Hikikomori : Multidimensional understanding, assessment, and future international perspectives
Open accessAbstract
Hikikomori , a severe form of social withdrawal, has long been observed in Japan mainly among youth and adolescents since around the 1970s, and has been especially highlighted since the late 1990s. Moreover, hikikomori ‐like cases have recently been reported in many other countries. Hikikomori negatively influences not only the individual's mental health and social participation, but also wider education and workforce stability, and as such is a novel urgent global issue. In this review, we introduce the history, definition, diagnostic evaluation, and interventions for hikikomori and also the international prevalence of hikikomori outside Japan. We propose a hypothesis regarding the globalization of hikikomori based on domestic and international perspectives. In addition, we introduce our latest assessment system for hikikomori (including the latest version of the ‘proposed diagnostic criteria of hikikomori for the future DSM/ICD diagnostic systems’) and propose therapeutic strategies, including family approaches and individualized therapies. Finally, we present future challenges that may lead to solutions for an internationalized hikikomori .
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Family interventions to improve parent-child relationships, family psychotherapy, and parent support groups have been identified as essential components of hidden youth interventions.
“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 [11]
The Family support section says family interventions are crucial for people with hikikomori who live with family and describes an educational support program for parents. It does not identify parent support groups specifically as an essential intervention; that is the part attached to this citation. (LLM, conf=0.84)
Experimental — accuracy not yet measuredLow stress tolerance and poor stress coping mechanisms in patients with hikikomori may be associated with the sum of such vulnerabilities.
“low stress tolerance and poor stress coping mechanisms in patients with hikikomori may be associated with the sum of such vulnerabilities”
The type of intervention should take into account the youth's level of social isolation.
“According to previous studies, the type of intervention should take into account the youth's level of social isolation (11).”
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“Since the information technology revolution, there has been increasing attention on hikikomori [42, 43].”
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Self-citation
- Authors
- Kato, T. A., Kanba, S., & Teo, A. R.
- Affiliations
- Kyushu University (JP)
- Portland State University (US)
- Corresponding author
- Kato, Takahiro A.
- Venue
- Psychiatry and Clinical Neurosciences
- Publisher
- Wiley
- Published
- 2019-06-24
- Volume
- 73
- Issue
- 8
- Pages
- 427-440
- ISSN
- 1323-1316 (ISSN-L)
- 1440-1819
- OpenAlex
- W2947832386
- Cited by
- 335
- References
- 115
- Citations by year
- 2026: 65 · 2025: 75 · 2024: 46 · 2023: 54 · 2022: 38 · 2021: 33 · 2020: 19 · 2019: 5
- FWCI
- 6.83
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Psychiatry and Clinical Neurosciences (publishedVersion)
- PubMed (publishedVersion)
- PDXScholar (Portland State University) (submittedVersion)
- Funders
- Japan Agency for Medical Research and Development
- Japan Society for the Promotion of Science
- SENSHIN Medical Research Foundation
- U.S. Department of Veterans Affairs
- Topics
- Social Sciences › Education › Youth Substance Use and School Attendance
- Health Sciences › Medicine › Psychiatry and Mental health › Psychosomatic Disorders and Their Treatments
- Social Sciences › Sociology and Political Science › Youth Education and Societal Dynamics
- Keywords
- hikikomori, social withdrawal, adolescents, youth, mental health, social participation (health and rehabilitation), diagnostic criteria, evaluation system, family therapy, personalized treatment, workforce stability
- MeSH terms
- Mental Disorders, Humans, Models, Psychological, Social Isolation, Internationality
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