease. Parents of a child with psychogenic fever can be confused about this symptom and worried that the child has a serious illness, a situation that can be difficult to manage. The purpose of this study was to clarify the characteristics and treatment of psychogenic fever.

Methods : This study included 16 pediatric patients (4 boys and 12 girls), with an average age of 12.2±1.8 years (median age, 13 years), whose chief complaint was fever and who attended the child psychological treatment unit of Okayama University Hospital. We investigated the timing of onset of the fever, comorbidity, treatment, and outcome.

Results : Among the 16 patients, 12 had poor attendance at school and 13 experienced difficulties with adapting to school. Three patients had suffered child abuse. Comorbidities included developmental disability and orthostatic dysregulation (OD). The mean treatment period was 28.9 months (median, 22.5 months), after which nine were cured, one improved, two were stable, one discontinued treatment, and three were transferred to the Department of Psychiatry.

Conclusions : These patients with psychogenic fever had experienced various psychosocial problems, and it was important for them and their families to ensure the child’s safety through appropriate physical conditions and environment. When an opportunity to address the psychogenic fever was clear, it was easy to resolve the symptoms ; for example, children with developmental disability often improved through adjustment of the environment. However, if the psychological causes were uncertain, it was difficult to bring about improvement because this needed growth of both the child’s mind and body, taking a long period of time to improve the psychogenic fever and the child’s adjustment disability.