Shifting the paradigm of social withdrawal: a new era of coexisting pathological and non-pathological hikikomori

Curr Opin Psychiatry. 2024 May 1;37(3):177-184. doi: 10.1097/YCO.0000000000000929. Epub 2024 Feb 28.

Abstract

Purpose of review: Social withdrawal syndrome, known as "hikikomori," has been highlighted since the late 1990 s in Japan. Hikikomori is more common in urban areas, and often comorbid with mental disorders, and now spreading throughout the world. In the post-COVID-19 era, not outing is no longer considered pathological in itself as the "new normal," and a novel concept of hikikomori is needed. This review summarizes the concept of hikikomori, and presents the latest methods for identification of hikikomori.

Recent findings: The novel definition can distinguish between pathological and non-pathological hikikomori using the scale of "Hikikomori Diagnostic Evaluation (HiDE)," which has been developed in the hikikomori research lab at Kyushu University. An online survey among non-working adults has revealed that persons who have become pathological hikikomori for less than three months showed a particularly strong tendency toward gaming disorder and depression.

Summary: Now, physical isolation itself is not pathological, but when dysfunction and distress are present, rapid mental health support should be provided. In the novel urban society, the establishment of a checkup system to assess whether persons who stay home are happy or suffering is important for prevention against mental disorders triggered by social isolation.

Publication types

  • Review

MeSH terms

  • Adult
  • Comorbidity
  • Humans
  • Mental Disorders* / psychology
  • Phobia, Social*
  • Shame
  • Social Isolation / psychology

Supplementary concepts

  • hikikomori