Hikikomori Phenomenon in East Asia: Regional Perspectives, Challenges, and Opportunities for Social Health Agencies

Abstract

Hikikomori, which originated in Japan, refers to the condition where youths withdraw into the home and do not participate in society for an extended period of time. Recent updates on hikikomori presentation within the region were exchanged at a Hikikomori Round Table and Regional Symposium (HRTRS) discussion late 2017, leading to this perspective paper. Hikikomori presents as an overall homogeneous construct, while diversity in clinical presentation exists across East Asian countries. We examined the various presentations, risk factors, theoretical frameworks, and classification issues about hikikomori. In particular, specific risk factors have emerged to some degree across the region, while some are more locale specific. We propose that hikikomori youths have differential onset and developmental patterns, potentially resulting in heterogeneous presentation. We briefly summarized existing interventions in the East Asian region. Intervention strategies need to be tailored to different subtypes. A multicomponent approach would address complexity, multifactorial onset, and development of the condition. The HRTRS presented to participating countries the opportunity to collectively work toward a more universal definition of the hikikomori condition and explored innovative ways to shape existing service structures. Opportunities for participating countries described pertain to early detection of cases, adoption of assessment tools, and improved intervention services.

Hikikomori and the COVID-19 pandemic: not leaving behind the socially withdrawn

“…4,6 Family interventions, comorbidity treatment, online interventions, physical activity, multiple psychotherapeutic approaches, social skills training, etc., have been indicated as potentially useful strategies for hikikomori cases. 3,[7][8][9][10][11] Nevertheless, the evidence to support these treatment approaches is weak, mainly due to a lack of studies on the topic. 3,6 In 2020, updated diagnostic criteria 4 were proposed for hikikomori, with the inclusion of a severity classification based on the weekly frequency the individual leaves his home or room.…”

Hikikomori from the Perspective of Overuse, Underuse, and Optimal Use of Character Strengths: Case Reports

“…Regarding the evidence for efficacy of treatment for hikikomori, and despite the growing number of research on the topic, to date, peer-reviewed published evidence is scarce (Wong et al 2019). One empirical study of an intervention is a five-session home visitation program mainly consisting of person-centered psychotherapy.…”

Multimodal treatment for a Brazilian case of hikikomori

“…Hikikomori is defined as a condition of severe and prolonged social withdrawal apparently not explained by other severe psychiatric disorders, lasting for at least 6 months, in which the individual -usually a young adultremains a recluse in his own house. [1][2][3] Initially described in Japan in the late 1990s as a cultural syndrome, hikikomori has been recently recognized as a prevalent pathological phenomenon worldwide, with reports from several countries. [4][5][6] We report the case of a 35-year-old man who was referred to outpatient psychiatric treatment during his second hikikomori episode, which started soon after he left university.…”

“…Thiago H. Roza, 1,2 0 0 0 0 -0 0 0 0 -0 0 0 0 -0 0 0 0 Daniel T. Spritzer, 3,4 Lucas M. Lovato, 2 Ives C. Smoking remains a major global public health challenge. About 8 million people die every year from tobacco use worldwide, of which 7 million occur from tobacco use and about 1.2 million non-smokers die due to passive consumption.…”

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