At the end of his second year, he dropped out of school. He hardly attended classes preferring to go out with friends. Upon graduating from high school, despite not having any particular motivation or goals, he followed his friends who were all going on to university by applying and being accepted to a relatively easy-to-enter local university. During his first year of high school, his father suddenly passed away due to an acute physical illness. He led a typical student lifestyle and regularly socialized with friends. In the second year of middle school, he was separated from a group classmates who he had known from elementary school and came to be ostracized by his new classmates.Īn average student, he was accepted to a local high school. He did not suffer from any particular issue from birth or early development, but as an elementary school student he began to copy the stutter of a popular comedian, which then became a habit. Mr A: A 38-year-old man lived with his elderly mother and younger brother. Finally, we present future challenges that may lead to solutions for an internationalized hikikomori. We also propose a hypothesis regarding the globalization of hikikomori based on our domestic and international research, and present our latest assessment system for hikikomori. In this review, we introduce the history, definition, diagnostic evaluation, and interventions for hikikomori and also the international prevalence of hikikomori outside Japan. The Oxford Dictionary's definition is: ‘(in Japan) the abnormal avoidance of social contact, typically by adolescent males.’ Hitherto hikikomori had been discussed as a culture-bound syndrome unique to Japan (as it is defined in the Oxford Dictionary) but we, the authors, now consider the condition to be far more global and perhaps better understood as a ‘contemporary society-bound syndrome.’ 5 Hikikomori negatively impacts not only the affected individual's mental health, but also population-level education and workforce stability and as such is an urgent issue in the administration of health, welfare, and labor in Japan. 2- 4 In 2010, the Oxford Dictionary published a new entry for the word hikikomori, signifying its presence and acceptance outside of a purely Japanese context. Initially hikikomori was seen as a phenomenon unique to Japanese society but more recently similar cases have been reported in many other countries and have been widely reported in the international media. Saito, published ‘ Hikikomori – Adolescence Without End.’ 1 Saito tentatively defined hikikomori as a person who has ceased to go to school or work for more than 6 months and has stayed at home for most of this time. Hikikomori became widely used as a noun in the latter half of the 1990s when a Japanese psychiatrist, T. In this way, individuals who have withdrawn from the group, in particular school or the workplace, for days, weeks, or months, spending most of the day within their home, are referred to in Japan as hikikomori. Collectivism is strongly rooted in Japan and this allows for an easy formation of groups, but when a situation arises where an individual has left the group and is isolated, they are described as ‘that person who has withdrawn into seclusion!’. Hikikomoru is a compound verb made up of the two characters for ‘to pull back’ and ‘to seclude oneself’. The Japanese word hikikomori has long and widely been used in its verb form – hikikomoru – within Japanese society. In addition, we introduce our latest assessment system for hikikomori (including the latest version of the ‘proposed diagnostic criteria of hikikomori for the future DSM/ICD diagnostic systems’) and propose therapeutic strategies, including family approaches and individualized therapies. We propose a hypothesis regarding the globalization of hikikomori based on domestic and international perspectives. Hikikomori negatively influences not only the individual's mental health and social participation, but also wider education and workforce stability, and as such is a novel urgent global issue. Moreover, hikikomori-like cases have recently been reported in many other countries. Hikikomori, a severe form of social withdrawal, has long been observed in Japan mainly among youth and adolescents since around the 1970s, and has been especially highlighted since the late 1990s.
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