![]() ![]() At the time of initial evaluation, the patient was noted to have normal hygiene and grooming. His parents became concerned and sought psychiatric evaluation. He likewise stopped any attempts at studying. ![]() He had no significant problems or difficulties during elementary school, but suddenly and without any apparent trigger, ceased attending school during the last quarter of the first year of middle school. The patient is a 14-year-old Japanese boy who complains of not wanting to attend school. Research diagnostic criteria for the condition are proposed. We suggest hikikomori may be considered a culture-bound syndrome and merits further international research into whether it meets accepted criteria as a new psychiatric disorder. However, a notable subset of cases with substantial psychopathology do not meet criteria for any existing psychiatric disorder. The majority of such cases of hikikomori are classifiable as a variety of existing DSM-IV-TR (or ICD-10) psychiatric disorders. A number of recent empiric studies have emerged from Japan. Electronic and manual literatures searches were used to gather information on social withdrawal and hikikomori, including studies examining case definitions, epidemiology, and diagnosis. The aim of this study was to review the evidence for hikikomori as a new psychiatric disorder. A form of severe social withdrawal, called hikikomori, has been frequently described in Japan and is characterized by adolescents and young adults who become recluses in their parents’ homes, unable to work or go to school for months or years. ![]()
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