Researchers have introduced a novel method to aid physicians and researchers in evaluating individuals for pathological social withdrawal, commonly known as Hikikomori. The newly devised tool, named the Hikikomori Diagnostic Evaluation (HiDE), serves as a valuable resource for gathering information on this swiftly emerging pathology globally.
Hikikomori is characterized by prolonged physical isolation or social withdrawal lasting more than six months. Initially identified in Japan in 1998, it was considered a Japan-specific ‘culture-bound’ condition. However, subsequent data reveal a significant rise in its global prevalence, with concerns growing about the impact of the recent COVID-19 pandemic on the surge of hikikomori cases.
Despite the escalating global occurrence, there has been a lack of a standardized tool for identifying hikikomori disorder. The HiDE evaluation instrument, detailed in World Psychiatry by Associate Professor Takahiro A. Kato of the Graduate School of Medical Sciences, aims to fill this gap and become a transcultural tool for identifying and assessing hikikomori patients.
Kyushu University Hospital, in 2013, established the world’s first hikikomori outpatient clinic to delve into the pathology and enhance treatment methods. Professor Kato and his team have developed various approaches for early hikikomori detection, even exploring potential pathology biomarkers. The HiDE questionnaire, evolved over years of refinement, takes approximately 5-20 minutes to complete and comprises two sections: one examining the patient’s behavior for hikikomori traits and the other providing context to the extent of social withdrawal.
To accommodate time constraints, a screening form has been added to HiDE. The full questionnaire is recommended for patients reporting spending ‘one hour or less per day out of their home, at least three days a week,’ and those whose social withdrawal is bothersome to themselves or others. While the HiDE proves invaluable in clinical practice, Professor Kato emphasizes the need for further empirical studies to validate its efficacy beyond their practice. He envisions global collaboration in refining the tool to address the escalating global phenomenon of hikikomori, emphasizing the importance of a collective effort in recognition and treatment.
