Hikikomori: contemporary forms of suffering in the transition from adolescence to adulthood

Manuella De Luca, Estelle Louët, Caroline Thompson, Benoît Verdon


Introduction: Since the emergence of Hikikomori syndrome in Japanese literature, special attention has been given to this phenomenon all over the world concerning adolescents and young adults. Several questions have risen: the novelty or not of such syndrome, its psychopathological and nosographical status, but also its social and cultural implications.

Material and method: We have first realized an analysis of studies published in French in order to confront them with the reference studies of international literature. As soon as 1950, a description of a “claustration syndrome” occurred with its psychological implications and transnosographical, mainly based on adult subjects. During the 2000’s, the interest for these adolescent behaviours increase, stressing the complexity both of its functioning and the treatment modalities, but also the access to these young secluded. Then we present two forms of Hikikomori, built after a clinical study of a cohorte of 30 adolescents, and illustrated them by to two clinical vignettes

Results and discussion: The predominance of Hikikomori among boy teenagers and young adults has led us to explore the functions of this behaviour during adolescence and its specific stakes: excitement treatment, passivity treatment, confrontation with loss and with ideal’s demand. We make the hypothesis of a double figure of Hikikomori. The first concerns temporary and defensive adjustments of conflicts, the other stresses the impossibility to treat the adolescence process. Therefore, the therapeutically propositions have to take into account these two figures of Hikikomori.


Hikikomori; Adolescent; Inhibition; Passivity; Ideal.

Full Text:



Borovoy, A. (2008). Japan’s Hidden Youths: Mainstreaming the Emotionally Distressed in Japan. Culture, Medicine, and Psychiatry, 32(4), 552–576.https://doi.org/10.1007/s11013-008-9106-2

Botella, C.& Botella, S. (2004). The Work of Psychic Figurability Mental States without Representation. Routledge with the Institute of Psychoanalysis.

Caputo, A., (2020). Emotional and symbolic components of hikikomori experience: A qualitative narrative study on social withdrawal Mediterranean Journal of Clinical Psychology, 8 (1), 7-15. https://doi.org/10.6092/2282-1619/mjcp.2312

Chan, G. H., & Lo, T. W. (2014). Hidden youth services: What Hong Kong can learn from Japan. Children and Youth Services Review, 42, 118–126. https://doi.org/10.1016/j.childyouth.2014.03.021

Chauliac, N., Couillet, A., Faivre, S., Brochard, N., & Terra, J.-L. (2017). Characteristics of socially withdrawn youth in France: A retrospective study. International Journal of Social Psychiatry, 63(4), 339–344. https://doi.org/10.1177/0020764017704474

Chong, S., & Chan, K.-M. (2012). A Case Study of a Chinese “Hikikomorian” in Canada - Theorizing the Process of Hikikomorization. Journal of Special Education and Rehabilitation, 13(3-4).


Coppola, E., & Mento, C. (2013). Clinical psychology and research: Epistemological notes. Mediterranean Journal of Clinical Psychology,1(1).https://doi.org/10.6092/2282-1619/2013.1.900

De Luca, M. (2017). Hikikomori: Cultural idiom or present-day expression of the distress engendered by the transition from adolescence to adulthood. L'Évolution Psychiatrique, 82(1), e1-e15.


De Luca, M, (2019). Hikikomori : retrait et claustration chez les adolescents et jeunes adultes contemporains. Encyclopédie Médico-Chirurgicale, - 20/06/19 [37-214-A-60] https://Doi:10.1016/S0246-1072(19)41506-X

De Luca, M. & Neau, F. (2016). Les conduites de retrait au domicile : un destin du fantasme de retour dans le ventre maternel à l’adolescence ? Psychologie clinique et projective 2016, 22(1):225. 243


De Luca, M. (2018). L’ennui comme disposition adolescente aux frontières. Cliniques, 15(1), 65. https://doi.org/10.3917/clini.015.0065

De Luca, M. (2020). Actualités de la méthode de l’étude de cas. Proposition d’une méthodologie hypothético-processuelle et traductive pour les recherches référées à la psychanalyse. L’Évolution Psychiatrique, 85(1), 33–48. https://doi.org/10.1016/j.evopsy.2019.12.008

De Luca, M., & Chenivesse, P. (2018). Formations de l’idéal, Hikikomori et virtuel à l’adolescence. L’Évolution Psychiatrique, 83(3), 443–456.https://doi.org/10.1016/j.evopsy.2018.03.004

Doi, T. (1973). The anatomy of dependence. Harper and Row.

Fédida, P. (2001). Des bienfaits de la dépression. Éloge de la psychothérapie. Odile Jacob. 2003.

Fong Yong, R. K., & Kaneko, Y. (2016). Hikikomori, a Phenomenon of Social Withdrawal and Isolation in Young Adults Marked by an Anomic Response to Coping Difficulties: A Qualitative Study Exploring Individual Experiences from First- and Second-Person Perspectives. Open Journal of Preventive Medicine, 06(01), 1–20. http://dx.doi.org/10.4236/ojpm.2016.61001

Frankova, I. (2017). Does hikikomori exist in Ukraine? European Psychiatry, 41(S1), S228-S228. https://doi.org/10.26226/morressier.5885d719d462b8028d891ea0

Frankova, I. (2019). Similar but Different: Psychological and Psychopathological Features of Primary and Secondary Hikikomori. Frontiers in Psychiatry, 10. https://doi.org/10.3389/fpsyt.2019.00558

Fujikawa, S., Ando, S., Nishida, A., Usami, S., Koike, S., Yamasaki, S., … Kasai, K. (2018). Disciplinary slapping is associated with bullying involvement regardless of warm parenting in early adolescence. Journal of Adolescence, 68, 207–216. https://doi.org/10.1016/j.adolescence.2018.07.018

Funakoshi, A., & Miyamoto, Y. (2014). Significant factors in family difficulties for fathers and mothers who use support services for children with hikikomori. Psychiatry and Clinical Neurosciences, 69(4), 210–219. https://doi.org/10.1111/pcn.12230

Furuhashi, T., Tsuda, H., Ogawa, T., Suzuki, K., Shimizu, M., Teruyama, J., … Castel, P.-H. (2013). État des lieux, points communs et différences entre des jeunes adultes retirants sociaux en France et au Japon (Hikikomori). L’Évolution Psychiatrique, 78(2), 249–266. https://doi.org/10.1016/j.evopsy.2013.01.016

Gayral, L., Carrie, J., Bonnet, J. (1953) La claustration. Annales Médico-Psychologiques , 111 (1), 469-496.

Hattori, Y. (2006). Social Withdrawal in Japanese Youth. Journal of Trauma Practice, 4(3-4), 181–201.


Heinze, U., & Thomas, P. (2014). Self and salvation: visions of hikikomori in Japanese manga. Contemporary Japan, 26(1), 151–169 https://doi.org/10.1515/cj-2014-0007

Kato, T. A., Hashimoto, R., Hayakawa, K., Kubo, H., Watabe, M., Teo, A. R., & Kanba, S. (2015). Multidimensional anatomy of “modern type depression” in Japan: A proposal for a different diagnostic approach to depression beyond the DSM-5. Psychiatry and Clinical Neurosciences, 70(1), 7–23.


Kato, T. A., Kanba, S., & Teo, A. R. (2020). Defining pathological social withdrawal: proposed diagnostic criteria for hikikomori. World Psychiatry, 19(1), 116–117. https://doi.org/10.1002/wps.20705

Katsuki, R., Inoue, A., Indias, S., Kurahara, K., Kuwano, N., Funatsu, F., … Kato, T. A. (2019). Clarifying Deeper Psychological Characteristics of Hikikomori Using the Rorschach Comprehensive System: A Pilot Case–Control Study. Frontiers in Psychiatry, 10. https://doi.org/10.3389/fpsyt.2019.00412

Kitayama, O. (2010). Prohibition of Don't Look: Living Through Psychoanalysis and Culture in Japan. Iwasaki Gakujutsu Shuppansha.

Kondo, N., Sakai, M., Kuroda, Y., Kiyota, Y., Kitabata, Y., & Kurosawa, M. (2011). General condition of hikikomori (prolonged social withdrawal) in Japan: Psychiatric diagnosis and outcome in mental health welfare centers. International Journal of Social Psychiatry, 59(1), 79–86.


Koyama, A., Miyake, Y., Kawakami, N., Tsuchiya, M., Tachimori, H., & Takeshima, T. (2010). Lifetime prevalence, psychiatric comorbidity and demographic correlates of “hikikomori” in a community population in Japan. Psychiatry Research, 176(1), 69–74. https://doi.org/10.1016/j.psychres.2008.10.019

Kraft, T. (1970). Sexual factors in the development of the housebound housewife syndrome. The Journal of Sex Research, 6(1), 59–63 https://doi.org/10.1080/00224497009550645

Lee, Y. S., Lee, J. Y., Choi, T. Y., & Choi, J. T. (2013). Home visitation program for detecting, evaluating and treating socially withdrawn youth in Korea. Psychiatry and Clinical Neurosciences, 67(4), 193–202.


Li, T. M., & Wong, P. W. (2015). Youth social withdrawal behavior (hikikomori): A systematic review of qualitative and quantitative studies. Australian & New Zealand Journal of Psychiatry, 49(7), 595–609.


Malagón-Amor, Á., Córcoles-Martínez, D., Martín-López, L. M., & Pérez-Solà, V. (2015). Hikikomori in Spain: A descriptive study. International Journal of Social Psychiatry, 61(5), 475–483.


Malagón-Amor, Á., Martín-López, L. M., Córcoles, D., González, A., Bellsolà, M., Teo, A. R., … Bergé, D. (2020). Family Features of Social Withdrawal Syndrome (Hikikomori). Frontiers in Psychiatry, 11. https://doi.org/10.3389/fpsyt.2020.00138

Merlo, E. M., Frisone, F., Settineri, S. Depression signs: Teasing and Low Self-esteem in Female Obese Adolescents: a clinical evaluation. Mediterranean Journal of Clinical Psychology, 6 (1) (2018).


Nagata, T., Yamada, H., Teo, A. R., Yoshimura, C., Nakajima, T., & van Vliet, I. (2011). Comorbid social withdrawal (hikikomori) in outpatients with social anxiety disorder: Clinical characteristics and treatment response in a case series. International Journal of Social Psychiatry, 59(1), 73–78.


Nonaka, S., Shimada, H., & Sakai, M. (2020). Family Behavioral Repertoires and Family Interaction Influence the Adaptive Behaviors of Individuals With Hikikomori. Frontiers in Psychiatry, 10.


Pereira-Sanchez, V., Alvarez-Mon, M. A., Asunsolo del Barco, A., Alvarez-Mon, M., & Teo, A. (2019). Exploring the Extent of the Hikikomori Phenomenon on Twitter: Mixed Methods Study of Western Language Tweets. Journal of Medical Internet Research, 21(5), e14167.


Ranieri, F. (2015). Gdy wycofanie społeczne przybiera postać skrajną: zjawisko, hikikomori” we Włoszech. Psychiatria i Psychologia Kliniczna, 15(3), 148–151. https://doi.org/10.15557/pipk.2015.0023

Ranieri, F., & Luccherino, L. (2018). Hikikomori: debating a XXI century phenomenon from a clinical point of view. Scandinavian Journal of Child and Adolescent Psychiatry and Psychology, 6(1), 72–79.


Rapp, M. S. (1984). Differential diagnosis and treatment of the" housebound syndrome". Canadian Medical Association Journal, 131(9), 1041.

Saito, T. (1998) Shakaiteki Hikikomori: owaranai shishunki. PHP Shinsho

Saitō, T., (2013). Shakaiteki hikikomori: owaranai shishunki. Social Withdrawal: Adolescence without End. University of Minnesota Press.

Sakamoto, N., Martin, R. G., Kumano, H., Kuboki, T., & Al-Adawi, S. (2005). Hikikomori, is it a Culture-Reactive or Culture-Bound Syndrome? Nidotherapy and a Clinical Vignette from Oman. The International Journal of Psychiatry in Medicine, 35(2), 191–198. https://doi.org/10.2190/7weq-216d-tvnh-pqj1

Settineri, S. Sicari F., Dritto I. P, Frisone F., Mobilia F., S. Merlo, E, M., (2019) Application of art therapy in adolescence: photo-novel analysis as an expressive technique, Mediterranean Journal of Clinical Psychology, 7(2). https://doi.org/10.6092/2282-1619/2019.7.2247

Sideli, L., La Barbera, D., Montana, S., Sartorio, C., R., SeminerioF., Corso, M., Guinta, S., Mannino, G., La Cascia, C., (2018) Pathological gambling in adolescence: a narrative review. Mediterranean Journal of Clinical Psychology, Mediterranean Journal of Clinical Psychology 6, (1). https://doi.org/10.6092/2282-1619/2018.6.1738

Stip, E. (2014). Interface santé mentale, société et toxicomanie – une thématique et deux illustrations : l’usage médical du cannabis et le hikikomori. Santé Mentale Au Québec, 39(2), 7. https://doi.org/10.7202/1027828ar

Stip, E., Thibault, A., Beauchamp-Chatel, A., & Kisely, S. (2016). Internet addiction, hikikomori syndrome, and the prodromal phase of psychosis. Frontiers in psychiatry, 7, 6. https://doi.org/10.3389/fpsyt.2016.00006

Suryhina, V. Endless the circle of Hikikomori. Does de current state of Japanese family promote the phenomenon of primary Hikikomori. 2017.https://DOI:10.13140/RG.2.2.26085.60649

Suwa, M., Suzuki, K., Hara, K., Watanabe, H., & Takahashi, T. (2003). Family features in primary social withdrawal among young adults. Psychiatry and Clinical Neurosciences, 57(6), 586–594.


Tajan, N. (2015). Social withdrawal and psychiatry: A comprehensive review of Hikikomori. Neuropsychiatrie de l’Enfance et de l’Adolescence, 63(5), 324–331. https://doi.org/10.1016/j.neurenf.2015.03.008

Tan, M. P. J., Lee, W., & Kato, T. A. (2020). International experience of hikikomori (prolonged social withdrawal) and its relevance to psychiatric research. BJPsych International, 1–3.


Teo, A. R. (2009). A New Form of Social Withdrawal in Japan: a Review of Hikikomori. International Journal of Social Psychiatry, 56(2), 178–185. https://doi.org/10.1177/0020764008100629

Teo, A. R., & Gaw, A. C. (2010). Hikikomori, a Japanese Culture-Bound Syndrome of Social Withdrawal? The Journal of Nervous and Mental Disease, 198(6), 444–449.


Teo, A. R., Fetters, M. D., Stufflebam, K., Tateno, M., Balhara, Y., Choi, T. Y., … Kato, T. A. (2014). Identification of the hikikomori syndrome of social withdrawal: Psychosocial feature and treatment preferences in four countries. International Journal of Social Psychiatry, 61(1), 64–72.


Teo, A. R., Stufflebam, K., Saha, S., Fetters, M. D., Tateno, M., Kanba, S., & Kato, T. A. (2015). Psychopathology associated with social withdrawal: Idiopathic and comorbid presentations. Psychiatry Research, 228(1), 182–183. https://doi.org/10.1016/j.psychres.2015.04.033

Todd, K. H. L. (2011). Hikikomania: Existential horror or national malaise. Southeast Review of Asian Studies, 33, 135-147.

Twenge, JM. (2017). iGen : why today’s super-connected kids are growing up less rebellious, more tolerant, less happy-and completely unprepared for adulthood (And what this means for the rest US) Atria books. https://doi.org/10.1111/fcsr.12345

Umeda, M., & Kawakami, N. (2012). Association of childhood family environments with the risk of social withdrawal (“hikikomori”) in the community population in Japan. Psychiatry and Clinical Neurosciences, 66(2), 121–129. https://doi.org/10.1111/j.1440-1819.2011.02292.x

Wilson, S. (2010). Braindance of the Hikikomori: Towards a Return to Speculative Psychoanalysis. Paragraph, 33(3), 392–409. https://doi.org/10.3366/para.2010.0206

Wong, P. W., Li, T. M., Chan, M., Law, Y., Chau, M., Cheng, C., Yip, P. S. (2015). The prevalence and correlates of severe social withdrawal (hikikomori) in Hong Kong: A cross-sectional telephone-based survey study. International Journal of Social Psychiatry, 61(4), 330–342. https://doi.org/10.1177/0020764014543711

Wooldridge, T. (2016). Understanding Anorexia Nervosa in Males : an integrative approach. Routledge https://doi.org/10.4324/9781315669137

Wu, A. F. W., Ooi, J., Wong, P. W. C., Catmur, C., & Lau, J. Y. F. (2019). Evidence of pathological social withdrawal in non-Asian countries: a global health problem? The Lancet Psychiatry, 6(3), 195–196. https://doi.org/10.1016/s2215-0366(18)30428-0

Yong, R., & Nomura, K. (2019). Hikikomori Is Most Associated With Interpersonal Relationships, Followed by Suicide Risks: A Secondary Analysis of a National Cross-Sectional Study. Frontiers in Psychiatry, 10. https://doi.org/10.3389/fpsyt.2019.00247

Yuen J, Yan Y, Wong V, Tam W, So K-W, Chien W. A Physical Health Profile of Youths Living with a “Hikikomori” Lifestyle. International Journal of Environmental Research and Public Health [Internet]. MDPI AG; 2018 Feb 11;15(2):315. Available from: http://dx.doi.org/10.3390/ijerph15020315

DOI: https://doi.org/10.6092/2282-1619/mjcp-2507


  • There are currently no refbacks.