Hikikomori and Social Withdrawal Syndrome: Association with Psychiatric Disorder Prevalence and Quality of Life

Background: Hikikomori, or social withdrawal syndrome, has become a global public health concern.However, systematic research on the mental health characteristics of hikikomori in Korea remains limited.This study investigated the prevalence of depression, anxiety, alcohol use disorder, and suicide risk among hikikomori individuals in Korea.Methods: This community-based study included 922 adults from Jeju Province.Hikikomori individuals were identified using the 25-item Hikikomori Questionnaire (cutoff=41).Mental health was assessed using the Patient Health Questionnaire-9, Generalized Anxiety Disorder-7, Korean version of the Alcohol Use Disorders Identification Test, and Mini-International Neuropsychiatric Interview suicide module.Logistic regression analyses were conducted, adjusting for age and sex.Results: The hikikomori group showed a significantly higher prevalence compared with controls: depressive symptoms (53.3% vs. 20.0%,adjusted odds ratio [AOR]=15.87,95% confidence interval [CI]=10.65-23.65),anxiety symptoms (35.4% vs. 12.9%, AOR=13.05,95% CI=8.11-21.00),and moderate-to-high suicide risk (23.2%, AOR=3.93,95% CI=2.58-5.99).Alcohol use disorder risk was also significantly higher.Mean symptom scores indicated clinically significant levels.Conclusion: Hikikomori in Korea experience severe mental health problems with markedly increased risks for depression, anxiety, and suicide.These findings underscore the urgent need for early detection, comprehensive psychiatric assessment, and integrated mental health interventions for this vulnerable population.