Alan R Teo1, Michael D Fetters2, Kyle Stufflebam3, Masaru Tateno4, Yatan Balhara5, Tae Young Choi6, Shigenobu Kanba7, Carol A Mathews8, Takahiro A Kato9. 1. Portland VA Medical Center, Health Services Research & Development, Portland, OR, USA teoa@ohsu.edu takahiro@npsych.med.kyushu-u.ac.jp. 2. Japanese Family Health Program, Department of Family Medicine, University of Michigan, Ann Arbor, MI, USA. 3. Robert Wood Johnson Foundation Clinical Scholars Program, University of Michigan, Ann Arbor, MI, USA. 4. Sapporo Hana Developmental Psychiatry Clinic, Department of Neuropsychiatry, Sapporo Medical University, Hokkaido, Japan. 5. National Drug Dependence Treatment Centre, All India Institute of Medical Sciences (AIIMS), New Delhi, India. 6. Department of Psychiatry, Catholic University of Daegu School of Medicine, Daegu, South Korea. 7. Department of Neuropsychiatry, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan. 8. Department of Psychiatry, University of California San Francisco, San Francisco, CA, USA. 9. Department of Neuropsychiatry, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan Innovation Center for Medical Redox Navigation, Kyushu University, Fukuoka, Japan.
Abstract
BACKGROUND: Hikikomori, a form of social withdrawal first reported in Japan, may exist globally but cross-national studies of cases of hikikomori are lacking. AIMS: To identify individuals with hikikomori in multiple countries and describe features of the condition. METHOD: Participants were recruited from sites in India, Japan, Korea and the United States. Hikikomori was defined as a 6-month or longer period of spending almost all time at home and avoiding social situations and social relationships, associated with significant distress/impairment. Additional measures included the University of California, Los Angeles (UCLA) Loneliness Scale, Lubben Social Network Scale (LSNS-6), Sheehan Disability Scale (SDS) and modified Cornell Treatment Preferences Index. RESULTS: A total of 36 participants with hikikomori were identified, with cases detected in all four countries. These individuals had high levels of loneliness (UCLA Loneliness Scale M = 55.4, SD = 10.5), limited social networks (LSNS-6 M = 9.7, SD = 5.5) and moderate functional impairment (SDS M = 16.5, SD = 7.9). Of them 28 (78%) desired treatment for their social withdrawal, with a significantly higher preference for psychotherapy over pharmacotherapy, in-person over telepsychiatry treatment and mental health specialists over primary care providers. Across countries, participants with hikikomori had similar generally treatment preferences and psychosocial features. CONCLUSION: Hikikomori exists cross-nationally and can be assessed with a standardized assessment tool. Individuals with hikikomori have substantial psychosocial impairment and disability, and some may desire treatment.
BACKGROUND: Hikikomori, a form of social withdrawal first reported in Japan, may exist globally but cross-national studies of cases of hikikomori are lacking. AIMS: To identify individuals with hikikomori in multiple countries and describe features of the condition. METHOD:Participants were recruited from sites in India, Japan, Korea and the United States. Hikikomori was defined as a 6-month or longer period of spending almost all time at home and avoiding social situations and social relationships, associated with significant distress/impairment. Additional measures included the University of California, Los Angeles (UCLA) Loneliness Scale, Lubben Social Network Scale (LSNS-6), Sheehan Disability Scale (SDS) and modified Cornell Treatment Preferences Index. RESULTS: A total of 36 participants with hikikomori were identified, with cases detected in all four countries. These individuals had high levels of loneliness (UCLA Loneliness Scale M = 55.4, SD = 10.5), limited social networks (LSNS-6 M = 9.7, SD = 5.5) and moderate functional impairment (SDS M = 16.5, SD = 7.9). Of them 28 (78%) desired treatment for their social withdrawal, with a significantly higher preference for psychotherapy over pharmacotherapy, in-person over telepsychiatry treatment and mental health specialists over primary care providers. Across countries, participants with hikikomori had similar generally treatment preferences and psychosocial features. CONCLUSION: Hikikomori exists cross-nationally and can be assessed with a standardized assessment tool. Individuals with hikikomori have substantial psychosocial impairment and disability, and some may desire treatment.
Authors: Frederick W Kron; Michael D Fetters; Mark W Scerbo; Casey B White; Monica L Lypson; Miguel A Padilla; Gayle A Gliva-McConvey; Lee A Belfore; Temple West; Amelia M Wallace; Timothy C Guetterman; Lauren S Schleicher; Rebecca A Kennedy; Rajesh S Mangrulkar; James F Cleary; Stacy C Marsella; Daniel M Becker Journal: Patient Educ Couns Date: 2016-10-29