Global psychiatrists' opinions about hikikomori from biopsychosocial perspectives: International case vignette survey
Abstract Aim The aim of this study was to investigate whether psychiatrists around the world believe they might encounter cases of hikikomori (prolonged social isolation), and how they formulate and treat such cases. Methods A hikikomori case vignette was sent to psychiatrists of 34 countries around...
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2025-06-01
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| Online Access: | https://doi.org/10.1002/pcn5.70120 |
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| author | Marcus P. J. Tan Kohei Hayakawa Yukako Nakagami Victor Pereira‐Sanchez Seon Cheol Park Yong Chon Park Seok Woo Moon Tae Young Choi Yu‐Tao Xiang Kang Sim Toru Horinouchi Ajit Avasthi Sandeep Grover Roy Abraham Kallivayalil Yugesh Rai Mohammadreza Shalbafan Pavita Chongsuksiri Pichet Udomratn Samudra T. Kathriarachchi Afzal Javed Mian‐Yoon Chong Tan Chay‐Hoon Toshiya Inada Toshiya Murai Tomohiro Nakao Shigenobu Kanba Shih‐Ku Lin Norman Sartorius Naotaka Shinfuku Takahiro A. Kato |
| author_facet | Marcus P. J. Tan Kohei Hayakawa Yukako Nakagami Victor Pereira‐Sanchez Seon Cheol Park Yong Chon Park Seok Woo Moon Tae Young Choi Yu‐Tao Xiang Kang Sim Toru Horinouchi Ajit Avasthi Sandeep Grover Roy Abraham Kallivayalil Yugesh Rai Mohammadreza Shalbafan Pavita Chongsuksiri Pichet Udomratn Samudra T. Kathriarachchi Afzal Javed Mian‐Yoon Chong Tan Chay‐Hoon Toshiya Inada Toshiya Murai Tomohiro Nakao Shigenobu Kanba Shih‐Ku Lin Norman Sartorius Naotaka Shinfuku Takahiro A. Kato |
| author_sort | Marcus P. J. Tan |
| collection | DOAJ |
| description | Abstract Aim The aim of this study was to investigate whether psychiatrists around the world believe they might encounter cases of hikikomori (prolonged social isolation), and how they formulate and treat such cases. Methods A hikikomori case vignette was sent to psychiatrists of 34 countries around the world. Participants rated for the vignette: frequency of similar cases in one's practicing country; and aspects of formulation, diagnosis, suicide risk, and treatment plan. Results In total, 344 complete responses from 34 countries were returned. Eight countries/areas had 10 or more respondents: Japan (61), South Korea (54), Nepal (48), Iran (40), Thailand (32), India (23), Hong Kong (12), and UK (10); the remainder were placed in the “others” group (64). Respondents from all countries except Thailand felt that similar cases were seen. Diverse patterns of response were obtained regarding formulation and treatment. Japan, South Korea, and “others” favored psychosocial aspects in the formulation, while Iran, Nepal, and India favored biological factors. Most respondents felt the case could be treated by an outpatient visit, while others preferred hospitalization. Psychotherapy was rated highly as an intervention; Iran, South Korea, and “others” also rated pharmacotherapy highly. Conclusion Despite its limitations as an exploratory study, we found evidence that hikikomori‐like cases might exist around the world. However, opinions on how such cases should be formulated and treated vary significantly among countries. We believe this reflects how the experience of hikikomori is dependent on the related sociocultural context. Further comparative work, preferably with standardized assessment tools, will help to clarify how society might influence the individual experiences of practitioner and hikikomori patients. |
| format | Article |
| id | doaj-art-0dfb01fc082e486d949552d0a2a78d47 |
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| language | English |
| publishDate | 2025-06-01 |
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| spelling | doaj-art-0dfb01fc082e486d949552d0a2a78d472025-06-26T12:48:41ZengWileyPCN Reports2769-25582025-06-0142n/an/a10.1002/pcn5.70120Global psychiatrists' opinions about hikikomori from biopsychosocial perspectives: International case vignette surveyMarcus P. J. Tan0Kohei Hayakawa1Yukako Nakagami2Victor Pereira‐Sanchez3Seon Cheol Park4Yong Chon Park5Seok Woo Moon6Tae Young Choi7Yu‐Tao Xiang8Kang Sim9Toru Horinouchi10Ajit Avasthi11Sandeep Grover12Roy Abraham Kallivayalil13Yugesh Rai14Mohammadreza Shalbafan15Pavita Chongsuksiri16Pichet Udomratn17Samudra T. Kathriarachchi18Afzal Javed19Mian‐Yoon Chong20Tan Chay‐Hoon21Toshiya Inada22Toshiya Murai23Tomohiro Nakao24Shigenobu Kanba25Shih‐Ku Lin26Norman Sartorius27Naotaka Shinfuku28Takahiro A. Kato29Department of Child and Adolescent Psychiatry South London and Maudsley NHS Foundation Trust London UKDepartment of Neuropsychiatry Graduate School of Medical Sciences, Kyushu University Fukuoka JapanKyoto University Health Service Kyoto JapanDepartment of Child and Adolescent Psychiatry NYU Grossman School of Medicine New York New York USADepartment of Neuropsychiatry Hanyang University Guri Hospital Guri Republic of KoreaDepartment of Psychiatry Inje University Haeundae Paik Hospital Busan Republic of KoreaDepartment of Neuropsychiatry Konkuk University Chungju Hospital Chungbuk Republic of KoreaDepartment of Psychiatry Catholic University of Daegu School of Medicine Daegu Republic of KoreaUnit of Psychiatry, Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, Avenida da Universidade, Taipa Macao SAR ChinaInstitute of Mental Health, Buangkok Green Medical Park Singapore SingaporeDepartment of Psychiatry Hokkaido University Graduate School of Medicine Sapporo JapanDepartment of Psychiatry Postgraduate Institute of Medical Education and Research (PGIMER) Chandigarh IndiaDepartment of Psychiatry Postgraduate Institute of Medical Education and Research (PGIMER) Chandigarh IndiaPushpagiri Institute of Medical Sciences Tiruvalla IndiaEssex Partnership University Trust Colchester UKMental Health Research Center, Iran University of Medical Sciences Tehran IranBuddhachinaraj Hospital Phitsanulok ThailandDepartment of Psychiatry Faculty of Medicine, Prince of Songkla University Hat Yai ThailandDepartment of Psychiatry Faculty of Medical Sciences, University of Sri Jayewardenepura Nugegoda Sri LankaPakistan Psychiatric Research Centre, Fountain House Lahore PakistanChiayi Chang Gung Memorial Hospital and School of Medicine, Chang Gung University Chiayi TaiwanDepartment of Pharmacology National University of Singapore SingaporeDepartment of Psychiatry and Psychobiology Graduate School of Medicine, Nagoya University Nagoya JapanKyoto University Health Service Kyoto JapanDepartment of Neuropsychiatry Graduate School of Medical Sciences, Kyushu University Fukuoka JapanDepartment of Neuropsychiatry Graduate School of Medical Sciences, Kyushu University Fukuoka JapanDepartment of Psychiatry Linkou Chang Gung Memorial Hospital Taoyuan TaiwanAssociation for the Improvement of Mental Health Programmes Geneva SwitzerlandKobe University School of Medicine Kobe JapanDepartment of Psychiatry Hokkaido University Graduate School of Medicine Sapporo JapanAbstract Aim The aim of this study was to investigate whether psychiatrists around the world believe they might encounter cases of hikikomori (prolonged social isolation), and how they formulate and treat such cases. Methods A hikikomori case vignette was sent to psychiatrists of 34 countries around the world. Participants rated for the vignette: frequency of similar cases in one's practicing country; and aspects of formulation, diagnosis, suicide risk, and treatment plan. Results In total, 344 complete responses from 34 countries were returned. Eight countries/areas had 10 or more respondents: Japan (61), South Korea (54), Nepal (48), Iran (40), Thailand (32), India (23), Hong Kong (12), and UK (10); the remainder were placed in the “others” group (64). Respondents from all countries except Thailand felt that similar cases were seen. Diverse patterns of response were obtained regarding formulation and treatment. Japan, South Korea, and “others” favored psychosocial aspects in the formulation, while Iran, Nepal, and India favored biological factors. Most respondents felt the case could be treated by an outpatient visit, while others preferred hospitalization. Psychotherapy was rated highly as an intervention; Iran, South Korea, and “others” also rated pharmacotherapy highly. Conclusion Despite its limitations as an exploratory study, we found evidence that hikikomori‐like cases might exist around the world. However, opinions on how such cases should be formulated and treated vary significantly among countries. We believe this reflects how the experience of hikikomori is dependent on the related sociocultural context. Further comparative work, preferably with standardized assessment tools, will help to clarify how society might influence the individual experiences of practitioner and hikikomori patients.https://doi.org/10.1002/pcn5.70120epidemiologyhikikomoriisolationpsychopathologypsychotherapysocial psychiatry |
| spellingShingle | Marcus P. J. Tan Kohei Hayakawa Yukako Nakagami Victor Pereira‐Sanchez Seon Cheol Park Yong Chon Park Seok Woo Moon Tae Young Choi Yu‐Tao Xiang Kang Sim Toru Horinouchi Ajit Avasthi Sandeep Grover Roy Abraham Kallivayalil Yugesh Rai Mohammadreza Shalbafan Pavita Chongsuksiri Pichet Udomratn Samudra T. Kathriarachchi Afzal Javed Mian‐Yoon Chong Tan Chay‐Hoon Toshiya Inada Toshiya Murai Tomohiro Nakao Shigenobu Kanba Shih‐Ku Lin Norman Sartorius Naotaka Shinfuku Takahiro A. Kato Global psychiatrists' opinions about hikikomori from biopsychosocial perspectives: International case vignette survey PCN Reports epidemiology hikikomori isolation psychopathology psychotherapy social psychiatry |
| title | Global psychiatrists' opinions about hikikomori from biopsychosocial perspectives: International case vignette survey |
| title_full | Global psychiatrists' opinions about hikikomori from biopsychosocial perspectives: International case vignette survey |
| title_fullStr | Global psychiatrists' opinions about hikikomori from biopsychosocial perspectives: International case vignette survey |
| title_full_unstemmed | Global psychiatrists' opinions about hikikomori from biopsychosocial perspectives: International case vignette survey |
| title_short | Global psychiatrists' opinions about hikikomori from biopsychosocial perspectives: International case vignette survey |
| title_sort | global psychiatrists opinions about hikikomori from biopsychosocial perspectives international case vignette survey |
| topic | epidemiology hikikomori isolation psychopathology psychotherapy social psychiatry |
| url | https://doi.org/10.1002/pcn5.70120 |
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