Hikikomori as a possible clinical term in psychiatry: a questionnaire survey

Abstract

Abstract Background The word hikikomori, the abnormal avoidance of social contact, has become increasingly well-known. However, a definition of this phenomenon has not been discussed thoroughly. The aim of this study is to gain a better understanding of the perception of hikikomori amongst health-related students and professionals and to explore possible psychiatric conditions underlying hikikomori. Methods A total of 1,038 subjects were requested to complete a questionnaire regarding hikikomori phenomenon. Results While some differences in the perception of hikikomori do exist, all subjects tended to disagree with the statement, “hikikomori is NOT a disorder”. Regarding the underlying psychiatric disorders of hikikomori, approximately 30% of psychiatrists chose schizophrenia as the most applicable ICD-10 diagnosis for hikikomori, whereas 50% of pediatricians chose neurotic or stress-related disorders. Conclusions An argument still exists regarding the relationship between hikikomori and psychiatric disorders. We propose that the term hikikomori could be used to describe severe social withdrawal in the setting of a number of psychiatric disorders.

Keywords

• Hikikomori
• Social withdrawal
• School refusal
• Psychiatric diagnosis
• Developmental disorders