Researchers at Kyushu University have developed a new tool to help clinicians and researchers assess people for pathological social withdrawal, known as Hikikomori. The tool, called the Hikikomori Diagnostic Evaluation or HiDE, can be a practical guide to gathering information about this globally growing pathology.
Hikikomori is a condition characterized by prolonged physical isolation or social withdrawal for a period exceeding six months. It was first defined in Japan in 1998, and while it is believed to be a Japan-specific “culture-bound” syndrome, recent evidence has shown its remarkable growth worldwide. Researchers and medical professionals also fear that the recent COVID-19 pandemic has exacerbated the rise of hikikomori patients around the world.
However, there is still no standardized tool for detecting hikikomori pathology. The new HiDE assessment tool, developed by Associate Professor Takahiro A. Kato of the Graduate School of Medical Sciences published in Global Psychiatryintended to be the next step in a cross-cultural tool to help identify and assess hikikomori individuals.
In 2013, Kyushu University Hospital established the world’s first hikikomori outpatient clinic in hopes of researching the pathology and finding better treatment methods. Over the years, Kato and his team developed different methods for the early detection of hikikomori and even investigated potential biomarkers of the pathology.
“The HiDE is a questionnaire that we develop in our clinic at University Hospital. We have perfected it over the years and today it takes about 5-20 minutes to complete depending on the answers,” Kato explains. “It’s mainly divided into two sections. The first section examines the patient’s behavioral characteristics to see if they exhibit hikikomori. The second section is used to help us gain context for the extent of the patient’s social withdrawal.”
The team has also added a screening form to the HiDE in case clinicians do not have the time to administer the entire tool. They suggest giving the full questionnaire to patients who answer that they “spend an hour or less a day outside their home, at least three days a week” and that “their family, others, or they are personally bothered by it.”
“The HiDE has proven to be an indispensable tool for the structured assessment of pathological social withdrawal in our clinical practice and research. But more empirical studies need to be done to assess its validity beyond our practice,” he concludes. Kato. “We would like to see this used by our colleagues around the world so we can work to improve the tool. Hikikomori is becoming a global phenomenon and a collaborative effort to identify and treat hikikomori will be vital .”