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2012 ; 47
(7
): 1061-75
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Does the hikikomori syndrome of social withdrawal exist outside Japan? A
preliminary international investigation
#MMPMID21706238
Kato TA
; Tateno M
; Shinfuku N
; Fujisawa D
; Teo AR
; Sartorius N
; Akiyama T
; Ishida T
; Choi TY
; Balhara YP
; Matsumoto R
; Umene-Nakano W
; Fujimura Y
; Wand A
; Chang JP
; Chang RY
; Shadloo B
; Ahmed HU
; Lerthattasilp T
; Kanba S
Soc Psychiatry Psychiatr Epidemiol
2012[Jul]; 47
(7
): 1061-75
PMID21706238
show ga
PURPOSE: 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. METHODS: 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. RESULTS: 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. CONCLUSIONS: 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.