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Int J Soc Psychiatry. 2015 Feb;61(1):64-72. doi: 10.1177/0020764014535758. Epub 2014 May 27.

Identification of the hikikomori syndrome of social withdrawal: Psychosocial features and treatment preferences in four countries.

Author information

1
Portland VA Medical Center, Health Services Research & Development, Portland, OR, USA teoa@ohsu.edu takahiro@npsych.med.kyushu-u.ac.jp.
2
Japanese Family Health Program, Department of Family Medicine, University of Michigan, Ann Arbor, MI, USA.
3
Robert Wood Johnson Foundation Clinical Scholars Program, University of Michigan, Ann Arbor, MI, USA.
4
Sapporo Hana Developmental Psychiatry Clinic, Department of Neuropsychiatry, Sapporo Medical University, Hokkaido, Japan.
5
National Drug Dependence Treatment Centre, All India Institute of Medical Sciences (AIIMS), New Delhi, India.
6
Department of Psychiatry, Catholic University of Daegu School of Medicine, Daegu, South Korea.
7
Department of Neuropsychiatry, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
8
Department of Psychiatry, University of California San Francisco, San Francisco, CA, USA.
9
Department of Neuropsychiatry, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan Innovation Center for Medical Redox Navigation, Kyushu University, Fukuoka, Japan.

Abstract

BACKGROUND:

Hikikomori, a form of social withdrawal first reported in Japan, may exist globally but cross-national studies of cases of hikikomori are lacking.

AIMS:

To identify individuals with hikikomori in multiple countries and describe features of the condition.

METHOD:

Participants were recruited from sites in India, Japan, Korea and the United States. Hikikomori was defined as a 6-month or longer period of spending almost all time at home and avoiding social situations and social relationships, associated with significant distress/impairment. Additional measures included the University of California, Los Angeles (UCLA) Loneliness Scale, Lubben Social Network Scale (LSNS-6), Sheehan Disability Scale (SDS) and modified Cornell Treatment Preferences Index.

RESULTS:

A total of 36 participants with hikikomori were identified, with cases detected in all four countries. These individuals had high levels of loneliness (UCLA Loneliness Scale M = 55.4, SD = 10.5), limited social networks (LSNS-6 M = 9.7, SD = 5.5) and moderate functional impairment (SDS M = 16.5, SD = 7.9). Of them 28 (78%) desired treatment for their social withdrawal, with a significantly higher preference for psychotherapy over pharmacotherapy, in-person over telepsychiatry treatment and mental health specialists over primary care providers. Across countries, participants with hikikomori had similar generally treatment preferences and psychosocial features.

CONCLUSION:

Hikikomori exists cross-nationally and can be assessed with a standardized assessment tool. Individuals with hikikomori have substantial psychosocial impairment and disability, and some may desire treatment.

KEYWORDS:

Social isolation; cross-national; culture

PMID:
24869848
PMCID:
PMC5573567
DOI:
10.1177/0020764014535758
[Indexed for MEDLINE]
Free PMC Article

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