Abstract

Background

Hikikomori in Japan is the phenomenon of social withdrawal that effects hundreds of thousands of individuals, in which the individual shuts his/herself in their room, generally at their family’s home, for several months or even years without engaging in social relationships. Although the number of articles on this topic is increasing, a thorough review of the literature has yet to be done.

Objective

The purpose of this article is to provide a review of psychiatrists’ studies on social withdrawal (hikikomori), bring out the main themes and recurrent problems, and suggest a focus for future research.

Methods

I reviewed the literature and identified 53 studies – books, guidelines and articles from 1978 to 2014 – investigating social withdrawal in Japan and outside Japan. I collected articles available from Japanese and international databases such as CiNii, JAIRO, JSTAGE, Web of Science, PubMed, and Scopus. I also summarize and analyze selected psychiatrists’ investigations.

Results

The results are broken down into four sections: first, an introduction to idioms of social withdrawal in Japan; second, an investigation into the insistence of hikikomori as a culture-bound syndrome; third, a description of the competition of two categories for inclusion in the DSM-5 – “hikikomori” and “taijin kyōfushō”; fourth, an analysis of the use of typification by psychiatrists, especially when it involves inventing fictive cases of hikikomori.

Conclusions

The results are coherent with the non-inclusion of hikikomori in the DSM-5, and a specific clinical description of hikikomori cannot be found in the existing scientific literature. Hence, the review suggests that hikikomori is not a syndrome, with a precise and specific clinical description, but an idiom of distress. The persons concerned resist psychiatric treatment for several reasons, the major one being that psychiatrists only meet with a minority of hikikomori cases.

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