Hikikomori and Intercultural Manifestations: a Bibliografic Review

Abstract

Introduction"Hikikomori” is known since the 80s and was described by Saito in 1998 as a different clinical picture from any current diagnostic category, being social withdrawal the most important aspect. Young hikikomoris, more than a million in Japan (Teo2010), withdraw in their room for at least six months, interrupting communication with the outside world. This picture was described by many international scholars (Watts 2002; Zielenzinger 2008; Teo 2010; Piotti et al.2014). Part of international literature, after DSMIV-TR, defined hikikomori as a culture-bound syndrome (Agugliaetal.,2010). However, recently similar cases were described in different contexts, both in Asia and Western world (Kato et al.,2012), highlighting peculiar clinical signs influenced by the context, although maintaining a common matrix referred to Saito framework.AimsThis literature review aims to gather descriptions of hikikomori in different cultures, to identify cross-cultural variables on which the phenomenon is based and to analyse any differences in clinical manifestations.MethodsEighty-two articles which contained ‘hikikomori” in the title or abstract were reviewed and searched using online databases (PsycINFO, PubMed, googleschoolar)ResultsThe scientific literature was divided by year of publication and by three phases:1. The articles are mostly Japanese2. Western articles, referring to Japanese contexts3. The Hikikomoriconcept isclosely related tosocial withdrawal (sources from many countries).ConclusionThe literature shows a tendency to consider hikikomori a phenomenon which exceeds cultural context (although influenced by it), rather than a culturally characterized syndrome.

Hikikomori: debating a XXI century phenomenon from a clinical point of view

“…This case is representative of the UFSMIA’s clinical approach. Other similar cases are reported in previous articles ( 42 , 46 , 33 ).…”

“…On the basis of its own clinical experience, the UFSMIA of Arezzo has articulated an approach based on several interventions, fine-tuned for each case and each individual moment. No rigid protocol was defined, rather therapeutic programs are organized following a careful assessment of the degree and the typology of social withdrawal, its comorbidity with other clinical conditions, the existence of withdrawal-based psychopathological symptoms, and the personal and family resources that can be activated ( 49 , 50 ). The actions of different professionals (child neuropsychiatrists, psychologists, teachers, social, and community workers) must be combined and arranged according to the concept of modularity ( 51 ), which should aim each single intervention at well-defined and specific objectives within a wide-ranging clinical project.…”

Protective and risk factors for social withdrawal in adolescence. A mixed-method study of Italian students’ wellbeing

“…In the last decade, an increasing number of cases have been reported in different countries around the world – in the Asian continent and the Arab region as well as in the United States (Kato et al 2011), and in the south of Europe; in Spain (Ovejero et al 2014; Malagón-Amor et al 2015), and recently in Italy (De et al 2013; Ranieri et al 2015). Different theories have been advanced to interpret the phenomenon: youth issues such as NEET (Not in Education, Employment, or Training; Furlong 2008) or a type of lifestyle (Chan and Lo 2013).…”