Examining the hikikomori syndrome in a French sample of hospitalized adolescents with severe social withdrawal and school refusal behavior

Bibliographic Data

ID2395500
AuthorsXavier Benarous (0000-0003-1994-5779, Inserm, corresponding author), Marie-Jeanne Guedj (Centre Hospitalier Sainte-Anne), Cora Cravero (0000-0002-8345-079X, Sorbonne Université), Barbara Jakubowicz (Sorbonne Université), Julie Brunelle (Sorbonne Université), Kunifumi Suzuki (Nagoya University), David Cohen (0000-0002-4970-0804, Department of Child and Adolescent Psychiatry, Pitié-Salpêtrière Hospital, Sorbonne University, Paris, France)
Year2022
Volume59
Issue6
Pages831-843
Publication date2022-12-01
Peer ReviewedYes
Open AccessYes
TypeARTICLE
VenueTranscultural Psychiatric Research Review (JOURNAL)
Journal identifiersISSN: 0041-1108 • E-ISSN: 0315-4386
PublisherSAGE Publications Inc (PUBLISHER)
DOI10.1177/13634615221111633
PMID35866212
OpenAlexW4286717654
LanguageEN
Citations received8
References cited30

While the term hikikomori (HKM) has spread internationally to describe a chronic and severe form of social withdrawal, its place in current nosography and its transposition into non-Asian cultures are still debated. A retrospective chart review was conducted to determine the rate and the clinical profiles of HKM among a French sample of adolescent inpatients. Data were obtained from 191 adolescents aged 12-18 years ( M = 15.0, 44% boys) consecutively admitted in two inpatient units from January 2017 to December 2019. Using a retrospective diagnosis of HKM based on Teo and Gaw's criteria, we compared socio-demographic characteristics, clinical features, and treatment outcomes between HKM patients and those with other forms of social withdrawal and/or school refusal (SW/SR). At admission, 7% of participants met HKM criteria ( n = 14, M = 14.3, 64% boys), one out of six adolescents with SW/SR. Among those with SW/SR, HKM + vs. HKM- participants had higher rates of anxiety disorder (Odd Ratio, OR = 35.2) and lower disruptive behavioral disorder ( OR = 0.03). A minority of the participants with anxiety and depressive disorders met the HKM criteria (respectively, 15% and 9%), but those with HKM had a longer duration of symptoms, longer hospitalization, and required more daily care facilities at discharge compared to HKM-. While HKM syndrome could not be delimitated from anxiety disorder, it was associated with specific clinical features and treatment outcomes. The clinical characteristics observed were consistent with the features reported in Asian HKM adults, supporting face validity of this clinical concept in adolescent inpatients with different cultural contexts

Anxiety · Psychiatry · Child and Adolescent Psychosocial and Emotional Development · Clinical Psychology · Medicine · Parental Involvement in Education · Psychology · Youth Substance Use and School Attendance