Risk Factors Associated with Hikikomori in Adolescents after the COVID-19 Pandemic
Keywords:
hikikomori, social isolation, adolescent, pandemic, COVID-19Abstract
Introduction: The COVID-19 pandemic is a factor with psychopathogenic potential that brought about changes in human behavior, and psychological disorders that affect mental health.
Objective: Determine risk factors associated with hikikomori in adolescents after the COVID-19 pandemic.
Method: A cross-sectional study was carried out from November to December 2022, in a public educational institution in Ica, Peru. The sample consisted of 581 adolescents; general variables were studied, and the risk of suffering from hikikomori was assessed with the hikikomori questionnaire (HQ-25). A descriptive and multivariate statistical analysis was applied using generalized linear models of the Poisson family to evaluate the association among variables.
Results: Of the female participants, 48.5% were found to be at risk of suffering from hikikomori. The feelings of sadness, anxiety or depression experienced by adolescent girls were associated with a greater risk of presenting this disorder (RPa = 1.29: 95 % CI: 1.07-1.58); feelings of shame (RPa = 1.42: 95 % CI: 1.19-1.68), as well as feelings of being rejected by society (RPa = 1.36: 95 % CI: 1.14-1.62), and preferring compulsory isolation due to the COVID-19 pandemic (RPa = 1.18: 95 % CI: 0.99-1.42). Likewise, the condition of having had COVID-19 was associated with a lower risk (RPa = 0.77: 95% CI: 0.65-0.92).
Conclusions: The proportion of adolescents at risk of hikikomori is high; there are general variables capable of being modified that could lower the risk of this disorder induced or enhanced by the COVID-19 pandemic.
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References
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21. Martinotti G, Vannini C, Di Natale C, Sociali A, Stigliano G, Santacroce R, di Giannantonio M. Hikikomori: psychopathology and differential diagnosis of a condition with epidemic diffusion. Int J Psychiatry Clin Pract. 2021; 25(2):187-194. doi: 10.1080/13651501.2020.1820524.
22. Kubo H, Katsuki R, Horie K, Yamakawa I, Tateno M, Shinfuku N, Sartorius N, Sakamoto S, Kato TA. Risk factors of hikikomori among office workers during the COVID-19 pandemic: A prospective online survey. Curr Psychol. 2022; 29:1-19. doi: 10.1007/s12144-022-03446-8
23. Hamasaki Y, Pionnié-Dax N, Dorard G, Tajan N, Hikida T. Preliminary study of the social withdrawal (hikikomori) spectrum in French adolescents: focusing on the differences in pathology and related factors compared with Japanese adolescents. BMC Psychiatry. 2022; 22(1):477. doi: 10.1186/s12888-022-04116-6
24. Wong J, Wan M, Kroneman L, Kato T, Lo T, Wong P, Chan G. Hikikomori Phenomenon in East Asia: Regional Perspectives, Challenges, and Opportunities for Social Health Agencies. Front Psychiatry. 2019;10:512. doi: 10.3389/fpsyt.2019.00512
2. Becerra-Canales B, Campos-Martínez H, Campos-Sobrino M, Aquije-Cárdenas GA. Trastorno de estrés postraumático y calidad de vida del paciente post-COVID-19 en Atención Primaria. Aten Primaria. 2022; 54(10):102460. Doi:https://doi.org/10.1016/j.aprim.2022.102460
3. Huckins JF, Wang W, Hedlund E, Rogers C, Nepal SK, Wu J, Campbell AT. Mental health and behavior of college students during the early phases of the COVID-19 pandemic: longitudinalsmartphone and ecological momentary assessment study. Journal medical internet research. 2020; 22(6):e20185. Doi: https://doi.org/10.2196/20185
4. Saito T. Hikikomori. Adolescence without end. [Hikikomori Adolescencia sin fin]. Estados Unidos: University of Minnesota Press; 2013. 192 p. Disponible en: https://www.academia.edu/9948534/Hikikomori_Adolescence_Without_End_by_Saito_Tamaki
5. Semeniuk GB. Hikikomori y síndrome de enclaustramiento. Medicina (Buenos Aires). 2021; 81(2):279-81.
6. Rooksby M, Furuhashi T, McLeod HJ. Hikikomori: a hidden mental health need following the COVID-19 pandemic. World Psychiatry. 2020; 19:399-400. Doi: https://doi.org/10.1002/wps.20804
7. Kato TA, Sartorius N, Shinfuku N. Forced social isolation due to COVID-19 and consequent mental health problems: Lesson from hikikomori. Psyquiatry and Clinical Neurosciences. 2020; 74(9):506-07. Doi: https://doi.org/10.1111/pcn.13112
8. Orsolini L, Bellagamba S, Volpe U, Kato TA. Hikikomori and modern-type depression in Italy: A new phenotypical trans-cultural characterization? Revista Internacional de Psiquiatría Social. 2022;68(5):1010-17. Doi: https://doi.org/10.1177/00207640221099408
9. Choi TY, Lee HJ, Je SR, Kim JW. Factors associated with korean adolescent hikikomori: loneliness, education level, and internet addiction.Journal of the American Academy of Child & Adolescent Psychiatry. 2022;61(10):141-42. Supplement. Doi: https://doi.org/10.1016/j.jaac.2022.09.019
10. Gavin J, Brosnan M. The relationship between hikikomori risk and internet use during COVID-19 restrictions. Cyberpsychol Behav Soc Netw. 2022;25(3):189-93. Doi: https://doi.org/10.1089/cyber.2021.0171
11. Wong PW, Li TM, Chan M, Law YW, Chau M, Cheng C, et al. The prevalence and correlates of severe social withdrawal (hikikomori) in Hong Kong: A cross-sectional telephone-based survey study. Int J Soc Psychiatry. 2015; 61(4):330-42. https://doi.org/10.1177/0020764014543711
12. Amendola S, Cerutti R, Presaghi F, Spensieri V, Lucidi C, Silvestri E, et al. Hikikomori, problematic internet use and psychopathology: correlates in non-clinical and clinical respondentss of young adults in Italy. J. Psychopathol. 2021; 27: 106–114. doi: 10.36148/2284-0249-412
13. Yong RK, Fujita K, Chau PY, Sasaki H. Characteristics of and gender difference factors of hikikomori among the working-age population: A cross-sectional population study in rural Japan. Nihon Koshu Eisei Zasshi. 2020; 67(4):237-246. doi: 10.11236/jph.67.4_237.
14. Al-Sibani N, Chan MF, Al-Huseini S, Al Kharusi N, Guillemin GJ, Al-Abri M, Ganesh A, Al Hasani Y, Al-Adawi S. Exploring Hikikomori-like idiom of distress a year into the SARS-CoV-2 pandemic inOman: Factorial validity of the 25-item Hikikomori Questionnaire, prevalence and associated factors. PLoS One. 2023 Aug 7;18(8):e0279612. doi: 10.1371/journal.pone.0279612.
15. Sparks M. Reflections on the International Union for Health Promotion and Education. Glob Health Promot. 2021;28(4):117-18. Doi: https://doi.org/10.1177/17579759211059034
16. Teo AR, Chen JI, Kubo H, Katsuki R, Sato-Kasai M, Shimokawa N, Kato TA. Development and validation of the 25-item Hikikomori Questionnaire (HQ-25). Psychiatry Clinical and Neurosciences. 2018;72(10):780-88. Doi:https://doi.org/10.1111/pcn.12691
17. Tateno M, Teo AR, Ukai W, Kanazawa J, Katsuki R, Kubo H, Kato TA. Internet addiction, smartphone addiction, and hikikomori trait in japanese young adult: social isolation and social network. Frontiers in Psychiatry. 2019;10(455):1-11. Doi: https://doi.org/10.3389/fpsyt.2019.00455
18. Romero ME. Hikikomori. Las voces silenciosas de la sociedad japonesa. México y la cuenca del pacífico. 2019;8(23):123-38. Doi: https://doi.org/10.32870/mycp.v8i23.561
19. Hamasaki Y, Pionnié-Dax N, Dorard G, Tajan N, Hikida T. Identifying social withdrawal (hikikomori) factors in adolescents: understanding the hikikomori spectrum. Child Psychiatry & Human Development. 2021;52:808-17. Doi: https://doi.org/10.1007/s10578-020-01064-8
20. Nonaka S, Sakai MA. Correlational study of socioeconomic factors and the prevalence of hikikomori in Japan from 2010 to 2019. Comprehensive Psychiatry 2021;108:152251. Doi:https://doi.org/10.1016/j.comppsych.2021.152251
21. Martinotti G, Vannini C, Di Natale C, Sociali A, Stigliano G, Santacroce R, di Giannantonio M. Hikikomori: psychopathology and differential diagnosis of a condition with epidemic diffusion. Int J Psychiatry Clin Pract. 2021; 25(2):187-194. doi: 10.1080/13651501.2020.1820524.
22. Kubo H, Katsuki R, Horie K, Yamakawa I, Tateno M, Shinfuku N, Sartorius N, Sakamoto S, Kato TA. Risk factors of hikikomori among office workers during the COVID-19 pandemic: A prospective online survey. Curr Psychol. 2022; 29:1-19. doi: 10.1007/s12144-022-03446-8
23. Hamasaki Y, Pionnié-Dax N, Dorard G, Tajan N, Hikida T. Preliminary study of the social withdrawal (hikikomori) spectrum in French adolescents: focusing on the differences in pathology and related factors compared with Japanese adolescents. BMC Psychiatry. 2022; 22(1):477. doi: 10.1186/s12888-022-04116-6
24. Wong J, Wan M, Kroneman L, Kato T, Lo T, Wong P, Chan G. Hikikomori Phenomenon in East Asia: Regional Perspectives, Challenges, and Opportunities for Social Health Agencies. Front Psychiatry. 2019;10:512. doi: 10.3389/fpsyt.2019.00512
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Published
2023-11-13
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1.
Becerra-Canales B, Hernández-Huaripaucar E, Laos-Anchante C, del Rio-Mendoza J, Dávalos-Almeyda M, Cevallos-Cardenas MJ, et al. Risk Factors Associated with Hikikomori in Adolescents after the COVID-19 Pandemic. Rev. Hosp. Psiq. Habana [Internet]. 2023 Nov. 13 [cited 2025 Aug. 18];20(3). Available from: https://revhph.sld.cu/index.php/hph/article/view/367
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