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

Abstract

Background: A prospective cohort study was conducted to follow-up on 104 participants on their changes of social, psychological and physical health as exposed to the hikikomori lifestyle. Methods: Participants were interviewed at baseline, 6 months and 12 months by administering a set of questionnaires and anthropometric measurements. Results: All three health domains of hikikomori were significantly improved over the follow-up period as evidenced by: (1) increased social network scores from 2.79 ± 1.80 to 3.09 ± 1.87, (2) decreased perceived stress scores from 21.18 ± 5.87 to 20.11 ± 5.79, and (3) reduced blood pressure levels from 118/75 to 115/71 and waist-to-hip ratios. Almost half of the participants have recovered from hikikomori by returning to the workforce in society; however, the health improvements were dominant in those that remained as hikikomori and were associated with the gradual swapping of exercise practices from light to moderate level strength. Conclusions: With intended exposure to social worker engagement, physical assessments of the cohort study triggered the social workers to encourage participants to do more exercises, which in turn enhanced their awareness of health modification towards a better health. Engagement of social workers could be considered as part of the intended exposure for all participants, which suggested social work intervention was effective in helping hikikomori recovery.

The <i>Hikikomori</i> Phenomenon: Could Loneliness Be a Choice of Self-Restriction from Society?

“…A study from Hong Kong found that hikikomori have a higher incidence of hypertension and pre-hypertension, partially associated with their sedentary lifestyle in combination with unhealthy dietary habits, insufficient physical activities and reversed sleep patterns [42]. However, the results of a one year longitudinal study by the same authors demonstrated that, surprisingly, blood pressure levels of hikikomori were improved by moderate-intensity daily exercises even when all other lifestyle aspects remained the same [43]. Meanwhile, research into blood biomarkers shows that oxidative stress and inflammation may contribute to the behavioural and psychological traits of hikikomori, thus suggesting a biological basis for the condition [44].…”

Contemporary Hermits: A Developmental Psychopathology Account of Extreme Social Withdrawal (Hikikomori) in Young People

“…Therefore, the threshold for the intervention should be kept as low as possible. In many countries, home visitation programs have been launched to detect, evaluate, and eventually treat socially withdrawn people, which seems to be a logical approach given the nature of the problem (e.g., Japan: Funakoshi et al, 2022 ; Hong Kong: Yuen et al, 2019 ; Korea: Lee et al, 2013 ; Spain: Malagón-Amor et al, 2020 ). Oftentimes (initially) social workers—and not clinical psychologists and psychiatrists—are involved to prevent pathologizing and hence to maximize the chance of a positive acceptation of the help (Li et al, 2018 ).…”

Social Withdrawal (Hikikomori) Conditions in China: A Cross-Sectional Online Survey

“…Hikikomori seems to be a transcultural condition (De Michele et al, 2013 ; Stip et al, 2016 ), which has proved the existence of hikikomori. A prospective cohort study was conducted in Hongkong to follow-up on 104 participants on their changes in social, psychological, and physical health as exposed to the hikikomori lifestyle (Yuen et al, 2019 ). Participants were interviewed at baseline, 6 and 12 months by administering a set of questionnaires and anthropometric measurements.…”

“…All three health domains of hikikomori were significantly improved over the follow-up period as evidenced by increased social network scores, decreased perceived stress scores, and reduced blood pressure levels and waist-to-hip ratios. Almost half of the participants have recovered from hikikomori by returning to the workforce in society; however, the health improvements were dominant in those that remained as hikikomori and were associated with the gradual swapping of exercise practices from light to moderate level strength (Yuen et al, 2019 ).…”