Hikikomori: Clinical and Psychopathological Issues

Abstract

Introduction

Hikikomori: Japanese term which means 'being confined, pulled inward”, translated as 'social withdrawal” in Western cultures. Cultural, social, familiar and educational features predispose to it. Diagnostic criteria include home-centred lifestyle, refusal to attend school or work, symptoms persistence for at least six months, exclusion of schizophrenia, mental retardation or other mental disorders and lack of personal relationships.

Material and Methods

We searched 'hikikomori” keyword on Pubmed and Scopus, and selected papers written in English, Italian or Spanish. We found 54 results:14 articles were excluded for being written in Japanese or French, and one paper for being unrelated to the topic. We also searched Google Scholar and PsychInfo, founding one additional relevant study.

Results

Generally, hikikomori is an Asiatic, and specifically Japanese, phenomenon. Nevertheless, social withdrawal cases similar to hikikomori have been recently described in Western Countries (United States, Australia, Spain, Italy)

Typically, the hikikomori subject is male, described as apathetic, nihilistic, disillusioned, estranged from school and society, the young adult eldest son of a family with a good socioeconomic background. The low rate of suicidality among hikikomoris needs to be emphasized.

Internet represents an “emergency exit” to the difficulties that adolescents and young adults face: therefore, they choose social withdrawal to preserve themselves from the risk of being ashamed by their own inadequacy.

Conclusions

Hikikomori is more than a medical and psychiatric disease. Scientific literature regarding both epidemiological and psychopathological issues is still lacking and more scientific researches are required.