The Relationship Between Addiction and Hikikomori Tendencies: a Case-control Study

Overview

Journal Front Psychiatry

Specialty Psychiatry

Date 2023 Dec 11

PMID 38076690

Authors

Peter Muris

Veerle van de Pasch

Janno van Kessel

Josine Peet

Affiliations

Soon will be listed here.

Abstract

Aim: The present study examined the relationship between addiction and hikikomori (extreme social withdrawal) symptoms.

Method: A group of clinically referred addiction patients ( = 31) and a group of age- and gender-matched non-clinical controls ( = 34) completed a self-report scale for measuring hikikomori symptoms (the Hikikomori Questionnaire-25) along with some other questionnaires assessing substance use (frequency and severity) and quality of life.

Results: The results showed that addiction patients displayed significantly higher levels of hikikomori symptoms than the non-clinical control (Cohen's = 3.41); 87.1% even showed such a high score that they were identified as being at risk for the hikikomori syndrome (vs. only 2.9% in the non-clinical control group). Correlational analyses revealed that within the addiction group, the severity of the substance use problem (as quantified by an index of craving) correlated positively with the level of hikikomori symptoms and negatively with quality of life. In other words, the more severe the addiction, the more extreme the social withdrawal tendencies and the lower the quality of life.

Conclusion: Altogether, the findings provide further support for the marked social impairments of people with substance use problems and underline that this should be an important target of intervention.

Citing Articles

Beyond the Locked Door: Hikikomori Through a Clinical Lens.

Paulino Ferreira L, Magalhaes M, Figueiredo M, Conde E Cureus. 2025; 17(2):e78600.

PMID: 39926630 PMC: 11804151. DOI: 10.7759/cureus.78600.

References

Provost S, Griffin M, Hilton B, McHugh R, Taghian N, Trinh C . Correlates of optimism among patients in substance use disorder inpatient treatment. Am J Addict. 2022; 31(6):494-501. DOI: 10.1111/ajad.13324. View

Hajema K, Knibbe R, Drop M . Social resources and alcohol-related losses as predictors of help seeking among male problem drinkers. J Stud Alcohol. 1999; 60(1):120-9. DOI: 10.15288/jsa.1999.60.120. View

Kato T, Tateno M, Shinfuku N, Fujisawa D, Teo A, Sartorius N . Does the 'hikikomori' syndrome of social withdrawal exist outside Japan? A preliminary international investigation. Soc Psychiatry Psychiatr Epidemiol. 2011; 47(7):1061-75. PMC: 4909153. DOI: 10.1007/s00127-011-0411-7. View

Schippers G, Broekman T, Buchholz A, Koeter M, van den Brink W . Measurements in the Addictions for Triage and Evaluation (MATE): an instrument based on the World Health Organization family of international classifications. Addiction. 2010; 105(5):862-71. DOI: 10.1111/j.1360-0443.2009.02889.x. View

Del Boca F, Noll J . Truth or consequences: the validity of self-report data in health services research on addictions. Addiction. 2001; 95 Suppl 3:S347-60. DOI: 10.1080/09652140020004278. View

Teo A, Chen J, Kubo H, Katsuki R, Sato-Kasai M, Shimokawa N . Development and validation of the 25-item Hikikomori Questionnaire (HQ-25). Psychiatry Clin Neurosci. 2018; 72(10):780-788. PMC: 6221010. DOI: 10.1111/pcn.12691. View

Kato T, Shinfuku N, Tateno M . Internet society, internet addiction, and pathological social withdrawal: the chicken and egg dilemma for internet addiction and hikikomori. Curr Opin Psychiatry. 2020; 33(3):264-270. DOI: 10.1097/YCO.0000000000000601. View

Chauliac N, Couillet A, Faivre S, Brochard N, Terra J . Characteristics of socially withdrawn youth in France: A retrospective study. Int J Soc Psychiatry. 2017; 63(4):339-344. DOI: 10.1177/0020764017704474. View

Sogaard T, Kolind T, Haller M, Hunt G . Ring and bring drug services: Delivery dealing and the social life of a drug phone. Int J Drug Policy. 2019; 69:8-15. DOI: 10.1016/j.drugpo.2019.02.003. View

10.

Stip E, Thibault A, Beauchamp-Chatel A, Kisely S . Internet Addiction, Hikikomori Syndrome, and the Prodromal Phase of Psychosis. Front Psychiatry. 2016; 7:6. PMC: 4776119. DOI: 10.3389/fpsyt.2016.00006. View

11.

Rehm J, Marmet S, Anderson P, Gual A, Kraus L, Nutt D . Defining substance use disorders: do we really need more than heavy use?. Alcohol Alcohol. 2013; 48(6):633-40. DOI: 10.1093/alcalc/agt127. View

12.

Ignaszewski M . The Epidemiology of Drug Abuse. J Clin Pharmacol. 2021; 61 Suppl 2:S10-S17. DOI: 10.1002/jcph.1937. View

13.

Amendola S, Presaghi F, Teo A, Cerutti R . Psychometric Properties of the Italian Version of the 25-Item Hikikomori Questionnaire. Int J Environ Res Public Health. 2022; 19(20). PMC: 9603413. DOI: 10.3390/ijerph192013552. View

14.

Pomrenze M, Paliarin F, Maiya R . Friend of the Devil: Negative Social Influences Driving Substance Use Disorders. Front Behav Neurosci. 2022; 16:836996. PMC: 8866771. DOI: 10.3389/fnbeh.2022.836996. View

15.

Kim H, Hodgins D . Component Model of Addiction Treatment: A Pragmatic Transdiagnostic Treatment Model of Behavioral and Substance Addictions. Front Psychiatry. 2018; 9:406. PMC: 6127248. DOI: 10.3389/fpsyt.2018.00406. View

16.

Tam C, Kwok S, Lo T, Lam S, Lee G . Hidden Drug Abuse in Hong Kong: From Social Acquaintance to Social Isolation. Front Psychiatry. 2018; 9:457. PMC: 6167475. DOI: 10.3389/fpsyt.2018.00457. View

17.

Groh D, Ferrari J, Jason L . Self-reports of Substance Abusers: The Relation between Social Desirability and Social Network Variables. J Groups Addict Recover. 2010; 4(1-2):51-61. PMC: 2922763. DOI: 10.1080/15560350802712397. View

18.

Christie N . The role of social isolation in opioid addiction. Soc Cogn Affect Neurosci. 2021; 16(7):645-656. PMC: 8259283. DOI: 10.1093/scan/nsab029. View

19.

Allen K, Gray D, Baumeister R, Leary M . The Need to Belong: a Deep Dive into the Origins, Implications, and Future of a Foundational Construct. Educ Psychol Rev. 2021; 34(2):1133-1156. PMC: 8405711. DOI: 10.1007/s10648-021-09633-6. View

20.

Muris P, Ollendick T . Contemporary Hermits: A Developmental Psychopathology Account of Extreme Social Withdrawal (Hikikomori) in Young People. Clin Child Fam Psychol Rev. 2023; 26(2):459-481. PMC: 9848719. DOI: 10.1007/s10567-023-00425-8. View