General condition of hikikomori (prolonged social withdrawal) in Japan: Psychiatric diagnosis and outcome in mental health welfare centres

• Published in: International journal of social psychiatry Vol. 59; no. 1; pp. 79 - 86
• Main Authors: Kondo, Naoji, Sakai, Motohiro, Kuroda, Yasukazu, Kiyota, Yoshikazu, Kitabata, Yuji, Kurosawa, Mie
• Format: Journal Article
• Language: English
• Published: London, England SAGE Publications 01.02.2013; Sage Publications Ltd
• Subjects: Adolescent; Adolescents; Adult; Antisocial personality disorder; Anxiety disorders; Anxiety Disorders - diagnosis; Anxiety Disorders - psychology; Anxiety Disorders - therapy; Clinical outcomes; Combined Modality Therapy; Community Mental Health Centers; Comorbidity; Cross-Cultural Comparison; Developmental Disabilities - diagnosis; Developmental Disabilities - psychology; Developmental Disabilities - therapy; Developmental disorders; Diagnosis; Drug therapy; Emotional disorders; Experts; Female; Health problems; Help seeking behavior; Humans; Japan; Male; Medical diagnosis; Mental disorders; Mental Disorders - diagnosis; Mental Disorders - psychology; Mental Disorders - therapy; Mental health; Mental health care; Mood Disorders - diagnosis; Mood Disorders - psychology; Mood Disorders - therapy; Patient Acceptance of Health Care - psychology; Patient Care Team; Personality Assessment; Personality disorders; Personality Disorders - diagnosis; Personality Disorders - psychology; Personality Disorders - therapy; Pervasive developmental disorders; Pharmacology; Psychotherapy; Psychotropic Drugs - therapeutic use; Schizophrenia; Schizophrenia - diagnosis; Schizophrenia - therapy; Schizophrenic Psychology; Social factors; Social Isolation; Social psychiatry; Social Support; Welfare; Young Adult; Japan; Adolescent and young adult; prolonged social withdrawal; psychiatric diagnosis; hikikomori; Japan
• ISSN: 0020-7640; 1741-2854; 1741-2854
• DOI: 10.1177/0020764011423611

Background: The issue of hikikomori (prolonged social withdrawal) among Japanese youth has attracted attention from international experts. In previous research, the unique cultural and social factors of Japanese society have been the focus; however, in order to resolve the problem of hikikomori, individual mental health problems must be included. Aim: We examined the psychiatric background of individuals with hikikomori. Methods: We recruited 337 individuals with hikikomori; 183 subjects who utilized the centres were designated as the help-seeking group. We examined the multi-axial psychiatric diagnosis based on the DSM-IV-TR, treatment policies and treatment outcomes. We also examined 154 subjects who did not utilize the centers (non-help-seeking group). Results: Most of the subjects in the utilization group were classified into one of the diagnostic categories. Forty-nine (33.3%) subjects were diagnosed with schizophrenia, mood disorders or anxiety disorders, and this group needed pharmacotherapy. Other subjects were diagnosed with personality disorders or pervasive developmental disorders, and they mainly needed psycho-social support. The Global Assessment of Functioning (GAF) scores of the non-help-seeking group were significantly lower than the GAF scores of those who used treatments. Conclusion: Most hikikomori cases can be diagnosed using current diagnostic criteria. Individuals with hikikomori are much worse if they do not seek help.