Citation

Masuda R, Katsuki R, Matsushima T, Kyuragi S, Nakao T, Kato TA. J. Affect. Disord. 2024; ePub(ePub): ePub.

Copyright

(Copyright © 2024, Elsevier Publishing)

DOI

10.1016/j.jad.2024.05.094

PMID

38777275

Abstract

BACKGROUND: In the 1990s, the concepts of hikikomori and modern-type depression (MTD) emerged in Japan. Hikikomori is a condition of social avoidance or isolation, characterized by staying at home and being physically isolated for at least six months. MTD is characterized by depressive symptoms-mainly in stressful work or school situations during adolescence and early adulthood-which tend to rapidly reduce or disappear after leaving the stressful situation. We hypothesized that childhood maltreatment can form MTD traits that lead to hikikomori.

METHODS: As a first step, we conducted a multigroup path analysis between childhood maltreatment, MTD traits, and physical isolation in the hikikomori group. This study utilized the nine-item Patient Health Questionnaire (PHQ-9), Home Environment Questionnaire (HEQ), 22-item Tarumi Modern-Type Depressive Trait Scale (TACS-22), 25-item Hikikomori Questionnaire (HQ-25), and Hamilton Depression Rating Scale (HDRS). The HQ-25 contains three factors: physical isolation, lack of socialization, and lack of emotional support.

RESULTS: The hikikomori group included 92 patients and the control group comprised 137 healthy individuals. All total and subscale scores of PHQ-9, HEQ, TACS-22, HQ-25, and HDRS were significantly higher in the hikikomori group than in the control group. The risk model of childhood maltreatment for physical isolation via MTD traits obtained good fit with a goodness-of-fit index of.982.

LIMITATIONS: The study's limitations were its sample selection bias, cross-sectional design, and use of self-report scales.

CONCLUSIONS: Our findings support the hypothesis that childhood maltreatment is an important risk factor for hikikomori via MTD traits.

Language: en

Keywords

Childhood maltreatment; Hikikomori; Suicidal tendency; Modern-type depression (MTD); Physical isolation