General condition of hikikomori (prolonged social withdrawal) in Japan: Psychiatric diagnosis and outcome in mental health welfare centres
The issue of hikikomori (prolonged social withdrawal) among Japanese youth has attracted attention from international experts. According to the epidemiology of hikikomori in a community population, a total of 1.2% had experienced the phenomenon in their lifetime. Many people suffer from hikikomori in Japan. For the first time this research analyzed the psychiatric background of sufferers whereas previous studies examined the unique social and cultural factors contributing to this phenomenon of social isolation. The participants in this study who sought help during the consultation and support process were classified as the ‘help-seeking group’. A third of subjects within this group were diagnosed with mental health conditions ranging between schizophrenia, mood disorders and anxiety disorders and this group needed pharmacotherapy. Other subjects were diagnosed with personality disorders or pervasive developmental disorders and they mainly needed psycho-social support. This study confirms that hikikomori is more than a social-cultural issue, and inclusion of mental health problems and mental disorders is therefore necessary. There is little doubt that sufferers are much worse if they do not seek help.
Aim: We examined the psychiatric background of individuals with hikikomori.
Methods: We recruited 337 individuals with hikikomori; 183 subjects who utilized the centres were designated as the help-seeking group. We examined the multi-axial psychiatric diagnosis based on the DSM-IV-TR, treatment policies and treatment outcomes. We also examined 154 subjects who did not utilize the centers (non-help-seeking group).
Results: Most of the subjects in the utilization group were classified into one of the diagnostic categories. Forty-nine (33.3%) subjects were diagnosed with schizophrenia, mood disorders or anxiety disorders, and this group needed pharmacotherapy. Other subjects were diagnosed with personality disorders or pervasive developmental disorders, and they mainly needed psycho-social support. The Global Assessment of Functioning (GAF) scores of the non-help-seeking group were significantly lower than the GAF scores of those who used treatments.
Conclusion: Most hikikomori cases can be diagnosed using current diagnostic criteria. Individuals
Kondo, N., Sakai, M., Kuroda, Y., Kiyota, Y., Kitabata, Y., & Kurosawa, M. (2011). General condition of hikikomori (prolonged social withdrawal) in Japan: Psychiatric diagnosis and outcome in mental health welfare centres International Journal of Social Psychiatry DOI: 10.1177/0020764011423611