<i>Taijin kyofusho</i>: A culture‐bound diagnosis discussed by Japanese and international early career psychiatrists

Nakagami, Yukako; Toshitaka,; Russ, Tom C.; Marques, João Gama; Riese, Florian; Sönmez, Elif; Hopwood, Malcolm; Akiyama, Tsuyoshi

doi:10.1111/pcn.12482

Cited by 6 publications

(4 citation statements)

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“…Anxiety in social interactions may precipitate hikikomori , and social anxiety disorder is a high comorbid psychiatric disorder among persons with hikikomori . In Japan, taijin kyofusho [disorder involving a strong fear of others] has long been identified as a Japanese cultural‐bound syndrome in which the sufferer experiences fear of interpersonal relations, especially face‐to‐face interactions, and is included in the DSM‐IV‐TR appendix of culture‐bound syndromes . Interestingly, several commonalities exist between taijin kyofusho and hikikomori .…”

Section: Hikikomori‐like Condition In Psychiatric Disorders and Othermentioning

confidence: 99%

“…19 In Japan, taijin kyofusho [disorder involving a strong fear of others] has long been identified as a Japanese culturalbound syndrome in which the sufferer experiences fear of interpersonal relations, especially face-to-face interactions, and is included in the DSM-IV-TR appendix of culture-bound syndromes. 20,21 Interestingly, several commonalities exist between taijin kyofusho and hikikomori. 18 Taijin kyofusho is common among the same youthful age group and is more prevalent among males.…”

Section: Social Anxiety Disorder and Other Anxiety-related Disordersmentioning

confidence: 99%

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Hikikomori : Multidimensional understanding, assessment, and future international perspectives

Kato

Kanba

Teo

2019

Psychiatry Clin Neurosci

178

271

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Hikikomori, a severe form of social withdrawal, has long been observed in Japan mainly among youth and adolescents since around the 1970s, and has been especially highlighted since the late 1990s. Moreover, hikikomori‐like cases have recently been reported in many other countries. Hikikomori negatively influences not only the individual's mental health and social participation, but also wider education and workforce stability, and as such is a novel urgent global issue. In this review, we introduce the history, definition, diagnostic evaluation, and interventions for hikikomori and also the international prevalence of hikikomori outside Japan. We propose a hypothesis regarding the globalization of hikikomori based on domestic and international perspectives. In addition, we introduce our latest assessment system for hikikomori (including the latest version of the ‘proposed diagnostic criteria of hikikomori for the future DSM/ICD diagnostic systems’) and propose therapeutic strategies, including family approaches and individualized therapies. Finally, we present future challenges that may lead to solutions for an internationalized hikikomori.

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Section: Hikikomori‐like Condition In Psychiatric Disorders and Othermentioning

confidence: 99%

Section: Social Anxiety Disorder and Other Anxiety-related Disordersmentioning

confidence: 99%

Hikikomori : Multidimensional understanding, assessment, and future international perspectives

Kato

Kanba

Teo

2019

Psychiatry Clin Neurosci

178

271

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“…Based on its symptomatology, shinkeishitsu was sub-grouped into obsession (being obsessed with ideas), ordinary shinkeishitsu (being obsessed with somatic symptoms), and paroxysmal neurosis (being obsessed with anxiety attacks and anxiety) [28]. Kasahara redefined Taijin-Kyofusho as a type of neurosis that includes excessive anxiety and tension in social situations and withdrawing from interactions with others [33]. Nagata later developed diagnostic criteria for Taijin-Kyofusho, which consist of the tension (fear of being looked at by others) and offensive (fear of offending or embarrassing others) subtypes [34].…”

Section: Taijin-kyofusho Diagnostic Criteriamentioning

confidence: 99%

Assessing Social Anxiety in Japanese and Japanese-Americans in the United States

Moriyasu¹,

Olkin²

2019

J Dep Anxiety

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A Social Anxiety Scale designed to assess culture-specific symptoms in Japanese clients was assessed for face validity data. Taijin-Kyofusho is a culture-bound syndrome specific to Japanese culture in the DSM-5. A Social Anxiety Scale (SAS) was designed by the first author from existing Western social anxiety scales and a Taijin-Kyofusho scale. A demographic form yielded information about culturally-knowledgeable clinician respondents, and a questionnaire was used to get feedback on the SAS. Responses were obtained from 27 mental health professionals who worked clinically with Japanese legal residents in the United States and Japanese Americans, regarding culturally appropriate social anxiety assessment. Participants perceived the SAS as comprehensive and applicable to Japanese residents and Japanese Americans. Regarding Taijin-Kyofusho, most agreed that it should be assessed in Japanese residents but were undecided about its clarity and applicability to Japanese Americans. Several concerns were expressed about the validity of Western social anxiety scales for these populations. Most stressed the need for contextualization of social anxiety scales, differences in stigma against mental disorders across ethnicities, and the need for sensitivity of mental health professions to LGBTQ members in these populations. This is the first study on the views of clinicians working with these populations about Taijin-Kyofusho and how to assess anxiety. Nuances between Japanese residents and Japanese Americans were noted. We urge incorporation of cultural differences in manifestations of distress and specifically on Taijin-Kyofusho in training for mental health professionals. The purpose of this paper is to report on the first step in development of a culturally appropriate social anxiety scale for Japanese and Japanese-Americans living in the United States (U.S.). We first review the literature on differences in anxiety presentation across U.S. and Japanese cultures. We then report on feedback from culturally knowledgeable clinicians of the new scale, and specifically on the question of whether Taijin-Kyofusho symptoms should be included.

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“…Outra síndrome ligada à cultura japonesa que deve ser considerada como diagnóstico diferencial é o taijin-kyofusho -caracterizado pelo medo excessivo de ofender ou magoar os outros por seu comportamento social inadequado ou por sua aparência 37 . Essa síndrome é subdividida em: jikoshu-kyofu -preocupação exagerada com a crença de o corpo exalar odor desagradável -, sekimen-kyofu -medo excessivo de enrubescer (apresentar rubor facial) em público -, jiko-shisen--kyofu -medo exagerado de contato visual -e shubo-kyofupreocupação excessiva com uma deformidade do corpo 38,39 . 25 , foram recrutados 337 indivíduos com hikikomori; 183 utilizavam centros de saúde mental e foram classificados de acordo com os critérios do DSM-IV-TR.…”

Section: Diagnóstico Diferencialunclassified

Hikikomori: revisão sobre um grave fenômeno de isolamento social

Domingues-Castro

Torres

2018

J. bras. psiquiatr.

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RESUMO Objetivos Expandir os conhecimentos sobre o fenômeno de isolamento social prolongado, voluntário e grave denominado hikikomori e facilitar a identificação e o acompanhamento terapêutico desses indivíduos. Métodos Foi realizada uma revisão da literatura de 2000 a 2017, sendo utilizadas várias bases de dados como instrumentos de busca usando as palavras-chave: “hikikomori”, “youth social withdrawal” e “isolamento social prolongado”. Resultados O hikikomori foi descrito inicialmente no Japão, sendo considerado uma síndrome ligada à cultura nipônica. Porém, nos últimos anos foi descrito em diversos países, inclusive no ocidente. Afeta principalmente adolescentes e adultos jovens do sexo masculino, os quais vivem espontaneamente reclusos em seus quartos por pelo menos seis meses. São pessoas solitárias, tímidas, com um suporte social deficiente e que, frequentemente, tiveram alguma experiência traumática na infância. A maioria dos indivíduos apresenta algum transtorno psiquiátrico associado. O fenômeno acarreta terríveis prejuízos para o indivíduo, familiares e para a sociedade como um todo. Conclusão O hikikomori é subdiagnosticado e subtratado fora do Japão, pelo desconhecimento dos profissionais da saúde e pela recusa dos portadores em buscar ajuda. O fenômeno ainda não foi incluído numa categoria de diagnóstico psiquiátrico, o que dificulta a padronização e a realização de pesquisas ao redor do mundo.

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Taijin kyofusho: A culture‐bound diagnosis discussed by Japanese and international early career psychiatrists

Cited by 6 publications

References 4 publications

Hikikomori : Multidimensional understanding, assessment, and future international perspectives

Hikikomori : Multidimensional understanding, assessment, and future international perspectives

Assessing Social Anxiety in Japanese and Japanese-Americans in the United States

Hikikomori: revisão sobre um grave fenômeno de isolamento social

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