A One-Year Prospective Follow-Up Study on the Health Profile of Hikikomori Living in Hong Kong

Abstract

Background: A prospective study was conducted to follow-up how the living lifestyle of hikikomori could change the social, mental and physical health profile. Methods: A cohort consisted of 104 young people living as Hikikomori were interviewed at baseline, 6 months and 12 months by using the same set of questionnaires and anthropometric measurements. Results: Besides the high attrition of 30% in wave 2 and 25% in wave 3, almost half of the participants have recovered from hikikomori by returning to the workforce in society. The three domains of health profile of hikikomori were significantly improved over the follow-up period by: 1) increasing the social network scores from 2.791.80 to 3.091.87, 2) decreasing the perceived stress scores from 21.185.87 to 20.115.79, and 3) reducing blood pressure levels from 118/75 to 115/71 and waist-to-hip ratios. Those variables were also predictable by lifestyle living with the hikikomori according to the Generalized Estimating Equation analysis, whereas the participants of current study had increased the practice of moderate-intensity exercises. Conclusion: Social work intervention was effective in helping the recovery of hikikomori while physical assessments followed by encouragement from social workers to do more exercises might enhance their awareness in health modification towards a better health.

Social Isolation Experienced by Youth in Social Withdrawal: Toward an Interdisciplinary Analysis and Practice

“…As demonstrated in the aforementioned interdisciplinary study of youth living a hikikomori lifestyle, the youth group showed interest to make improvement of their own health, which coincides with the principles of the McGill model of nursing where the client's health is improved by means of actively engaging them in the learning process of their care [28]. The aforementioned study identified many health risks of the youth group such as prehypertension, hypertension, obesity, an unhealthy diet, and disrupted sleep patterns [17]. If these were the health focuses for the client, the nursing intervention would be to provide health education or promotion knowledge to clients in order to help them make an informed choice regarding their care or activity performed on a daily basis.…”

“…Most surprisingly, the prevalence of hypertension was significantly reduced from 15.4 to 9.0% over 1 year, which was below the 12.6% adult prevalence of diagnosed hypertension [24] and the 12.8% age-specific prevalence for young people aged 15-34 [25]. The prevalence of prehypertension also slightly dropped from 31.7 to 29.1% [17]. In 12 months' time, they also witnessed an upward trend of practicing moderate-intensity exercises among the respondents.…”

“…In case of worsened relationship with parents and family members, young people suffering from extended social withdrawal at home may just retreat to their own tiny room with a modest level of interaction with their family. Worse comes to worse, they may even decline eating with the family and take a few biscuits or a cup of instant noodle in their own tiny safe cocoon on a daily basis [6], which is, however, harmful to their health in terms of poor diet and lack of physical exercises [16,17].…”

“…Measurements were taken by a well-trained nursing student, which include body weight, height, length and width of ears, blood pressure, pulse rate, respiratory rate, and waist and hip circumference which were recorded and used for calculating the body mass index and waist-hip ratio. This interdisciplinary study across nursing and social work professions is the first ever study studying the physical health aspects of hikikomori [17].…”

Home visiting support for people with hikikomori (social withdrawal) provided by experienced and effective workers

“…These included increased outdoor activities, engaging more in family conversations, improved interpersonal contact, spending more time outside, increased participation in group activities, returning to school, acquiring part-time jobs and significant improvements in participants' average GAF scores. Similarly, a study by Yuen et al (2019) conducted in Hong Kong showed significant improvement in participants' social, psychological and physical health. Furthermore, nearly half of the participants recovered from hikikomori by returning to the workforce after social workers provided social counselling and life planning in regular visits.…”