TY - JOUR
T1 - A 12-month study of the hikikomori syndrome of social withdrawal: Clinical characterization and different subtypes proposal
AU - Malagón-Amor, Ángeles
AU - Martín-López, Luis Miguel
AU - Córcoles, David
AU - González, Anna
AU - Bellsolà, Magda
AU - Teo, Alan R.
AU - Pérez, Víctor
AU - Bulbena, Antoni
AU - Bergé, Daniel
PY - 2018/12/1
Y1 - 2018/12/1
N2 - © 2018 Elsevier B.V. Social withdrawal is a new mental health problem increasingly common, present in different cultures, whose psychopathology and treatment is not yet established. This study aims to determine the socio-demographic and clinical features and possible clinical subtypes that predict the 12-month outcomes of cases with hikikomori syndrome, a severe form of social withdrawal. Socio-demographic and clinical data at baseline were analysed as well as data obtained for 12 months after at-home treatment in 190 cases. The inclusion criteria were: spending all time at home, avoiding social situations and relationships, significant deterioration due to social isolation, with a minimum duration of 6 months. Six major diagnostic groups were identified: affective, anxiety, psychotic, drug use, personality and other Axis I disorders. The anxiety-affective subgroup demonstrated lower clinical severity, but worse evolution. Less than half of the cases were available for medical follow-up at 12-months. Subjects undergoing intensive treatment had a higher medical follow-up rate and better social networks at 12-months. Therefore, our findings provide data to reach consensus on the specific characteristics of social isolation hikikomori syndrome. The analysis demonstrated the fragility and tendency to relapse and have disengagement, particularly relevant in the anxiety-affective subgroup, suggesting that intensive treatments are more effective.
AB - © 2018 Elsevier B.V. Social withdrawal is a new mental health problem increasingly common, present in different cultures, whose psychopathology and treatment is not yet established. This study aims to determine the socio-demographic and clinical features and possible clinical subtypes that predict the 12-month outcomes of cases with hikikomori syndrome, a severe form of social withdrawal. Socio-demographic and clinical data at baseline were analysed as well as data obtained for 12 months after at-home treatment in 190 cases. The inclusion criteria were: spending all time at home, avoiding social situations and relationships, significant deterioration due to social isolation, with a minimum duration of 6 months. Six major diagnostic groups were identified: affective, anxiety, psychotic, drug use, personality and other Axis I disorders. The anxiety-affective subgroup demonstrated lower clinical severity, but worse evolution. Less than half of the cases were available for medical follow-up at 12-months. Subjects undergoing intensive treatment had a higher medical follow-up rate and better social networks at 12-months. Therefore, our findings provide data to reach consensus on the specific characteristics of social isolation hikikomori syndrome. The analysis demonstrated the fragility and tendency to relapse and have disengagement, particularly relevant in the anxiety-affective subgroup, suggesting that intensive treatments are more effective.
KW - Comorbidity
KW - Differential diagnosis
KW - Home treatment
KW - Long-term treatment
KW - Social isolation
U2 - 10.1016/j.psychres.2018.03.060
DO - 10.1016/j.psychres.2018.03.060
M3 - Article
SN - 0165-1781
VL - 270
SP - 1039
EP - 1046
JO - Psychiatry Research
JF - Psychiatry Research
ER -