Hikikomori goes global: A Portuguese case

Abstract

IntroductionHikikomori, a form of severe social isolation, once characterized as a Japanese cultural-bond behavior with social and economic consequences, it is now being described in other countries. Its presentation mimics some clinical features of various classified mental diseases, such as prodromal phase of schizophrenia, personality disorders, Internet dependence, social phobia or depression, without fulfilling their defining criteria.Objectives/methodThis work aimed to do a brief review of this subject, describing one case that is probably the first ever reported in Portugal, comparing it with similar cases around the world.ResultsThe patient was a 22-year-old male, taken to psychiatry evaluation after 4 years of social withdrawal, avoiding or blocking any contact even with family members, which resulted in work and school impairment. He spent most of his days locked at his room, investing his time in particular interests and Internet use, only leaving to eat or do his basic hygiene. At that time, he presented no affective or psychotic symptoms and perceived his behavior as egosintonic. After six appointments with psychotherapeutic approach, he was able to get a job and improved his communication with the others, especially with family.Discussion/conclusionThis case fits most of the reports found on literature, in its presentation and clinical management. Hikikomori is not considered yet a disorder and further documentation of these cases is still needed to define its place in psychiatric nosology.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Mental Health Screening for COVID-19: a Proposed Cutoff Score for the Greek Version of the Fear of COVID-19 Scale (FCV-19S)

“…Intense and prolonged stressors, such as own and family health concerns, may amplify fear and deteriorate mental health (Fiorillo and Gorwood 2020 ). Elevated fear may also be related to increased prevalence of Hikikomori syndrome, an acute and prolonged social withdrawal for at least six consecutive months, typically considered a Japanese culture-bound syndrome, yet with emerging evidence of its global extent (Kato et al 2019 ; Macedo et al 2017 ) to prevent contamination (Taylor and Asmundson 2020 ) or as another adverse outcome of the current pandemic (Kato et al 2020 ). A recent systematic review and meta-analysis summarizing the psychological impact of previous and current coronavirus epidemics reports persistent psychiatric symptoms, especially in those who had been seriously ill (Rogers et al 2020 ).…”

Secondary school teachers' beliefs and needs about hikikomori and social withdrawn students

“…Hikikomori cases have been studied in Europe, and specifically in Croatia (Silić et al ., 2019), Finland (Haasio and Naka, 2019), France (Benarous et al ., 2022; Furuhashi et al ., 2012; Hamasaki et al ., 2022), Italy (Amendola et al ., 2021; Esposito et al ., 2023; Orsolini et al ., 2022a, b; Ranieri, 2015), Poland (Adamski, 2018), Russia (Borisova and Molonova, 2017; Voiskunskii and Soldatova, 2019), Portugal (Macedo et al ., 2017), Spain (García-Campayo et al ., 2007; Malagón-Amor et al ., 2015) and Ukraine (Frankova, 2017, 2019). Although life habits and society in European countries are different than in Japan (Adamski, 2018; Hamasaki et al ., 2022), people who decide to retire from social life seem to fear the real world, preferring to seek refuge in virtual contexts, where they can have a control over the social and emotional exchanges.…”