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Towards an early detection of the pathological social withdrawal syndrome known as “Hikikomori” – Neuroscience News

Summary: Hikikomori is a complex condition where a person withdraws from society and remains isolated at home for more than six months. The condition is increasingly prevalent in Western societies. Researchers have developed a new method designed to help detect hikikomori at an earlier stage and provide treatment.

Source: Kyushu University

Kyushu University researchers have developed a new “Hikikomori questionnaire” with the aim of detecting the disease at an earlier stage.

Preliminary results show that isolation is a possible factor that may discriminate between non-hikikomori and pre-hikikomori individuals, offering possible validation of the new questionnaire as an early detection and treatment tool.

Hikikomori is a complex medical condition where an individual withdraws from society and stays at home almost every day for over six months. Although it may be considered a condition unique to Japan, hikikomori has been reported worldwide across Asia, Europe, and North America.

“Hikikomori was first defined in 1998. In studying the condition, we found that it is a very complex pathology caused by an overlap of physical, societal and psychological conditions,” says Takahiro A. Kato from the Faculty of Medical Sciences of Kyushu University and first author of the study.

“Its growing international recognition has placed hikikomori within the purview of many researchers and medical professionals, especially in the wake of the long COVID-19 pandemic. This year alone, Hikikomori was recognized in the revised edition of DSM-5.

Kato and his team worked on measures to assess, identify and treat hikikomori patients, to the point of opening the world’s first outpatient clinic for hikikomori individuals in 2013. In 2018, the team developed the “Hikikomori Questionnaire” , or HQ-25, which aimed to assess whether people with social withdrawal after six months are symptomatic of hikikomori.

“This questionnaire allowed us to identify symptomatic individuals with hikikomori. As our work progressed, we realized that we needed an assessment tool that could assess symptomatic individuals at an earlier stage to help detect and potentially prevent hikikomori,” Kato continues.

The new Hikikomori Questionnaire, or HQ-25M, produced in collaboration with Nihon University and Oregon Health and Science University, is comprised of 25 questions that assess the three subfactors of socialization, isolation and emotional support on a scale of 0 to 4, with 4 being “strongly agree”.

For example, questions such as “I feel uncomfortable around others” assess socialization, while “there are few people with whom I can discuss important matters” covers emotional support.

The pilot test of the new questionnaire, reported in Clinical Psychiatry and Neurosciences, was conducted among 762 Japanese individuals. The questionnaire first asked about the individual’s social withdrawal status in the previous month in order to categorize participants into hikikomori, non-hikikomori, and pre-hikikomori groups. The team also added a questionnaire that assesses the psychological distress of the individual during the same month.

This shows a woman standing at a fence
Hikikomori is a complex medical condition where an individual withdraws from society and stays at home almost every day for over six months. Image is in public domain

“We analyzed the data to see comparable differences between different category groups,” Kato says. “Several models showed us that hikikomori groups scored significantly higher on all measures compared to non-hikikomori and pre-hikikomori.”

Interestingly, between pre-hikikomori and non-hikikomori respondents, of the three sub-factors measured, the isolation sub-factor was the only one to show a significant difference in scores.

Although still preliminary, the team is pleased with its initial results and plans to use them to improve its questionnaire and data collection.

“These first results are promising and show that our questionnaire can be a good tool for the early detection of hikikomori”, concludes Kato.

“Nevertheless, we must work to broaden and diversify our sample size and refine our questions. Additionally, since hikikomori pathology is reported worldwide, we need to work with researchers and patients outside of Japan.

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About this psychology research news

Author: Press office
Source: Kyushu University
Contact: Press Office – Kyushu University
Image: Image is in public domain

Original research: Free access.
“One-Month Version of the Hikikomori Questionnaire-25 (HQ-25M): Development and Initial Validation” by Takahiro A. Kato et al. Clinical Psychiatry and Neurosciences


One-Month Version of the Hikikomori Questionnaire-25 (HQ-25M): Development and Initial Validation

Hikikomori is a medical condition of social withdrawal in which a person stays at home almost every day for more than 6 months.

Although first observed in Japan, hikikomori is described worldwide, with serious implications for health care, well-being and the economy.

The COVID-19 pandemic has further resulted in social isolation at home to avoid the risk of infection, and possibly increased the number of people with hikikomori-like illnesses. The 25-item Hikikomori Questionnaire (HQ-25) was designed to assess social withdrawal after at least 6 months of symptoms.

However, assessment tools capable of rapidly assessing social withdrawal at an early stage are needed to help detect and potentially prevent hikikomori. Therefore, here we have developed a modified version of the HQ-25 to assess the previous month and preliminary examine its validity.

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