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Multicenter Study
. 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

Alan R Teo  1 , Michael D Fetters  2 , Kyle Stufflebam  3 , Masaru Tateno  4 , Yatan Balhara  5 , Tae Young Choi  6 , Shigenobu Kanba  7 , Carol A Mathews  8 , Takahiro A Kato  9
Affiliations
Multicenter Study

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

Alan R Teo et al. Int J Soc Psychiatry. 2015 Feb.

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.

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Figures

Figure 1
Figure 1
Top two treatment preferences of participants with hikikomori for their social withdrawal (n = 32).
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References

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