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Introduction: The term "Hikikomori" is known as social-withdrawal which is characteristic to young Japanese recently. The hikikomori syndrome is defined as withdrawal from society for 6 months or longer by Japanese Ministry of Public Welfare. According to previous studies, "hikikomori" occurs during puberty and adolescence. On the other hand, it is also reported that not a few "hikikomori" occur after adulthood. Aim: The aim of this study was to compare the factors between teen-onset hikikomori groups and adult-onset hikikomori groups. Methods: We have retrospectively reviewed the clinical course of 46 patients of the hikikomori syndrome from 13 years old to 28 years old through medical records for 48 months. There were 27 males and 19 females. All the patients were allocated into 2 groups, A: teen-onset hikikomori, B: adult-onset hikikomori. We investigated diagnosis during treatment, duration of social-withdrawal before treatment, presence of domestic violence, human relations of the family, and prognosis on the end of treatment, respectively. Results: Group A is composed of 24 patients. Group B is composed of 22 patients. Referred tables further factors. Conclusions: The factor which effects prognosis of teen-onset hikikomori was positive social support of the parents. Otherwise, the factor which effects prognosis of adult-onset hikikomori was to treat psychiatric disorders.

The association between disorders of thyroid function and psychiatric symptoms is well established. Generally, hypothyroidism is recognized as being able to induce psychotic symptoms. However, psychotic symptoms without affective and cognitive disturbances are rare in hyperthyroidism. We presented a patient with Graves' disease who suffered from delusions and hallucinations without affective and cognitive disturbances following abrupt normalization of thyroid function. Furthermore, the patient was clinically and biochemically euthyroid when the psychotic symptoms developed. There was resolution of psychotic symptoms in this case. It is suggested that the abrupt change of thyroxine may cause susceptible individuals to become transient psychotic state.

Autism spectrum disorder (ASD) is characterized by social impairment and circumscribed and repetitive behavior and interests. This study aimed to examine the effectiveness of group therapy, which was designed to enhance university-related behavior, in Japanese university students with high-functioning ASD, based on their specific social, communication and emotional needs. The participants included 11 students with ASD aged between 19 and 24 (mean 21.0) years. A single-group, pre-post-intervention design was implemented in the study. The Clinical global Impressions-Severity scale, Beck Depression Inventory, State Trait Anxiety Inventory, and Rosenberg SelfEsteem Inventory Scale were completed before and after group therapy. The results showed significant post intervention improvements in depressive symptom, anxiety, and self-esteem, indicating that the group therapy was effective for students with ASD.

Purpose: Patients with AD commonly exhibit behavioral and psychological symptoms of dementia (BPSD). This study is aimed to compare the efficacy of yokukansan (YKS) and risperidone (RIS) on BPSD in patients with severe Alzheimer's disease (AD). Methods: Thirty-eight inpatients with AD were investigated. Patients were randomly assigned to the YKS group (N = 18) or the RIS group (N = 20) and treated for 4 weeks. The primary outcomes were changes in the scores on the Neuropsychiatric Inventory (NPI), the Mini-Mental State Examination (MMSE), the Barthel Index, and the Cohen-Mansfield Agitation Inventory (CMAI). The frequency of extrapyramidal symptoms (EPS) and other adverse events were recorded at every visit. Results: All participants in both groups completed the trial. The Barthel Index did not significantly change either in the RIS group or the YKS group. The MMSE scores did not change either in the RIS group or the YKS group. Significant improvements in mean total NPI and CMAI scores showed in both groups. Between the YKS and the RIS groups, there were no significant differences in the NPI or the CMAI scores. EPS and other serious adverse effects were not observed in either group. Conclusions: In this 4-week trial, YKS treatment significantly improved BPSD in the patients with severe AD. The present study suggests that YKS is as effective as RIS on BPSD with severe AD.