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Hikikomori in Spain: A descriptive study.

Ángeles Malagón-Amor1, David Córcoles-Martínez2, Luis M Martín-López2

  • 1Institute of Neuropsychiatry and Addictions (INAD), Parc de Salut Mar, Barcelona, Spain Department of Psychiatry and Forensic Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain 95451@parcdesalutmar.cat.

The International Journal of Social Psychiatry
|October 12, 2014
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Summary

Social withdrawal, or hikikomori, is prevalent in Spain, often affecting young males with severe mental health issues and social functioning impairment. Early detection and specialized teams are crucial for effective treatment.

Keywords:
Hikikomoridiagnosishome visitation programmesocial isolationsocial withdrawal

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Area of Science:

  • Psychiatry
  • Clinical Psychology
  • Sociology

Background:

  • Social withdrawal behavior is a growing global health concern.
  • Understanding its psychopathology and cultural variations is essential.
  • Hikikomori, a severe form of social withdrawal, requires further investigation.

Purpose of the Study:

  • To characterize clinical and socio-demographic features of hikikomori individuals in Spain.
  • To assess the prevalence and nature of mental disorders associated with hikikomori.
  • To evaluate the functional impairment and treatment engagement of hikikomori patients.

Main Methods:

  • Study included 200 individuals referred for social isolation, meeting the hikikomori definition (≥6 months withdrawal).
  • Analyzed socio-demographic data and clinical assessments using Severity of Psychiatric Illness (SPI), Global Assessment of Functioning (GAF), Clinical Global Impression (CGI), and World Health Organization Disability Assessment (WHODAS) scales.
  • Evaluated 164 confirmed hikikomori cases.

Main Results:

  • Hikikomori predominantly affected young males, with a mean age of onset at 40 and 3 years of withdrawal.
  • Most individuals (161/164) had comorbid mental disorders, primarily psychotic and anxiety disorders.
  • Significant psychiatric symptoms and social functioning impairment were observed, with low treatment collaboration.

Conclusions:

  • This study confirms the existence of hikikomori in Spain, presenting diagnostic and treatment challenges.
  • High comorbidity suggests hikikomori may be a severe syndrome linked to various mental illnesses, rather than a distinct diagnosis.
  • Specialized domiciliary teams and further cross-national research are needed to define and understand hikikomori psychopathology.