Recently, persistent school non-attendance (PSNA) has been a big problem not only for children and adolescents but also in the society. According to the Ministry of Education, PSNA is defined as absenteeism for＞30 school days annually or “a situation in which a student is unable or unwilling to attend school because of psychological, emotional, physical, or social factors/backgrounds (excluding illness or economic reasons).” In 2021, 244,940 students of elementary and intermediate schools (50 in 1,000 intermediate school students and 13 in 1,000 elementary school students) were registered with PSNA, increasing by 24.9% from 2020. Considering the COVID-19 pandemic, the rate of increase in 2021 was remarkable. The Ministry of Education said that it is a serious problem that should be approached from the perspective that PSNA can happen to any student.

PSNA appears to be driven by overlapping medical, individual, family, and social factors. Children and adolescents complain about symptoms, such as headache and abdominal pain in the morning of school days. Home doctors should take care of the symptoms and support them. If any illness is not found, doctors should assume that they have some difficulties in their lives at school and/or home. Teachers, nurses, and psychologists in schools could support the children. If children and adolescents with PSNA refuse to contact them, they may be encouraged to attend another public educational center. Making attendance school calendars is sometimes useful as a behavior therapy. Supportive psychotherapy, separate from the guardian, is necessary and useful for children and adolescents with PSNA. Early intervention is necessary to care for their environment at school and home and/or psychosocial factors. It aims to regain spirits, find something to inspire them, and engage with the society eventually.

In the clinical practice of psychosomatic medicine, active listening, which is listening to the speaker in an empathetic and receptive manner, is an important attitude of physicians regardless of the department. Since visual inspection and palpation examination of skin lesions are important in dermatological consultation, the dermatologist must continue active listening while conducting these examination techniques, which requires some ingenuity.

Active listening helps develop a good patient-physician relationship and contributes to better outcomes. Moreover, it may enhance the humanity of physicians and develop a therapeutic self.

The psychodermatological approach is defined as seeing and treating patients’ skin holistically based on their psychological and social background. We must consider the psychological effect on skin symptoms, such as itching, chronic process, and rash on their exposed area.

Transactional analysis (TA) is a theory of personality and relationships based on the study of specific ego states. TA shows phycotherapy that is fundamentally based on structural, transactional, game, and script analyses. Egogram is important in understanding patient’s character, way of instructions of skin selfcare, and suggesting a treatment choice. We aim to control their skin symptoms and boost self-esteem to live their own ways. We often use egogram to reach this goal in daily clinical practice.

Autogenic training (AT) is a form of psychotherapy created by J. H. Schultz, a German psychiatrist, in 1932. It evolved from his work on hypnosis and was later refined by W. Luthe. Currently, AT is recognized as a main form of psychotherapy, alongside psychoanalytic and cognitive-behavioral therapies. It is known for its emphasis on self-regulation. Patients learn to relieve physical and mental tensions by repeatedly reciting short, calming phrases which aids relaxation and promotes overall health.

Originally, AT was used to treat neurosis and psychosomatic disorders, but it has been applied to a range of conditions within psychosomatic medicine. Particularly, this technique is user-friendly for dermatologists and a preferred treatment for skin-related psychosomatic conditions caused by stress and anxiety.

This study outlines the specific techniques of AT, its application for skin conditions, and important considerations for its use. Moreover, we present a case study illustrating the successful treatment of a dermatological psychosomatic disorders with AT.

Behavior therapy is a psychotherapy in which psychological intervention transforms inappropriate behavior to an appropriate behavior. This therapy includes progressive exposure, self-monitoring, habit reversal, operant conditioning, flooding method, and ordeal method. In dermatology, inappropriate behavior includes excessive scratching of a patient with atopic dermatitis, trichotillomania, skin picking, and nail biting. Cholinergic urticaria may appear in public. Excessive scratching, trichotillomania, skin picking, and nail biting are indications of self-monitoring and habit reversal. Behavioral therapy requires patients to perform tasks. Therefore, it is not effective unless patients are motivated.

Background : Breathing exercises in respiratory rehabilitation for patients with chronic obstructive pulmonary disease (COPD) have low implementation rates and issues with continuity. The keyboard harmonica is acknowledged to be useful for mastering mouth-sucking breathing ; however, there are no studies that conclusively prove this. As part of a basic study to verify the usefulness of the keyboard harmonica as an exhalation practice device, aspects of patients’subjective indices before and after playing the keyboard harmonica were examined and compared with the medically proven effectiveness of the threshold.

Method : Seventeen COPD patients with stable respiratory status were randomly assigned to the keyboard harmonica group (8 patients) or the threshold group (9 patients). Breathing exercises were performed for approximately 15 minutes, and Profile of Mood States (POMS) 2 measurements were taken before and after the breathing exercises as a measure of mood.

Results : Analysis of variance for the two factors of Total Mood Disturbance (TMD) scores in the group and after the breathing exercises were significant, with lower TMD scores after the breathing exercises compared to before the breathing exercises. Furthermore, the results of multiple regression analysis showed that housework and activity frequency were adopted as explanatory variables, with a contribution rate of 31.1%.

Conclusion : These findings suggest that breathing exercises with keyboard harmonica and thresholds have a mood-improving effect, and that people who are active on a daily basis are more likely to improve their mood. The use of a keyboard harmonica presented a new option for breathing exercises with the potential for continuity.

Objectives : To develop an 8-item premenstrual syndrome (PMS-8) scale to measure the severity of PMS as perceived by the patient, and to test its reliability and validity.

Methods : First, we developed the PMS-8 based on 8 items from the Short version of DRSP, which examines the perceived severity of premenstrual symptoms in general. Cronbach’s alpha was calculated and RMSEA and CFI were calculated by confirmatory factor analysis for PMS-8. Spearman’s correlation coefficient with the PMS-Impact scale was calculated for concurrent validity.

Results : Cronbach’s alpha for PMS-8 was 0.75, with a two-factor structure of psychological and physical factors; RMSEA was 0.08 and CFI was 0.94. Spearman’s correlation coefficient with PMS-Impact was 0.72 (p＜0.01).

Conclusion : Overall, PMS-8 demonstrated acceptable reliability and validity.