J Korean Neuropsychiatr Assoc.  2023 Nov;62(4):164-172. 10.4306/jknpa.2023.62.4.164.

Prevalence of Psychiatric Diagnosis and Related Psychosocial Characteristics Among Hikikomori (Social Withdrawal Syndrome) in Korea

• Jung JY
• An JH
• Kim MH
• Park SH
• Hong JP

• KMID: 2548765
• DOI: http://doi.org/10.4306/jknpa.2023.62.4.164

Abstract

Objectives
Social withdrawal is emerging as a significant health issue in Korea. This study examines the prevalence of psychiatric disorders, including personality disorders, and the psychosocial characteristics of hikikomori individuals in Korea.
Methods
We recruited 30 hikikomori cases from the hikikomori family association, internet cafés, and psychiatric patients at the Samsung Medical Center. Hikikomori is defined as a prolonged withdrawal from social interactions, lasting at least three months. Psychiatric disorders were assessed using the Mini-International Neuropsychiatric Interview and the Structured Clinical Interview for DSM-5 Personality Disorders. Self-reported psychosocial characteristics, such as depression, anxiety, and life satisfaction, were measured using various scales.
Results
The hikikomori participants were predominantly young, unmarried males, with high unemployment rates and an average duration of social withdrawal of 38.7 months. The lifetime prevalence of psychiatric disorders was 76.6%, with depression and anxiety being the most common comorbid conditions. The prevalence rates in the current sample for major depressive disorders, social anxiety disorders, agoraphobia, and body dysmorphic disorders were 46.7%, 16.5%, 10.0%, and 10.0%, respectively. Personality disorders were diagnosed in 63.3% of the subjects. Additionally, 50.0% of the subjects scored above the cutoff point on the Korean version of the autism-spectrum quotient. The hikikomori group exhibited high levels of depressive anxiety, suicidality, poor subjective well-being, and compromised physical health.
Conclusion
This study highlights hikikomori as a severe syndrome associated with multiple psychiatric comorbidities, including personality disorders and the autism spectrum. Comprehensive psychiatric evaluation for hikikomori individuals is essential to facilitate appropriate therapeutic interventions and social rehabilitation.

Keyword

Hikikomori, Social Withdrawal Syndrome; Mental health; Psychiatric diagnosis; Personality disorder