Being Hikikomori: Review of Social and Cultural Causes

Social withdrawal (hikikomori) has become an internationally recognized phenomenon, but its pathology and related factors are still not fully understood. Previously, we conducted a statistical case-control study in adolescent hikikomori patients in Japan, which revealed the lack of specificity of pathology in hikikomori patients. Furthermore, environmental factors such as lack of communication between parents and excessive use of the Internet were found to be significant predictors of the severity of hikikomori. Here, our aim was to perform a similar preliminary case-control study in France and compare the results with those of the study conducted in Japan.

⬇️In the following video we give our opinion on this topic!⬇️

Social withdrawal called in Japan as “hikikomori” is a serious psychosocial problem in Japan since the late 1990s. In Japan, the term “hikikomori” is used to describe both the phenomenon and a person who has stopped going to school. school or work and spends most of her time confined to her home.

Hikikomori usually occurs in adolescence or early adulthood and is usually preceded by a latent period before it is clinically treated. It has been studied that when a person goes through moments of failure, not having someone to talk to about their problem, they withdraw socially.

According to the studies and surveys made to the same people who were hikikomori, the main factor in being a hikikomori is the lack of communication, especially with the family.

Initially, this phenomenon was considered a culture-bound syndrome unique to Japan; however, it has also been reported in other countries, including Hong Kong, Oman, Spain, France, Brazil, China, Canada, and Italy . Consequently, hikikomori is currently considered a worldwide phenomenon .

Hikikomori does not yet have a strict definition or diagnostic criteria. In 2010, the Japanese Ministry of Health, Labor and Welfare defined hikikomori as ” a state in which a person without mental illness withdraws home for ≥ 6 months and does not participate in society, including school attendance.”

A period of ≥ 6 months of spending most of the time at home and avoiding social situations and relationships, accompanied by significant distress and disability. On the other hand, to classify people who do not meet the 6-month criteria on the severity spectrum as “pre-hikikomori”.

Hikikomori is associated with various mental disorders , including mood, anxiety, personality, developmental disorders, and the prodromal phase of schizophrenia. In addition, there are numerous cases of hikikomori without distress (especially in the initial stage), which require diagnostic attention. Studies report the comorbidity of withdrawal and various mental disorders, including avoidant personality disorder, social anxiety disorder, and major depression.

The findings suggest that hikikomori is not a single clinical category with a specific psychopathology; instead, it is a common phenotype with several underlying pathologies. However, the question remains as to why this phenotype is increasing worldwide.

At this point, it may be reasonable to assume that the hikikomori epidemic has arisen from various pathological bases in the context of rapidly changing socio-familial systems due to the influence of the information technology revolution and other factors, as indicated by the previous research studies.

It is also important to note here that there are cultural differences in the factors that accelerate or mitigate the progression of hikikomori. Different strategies would be needed to prevent hikikomori in different cultures. These factors are important for medical, as well as welfare and educational interventions for hikikomori adolescents. Further studies are warranted to clarify the elaborate mechanisms of the onset/severity of the hikikomori phenotype, while clarifying the causal relationships between these factors and providing clinicians with useful knowledge for early intervention in multiple fields.