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Hikikomori as a possible clinical term in psychiatry: a questionnaire survey

Masaru Tateno1*, Tae Woo Park2, Takahiro A Kato3, Wakako Umene-Nakano4 and Toshikazu Saito1

Author Affiliations

1 Department of Neuropsychiatry, Sapporo Medical University, School of Medicine, South-1, West-16, Chuo-ku, Sapporo 0608543, Japan

2 Department of Psychiatry, Boston University School of Medicine and VA Boston Healthcare System, 251 Causeway Street, Boston, MA, 02114, USA

3 Department of Neuropsychiatry, Graduate school of Medical Sciences, Kyushu University, 3-1-1 Maidashi Higashi-ku, Fukuoka, 8128582, Japan

4 Department of Psychiatry, School of Medicine, University of Occupational and Environmental Health, Iseigaoka, Yahatanishi-ku, Kitakyushu, Fukuoka, 8078555, Japan

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BMC Psychiatry 2012, 12:169  doi:10.1186/1471-244X-12-169

Published: 15 October 2012



The word hikikomori, the abnormal avoidance of social contact, has become increasingly well-known. However, a definition of this phenomenon has not been discussed thoroughly. The aim of this study is to gain a better understanding of the perception of hikikomori amongst health-related students and professionals and to explore possible psychiatric conditions underlying hikikomori.


A total of 1,038 subjects were requested to complete a questionnaire regarding hikikomori phenomenon.


While some differences in the perception of hikikomori do exist, all subjects tended to disagree with the statement, “hikikomori is NOT a disorder”. Regarding the underlying psychiatric disorders of hikikomori, approximately 30% of psychiatrists chose schizophrenia as the most applicable ICD-10 diagnosis for hikikomori, whereas 50% of pediatricians chose neurotic or stress-related disorders.


An argument still exists regarding the relationship between hikikomori and psychiatric disorders. We propose that the term hikikomori could be used to describe severe social withdrawal in the setting of a number of psychiatric disorders.

Hikikomori; Social withdrawal; School refusal; Psychiatric diagnosis; Developmental disorders