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.
Background-Hikikomori, a form of social withdrawal first reported in Japan, may exist globally but cross-national studies of cases of hikikomori are lacking.
Due to the lack of a common acceptable model across all countries, namely the same numbers of factors (i.e., dimensional invariance), it was not possible to perform the metric and scalar invariance test, what indicates that the SDQ self-report models tested lack appropriate measurement invariance across adolescents from these seven nations and it needs to be revised for cross-country comparisons.
As injectable therapies such as human insulin, insulin analogs, and glucagon-like peptide-1 receptor agonists are used to manage diabetes, correct injection technique is vital for the achievement of glycemic control. The forum for injection technique India acknowledged this need for the first time in India and worked to develop evidence-based recommendations on insulin injection technique, to assist healthcare practitioners in their clinical practice.
Background:Compassion fatigue is a broad term comprising of two components – burnout and secondary traumatic stress. The current study is aimed at identifying ‘burnout’ and ‘compassion fatigue’ among clinicians involved in care of individuals suffering from medical illness.Materials and Methods:A total of 60 clinicians were included in the study. A semi-structured questionnaire was administered to gather information related to personal, professional, anthropometric, and metabolic profile of the study participants. Professional Quality of Life Scale (ProQoL Version V) was used to assess burnout, compassion satisfaction and secondary traumatic stress. Analysis was carried out using the SPSS version 19.0.Results:The mean age of clinicians was 46.68±11.06 (range 26-67 years). Burnout score was significantly higher in those involved in diabetology practice. Similarly, compassion satisfaction score was greater among those with greater years of practice as well as among those in private practice. Clinicians who reported a poor working condition, as opposed to good, had more burnout and less compassion satisfaction.Conclusion:The current study suggests that it is important to find out ways of decreasing burnout and compassion fatigue among clinicians.
Study has added to the currently limited data on prevalence of mental health problems among adolescents in developing countries. It further established that socioeconomic and family factors still play a major role in the mental health of children irrespective of region of the world. Significant but surmountable methodological issues for a larger scale study were raised.
Dhat syndrome is described as a culture bound syndrome (CBS). There is an ongoing debate on the nosological status of CBS. Dhat syndrome has been found to be prevalent in different geographical regions of the world. It has been described in literature from China, Europe, Americas, and Russia at different points of time in history. Mention of semen as a “soul substance” could be found in the works of Galen and Aristotle who have explained the physical and psychological features associated with its loss. However, the current classification systems such as International Statistical Classification of Diseases and Related Health Conditions-10 (ICD-10) (World Health Organization (WHO)) and Diagnostic and Statistical Manual (DSM)-IV-TR (American Psychiatric Association) do not give guidelines to diagnose these culture-bound conditions in the main text. The revisions of these two most commonly used nosological systems (the ICD and DSM) are due in near future. The status of this condition in these upcoming revisions is likely to have important implications. The article reviews the existing literature on dhat syndrome.
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