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Hikikomori, a Japanese Culture-Bound Syndrome of Social Withdrawal?: A Proposal for DSM-5
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A form of severe social withdrawal, called hikikomori, has been frequently described in Japan and is characterized by adolescents and young adults who become recluses in their parents' homes, unable to work or go to school for months or years. The aim of this study was to review the evidence for hikikomori as a new psychiatric disorder. Electronic and manual literature searches were used to gather information on social withdrawal and hikikomori, including studies examining case definitions, epidemiology, and diagnosis. A number of recent empirical studies have emerged from Japan. The majority of such cases of hikikomori are classifiable as a variety of existing Diagnostic and Statistical Manual (DSM) psychiatric disorders. However, a notable subset of cases with substantial psychopathology does not meet criteria for any existing psychiatric disorder. We suggest hikikomori may be considered a culture-bound syndrome and merits further international research into whether it meets accepted criteria as a new psychiatric disorder. Research diagnostic criteria for the condition are proposed.
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“In line with FST, family interventions to improve parent-child relationships (11), family psychotherapy (18), and parent support groups (22), have been identified as essential components of hidden youth interventions.”
From Reaching hidden youth in Singapore through the Hidden Youth Intervention Program: A biopsychosocial approach integrating mental health and social work interventions (2023) · cites this paper as [18]
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Park, H., & Yap, S. F. (2024) · Psychology and Marketing · doi:10.1002/mar.21991 · Cited by 17
Batra, R., Flatt, J. D., Pharr, J. R., Sharma, M., Khubchandani, J., Kanekar, A. S., Chirico, F., & Batra, K. (2024) · Healthcare · doi:10.3390/healthcare12212149 · Cited by 21
Hihara, S., Sugimura, K., Umemura, T., Iwasa, Y., & Syed, M. (2021) · Development and Psychopathology · doi:10.1017/s0954579421000043 · Cited by 17
Validation of the Italian version of the 25‐item Hikikomori Questionnaire (HQ‐25‐I)
Fino, E., Iliceto, P., Carcione, A., Giovani, E., & Candilera, G. (2022) · Journal of Clinical Psychology · doi:10.1002/jclp.23404 · Cited by 17
The Intersection of Culture and Solitude
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Self-citationAmendola, S., Presaghi, F., Teo, A. R., & Cerutti, R. (2022) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph191610408 · Cited by 16
Self-citationTajan, N. (2015) · Subjectivity · doi:10.1057/sub.2015.11 · Cited by 16
Self-Construal, Social Support, and Loneliness in Japan
Taniguchi, H., & Kaufman, G. (2018) · Applied Research in Quality of Life · doi:10.1007/s11482-018-9636-x · Cited by 19
Suicide Motives and Protective Factors - Contributions from a Hikikomori Discussion Board
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Current Challenges and Future Opportunities for Child and Adolescent Psychiatry in Japan
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Hikikomori: debating a XXI century phenomenon from a clinical point of view
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Al‐Sibani, N., Chan, M. F., Al‐Huseini, S., Kharusi, N. A., Guillemin, G. J., Al-Abri, M., Ganesh, A., Hasani, Y. A., & Al‐Adawi, S. (2023) · PLoS ONE · doi:10.1371/journal.pone.0279612 · Cited by 15
Metadata
- Authors
- Teo, A. R., & Gaw, A. C.
- Affiliations
- University of California, San Francisco (US)
- ORCID
- Teo, Alan R.
- Venue
- Journal of Nervous & Mental Disease
- Published
- 2010-06
- Volume
- 198
- Issue
- 6
- Pages
- 444-449
- ISSN
- 0022-3018 (ISSN-L)
- PMC
- PMC4912003
- OpenAlex
- W2038618640
- Cited by
- 276
- References
- 22
- Citations by year
- 2026: 30 · 2025: 28 · 2024: 17 · 2023: 34 · 2022: 24 · 2021: 18 · 2020: 27 · 2019: 22 · 2018: 15 · 2017: 13 · 2016: 10 · 2015: 12 · 2014: 9 · 2013: 6 · 2012: 3
- FWCI
- 25.68
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- The Journal of Nervous and Mental Disease (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institute of Mental Health (R25MH060482)
- Topics
- Social Sciences › Education › Youth Substance Use and School Attendance
- Health Sciences › Medicine › Psychiatry and Mental health › Psychosomatic Disorders and Their Treatments
- Social Sciences › Psychology › Clinical Psychology › Psychology and Mental Health
- Keywords
- hikikomori, social withdrawal, culture-bound syndromes, psychiatric classification, DSM diagnostic criteria, adolescents and young adults, reclusion, case definition, diagnosis, Research Diagnostic Criteria
- MeSH terms
- Adolescent, Adult, Mental Disorders, Culture, Female, Humans, Japan, Male, Psychiatric Status Rating Scales, Psychometrics, Social Isolation, Syndrome, International Classification of Diseases, Diagnostic and Statistical Manual of Mental Disorders, Asian People, Young Adult
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