Does the ‘hikikomori’ syndrome of social withdrawal exist outside Japan? A preliminary international investigation
- 3.5k Downloads
To explore whether the ‘hikikomori’ syndrome (social withdrawal) described in Japan exists in other countries, and if so, how patients with the syndrome are diagnosed and treated.
Two hikikomori case vignettes were sent to psychiatrists in Australia, Bangladesh, India, Iran, Japan, Korea, Taiwan, Thailand and the USA. Participants rated the syndrome’s prevalence in their country, etiology, diagnosis, suicide risk, and treatment.
Out of 247 responses to the questionnaire (123 from Japan and 124 from other countries), 239 were enrolled in the analysis. Respondents’ felt the hikikomori syndrome is seen in all countries examined and especially in urban areas. Biopsychosocial, cultural, and environmental factors were all listed as probable causes of hikikomori, and differences among countries were not significant. Japanese psychiatrists suggested treatment in outpatient wards and some did not think that psychiatric treatment is necessary. Psychiatrists in other countries opted for more active treatment such as hospitalization.
Patients with the hikikomori syndrome are perceived as occurring across a variety of cultures by psychiatrists in multiple countries. Our results provide a rational basis for study of the existence and epidemiology of hikikomori in clinical or community populations in international settings.
KeywordsHikikomori Social withdrawal Taijin kyofusho Amae Internet addiction
The present study was supported by the World Psychiatric Association (WPA) Research Fund 2010, and a grant from Japan Foundation for Neuroscience and Mental Health (both to T.A.K.). We thank the Japan Young Psychiatrists Organization (JYPO) for promoting our research activity. We are grateful to Drs. Horikawa H, Kuga H, Tanaka M and Barroilhet S for their cooperation.
Conflict of interest
All authors declare that they have no conflicts of interest.
- 1.Tseng WS (2001) Handbook of cultural psychiatry. Academic Press, San DiegoGoogle Scholar
- 5.Saito T (1998) Social Withdrawal (Shakaiteki Hikikomori). PHP Shinsho (in Japanese), TokyoGoogle Scholar
- 13.Lee KM, Koo JG, Kim EJ, Lee SH (2001) The psychosocial characteristics of oiettolie adolescents (in Korean). Korean J Counsel Psychother 13(1):147–162Google Scholar
- 15.Kano R, Kondo N (2000) Seinen no Hikikomori (Adolescent Social Withdrawal) (in Japanese). Iwasaki gakuzyutsu shuppansha, TokyoGoogle Scholar
- 17.Saito K (2010) Hikikomori No Hyouka-Shien Ni Kansuru Gaido-Rain [Guideline of Hikikomori for their evaluations and supports]. Ministry of Health, Labour and Welfare (http://www.ncgmkohnodai.go.jp/pdf/jidouseishin/22ncgm_hikikomori.pdf), Tokyo
- 21.Eichelsheim VI, Buist KL, Dekovic M, Wissink IB, Frijns T, van Lier PA, Koot HM, Meeus WH (2010) Associations among the parent-adolescent relationship, aggression and delinquency in different ethnic groups: a replication across two Dutch samples. Soc Psychiatry Psychiatr Epidemiol 45(3):293–300PubMedCrossRefGoogle Scholar
- 24.Kitayama O, Saito T, Watanabe T, Muto S (2001) Zadankai Hikikomori Ni Tsuite (Forum Hikikomori)(in Japanese). In: Watanabe T, Muto S (eds) Gendai No Esprit 403-Hikikomori-. Shibundo, Tokyo, pp 5–34Google Scholar
- 25.Doi T (1973) The anatomy of dependence. Kodensha International, TokyoGoogle Scholar
- 26.Kato T (2008) The significance of communicating with neighbors for young psychiatrists. World Cult Psychiatr Res Rev 3(4):219–225. http://www.wcprr.org/pdf/03-04/2008.04.219225.pdf
- 29.Kinugasa T (1998) Young Adults and withdrawal (Yangu Adaruto No Hikikomori) (in Japanese). Rinsho Shinkeigaku 27:147–152Google Scholar
- 30.Mann JJ, Apter A, Bertolote J, Beautrais A, Currier D, Haas A, Hegerl U, Lonnqvist J, Malone K, Marusic A, Mehlum L, Patton G, Phillips M, Rutz W, Rihmer Z, Schmidtke A, Shaffer D, Silverman M, Takahashi Y, Varnik A, Wasserman D, Yip P, Hendin H (2005) Suicide prevention strategies: a systematic review. JAMA 294(16):2064–2074PubMedCrossRefGoogle Scholar
- 34.American Psychiatric Association (2000) Diagnostic and statistical manual of mental disorders (4th edn). American Psychiatric Association, Washington (DC)Google Scholar
- 36.Nakamura K, Shioji R (1997) Taijin kyoufushou to hikikomori (in Japanese). Rinshou Seishin Igaku (Clin Psychiatry) 26:1169–1176Google Scholar
- 39.Kenny MG (1983) Paradox lost. The latah problem revisited. J Nerv Ment Dis 171(3):159–167Google Scholar
- 45.Hagihara A, Miyazaki S, Tarumi K (2010) Internet use and suicide among younger age groups between 1989 and 2008 in Japan. Acta Psychiatr Scand 121(6):485; author reply 485–486Google Scholar
- 49.Kato TA, Tateno M, Umene-Nakano W, Balhara YP, Teo AR, Fujisawa D, Sasaki R, Ishida T, Kanba S (2010) Impact of biopsychosocial factors on psychiatric training in Japan and overseas: are psychiatrists oriented to mind, brain, or sociocultural issues? Psychiatry Clin Neurosci 64(5):520–530PubMedCrossRefGoogle Scholar