Gender, Anxiety, and Depression in Connection to Hikikomori

Danang Nur Adiwibawa (1) , Ayu Anulus (2) , Fahriana Azmi (3) , Chee Kok Yoon (4) , Trisakti Halimah Delimasari (5)
(1) Faculty of Medicine, Universitas Islam Al-Azhar, Indonesia & Patut Patuh Patju General Hospital, West Lombok, Indonesia, Indonesia,
(2) Faculty of Medicine, Universitas Islam Al-Azhar, Indonesia, Indonesia,
(3) Patut Patuh Patju General Hospital, West Lombok, Indonesia, Indonesia,
(4) Ministry of Health Malaysia, Malaysia & Department of Psychiatry & Mental Health, Kuala Lumpur Hospital, Malaysia, Malaysia,
(5) Politeknik Negeri Jember, East Java, Indonesia , Indonesia

Abstract

Hikikomori is a mental health condition characterized by social withdrawal, causing distress for both the affected individuals and those around them. While factors such as gender, anxiety, and depression have been linked to hikikomori, research on this condition in Indonesia remains limited. This study investigated the association between gender, depression, and anxiety with the risk of hikikomori in West Lombok, Indonesia.  A cross-sectional study was conducted at Hospital X in West Lombok, Indonesia, involving 60 patients with depression attending the Mental Health Polyclinic. The respondent ages ranged from 20 to 79 years. Data on gender, depression, anxiety, and hikikomori were collected using self-rated questionnaires and analysed with the Chi-square test.  The results showed that patients with moderate-severe anxiety had a fivefold increased risk of hikikomori (OR=5.00; 95% CI=1.42-17.57; p=0.009). Female patients were 2.5 times more likely to be at risk compared with male patients, while those with moderate-severe depression had a 2.83 times higher risk. However, this association was not statistically significant.  The study concluded that anxiety is a significant risk factor for hikikomori, whereas the association between gender and depression requires further investigation. Understanding these relationships is crucial for developing targeted mental health interventions and improving support for individuals at risk of hikikomori in Indonesia.

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References

1. Rooksby M, Furuhashi T, McLeod HJ. Hikikomori: a Hidden Mental Health Need Following the COVID-19 Pandemic. World Psychiatry. 2020;19(3):399–400. https://doi.org/10.1002/wps.20804

2. Neoh MJY, Carollo A, Lim M, Esposito G. Hikikomori: A Scientometric Review of 20 Years of Research. International Journal of Environmental Research and Public Health. 2023;20(9). https://doi.org/10.3390/ijerph20095657

3. Lin PKF, Andrew, Koh AHQ, Liew K. The Relationship Between Hikikomori Risk Factors and Social Withdrawal Tendencies Among Emerging Adults—An Exploratory Study of Hikikomori in Singapore. Front Psychiatry. 2022;13:1065304. https://doi.org/10.3389/fpsyt.2022.1065304

4. Fino E, Iliceto P, Carcione A, Giovani E, Candilera G. Validation of The Italian Version of the 25‐Item Hikikomori Questionnaire (HQ‐25‐I). Journal of Clinical Psychology. 2022;79(1):210-227. https://doi.org/10.1002/jclp.23404

5. Koyama A, Miyake Y, Kawakami N, Tsuchiya M, Tachimori H, Takeshima T. Lifetime Prevalence, Psychiatric Comorbidity and Demographic Correlates of “Hikikomori” in A Community Population in Japan. Psychiatry Research. 2010;176(1):69–74. https://doi.org/10.1016/j.psychres.2008.10.019

6. Yong RK, Fujita K, Chau PY, Sasaki H. Characteristics of and Gender Difference Factors of Hikikomori Among the Working-Age Population: A Cross-Sectional Population Study in Rural Japan. Nihon Koshu Eisei Zasshi. 2020;67(4):237–246. https://doi.org/10.11236/jph.67.4_237

7. Novianti WR, Rachmawati W, Sutini T. Prevalensi Kecenderungan Social Withdrawal (Hikikomori) pada Remaja di Kota Bandung. Jurnal Keperawatan Silampari. 2023;6(2): 1730–1736. https://doi.org/10.31539/jks.v6i2.5407

8. Orsolini L, Bellagamba S, Volpe U, Kato TA. Hikikomori and Modern-Type Depression in Italy: A New Phenotypical Trans-Cultural Characterization?. 2022;68(5):1010–1017. https://doi.org/10.1177/00207640221099408

9. Kato TA, Kanba S, Teo AR. Defining Pathological Social Withdrawal: Proposed Diagnostic Criteria for Hikikomori. World Psychiatry. 2020; 19(1): 116–117. https://doi.org/10.1002/wps.20705

10. Teo AR, Malagon-Amor A, Frankova I. Similar but Different: Psychological and Psychopathological Features of Primary and Secondary Hikikomori. Front Psychiatry. 2019;10:443700. https://doi.org/10.3389/fpsyt.2019.00558

11. Teo AR, Nelson S, Strange W, Kubo H, Katsuki R, Kurahara K, et al. Social Withdrawal in Major Depressive Disorder: A Case-Control Study of Hikikomori in Japan. Journal of Affective Disorders. 2020;274:1142–1146. https://doi.org/10.1016/j.jad.2020.06.011

12. Hamasaki Y, Pionnié-Dax N, Dorard G, Tajan N, Hikida T. Identifying Social Withdrawal (Hikikomori) Factors in Adolescents: Understanding the Hikikomori Spectrum. Child Psychiatry & Human Development. 2021;52 (5):808–817. https://doi.org/10.1007/s10578-020-01064-8

13. Satriatama PE. Fenomena Faktor Lingkungan yang Menyebabkan Hikikomori pada Masya-rakat di Jepang. Kiryoku: Jurnal Studi Kejepangan. 2022;6(2):170-175. https://doi.org/10.14710/kiryoku.v6i2.170-175

14. Lee JI, Parhar IS, Soga T. Hikikomori: Social Withdrawal A Risk Factor for Depression. Psychiatry and Clinical Neurosciences. 2022; 76(7):343–344. https://doi.org/10.1111/pcn.13354

15. Li TMH, Wong PWC. Youth Social Withdrawal Behavior (Hikikomori): A Systematic Review of Qualitative and Quantitative Studies. Australian & New Zealand Journal of Psychiatry. 2015;49(7):595–609. https://doi.org/10.1177/0004867415581179

16. Suwa M, Suzuki K. The Phenomenon of “Hikikomori” (Social Withdrawal) and The Socio-Cultural Situation in Japan Today. Journal of Psychopathology. 2013;19:191–198. https://old.jpsychopathol.it/article/the-phenomenon-of-hikikomori-social-withdrawal-and-the-socio-cultural-situation-in-japan-today/

17. Hairston M. A Cocoon with a View: Hikikomori, Otaku, and Welcome to the NHK. Mechademia. 2010. 5: 311-323. http://dx.doi.org/10.2307/41510970

18. Yong R, Nomura K. Hikikomori is Most Associated with Interpersonal Relationships, Followed by Suicide Risks: A Secondary Analysis of a National Cross-Sectional Study. Front Psychiatry. 2019;10:247. https://doi.org/10.3389/fpsyt.2019.00247

19. Yong RK, Fujita K, Chau PY, Sasaki H. Characteristics of and Gender Difference Factors of Hikikomori Among the Working-Age Population: A Cross-Sectional Population Study in Rural Japan. Nihon Koshu Eisei Zasshi. 2020;67(4):237–246. https://doi.org/10.11236/jph.67.4_237

20. Teo AR, Gaw AC. Hikikomori, A Japanese Culture-Bound Syndrome of Social With-drawal?. A Proposal for DSM-5. Journal of Nervous and Mental Disease. 2010;198(6): 444–449. https://doi.org/10.1097/nmd.0b013e3181e086b1

21. Panto F, Saito T, Morita N, Ogai Y. The Correlation between Enjoying Fictional Narratives and Empathy in Japanese Hikikomori. 2021;10:776. https://doi.org/10.12688/f1000research.55398.2

22. Nagata T, Yamada H, Teo AR, Yoshimura C, Nakajima T, van Vliet I. Comorbid Social Withdrawal (Hikikomori) in Outpatients with Social Anxiety Disorder: Clinical Characteristics and Treatment Response in A Case Series. International Journal of Social Psychiatry. 2013;59(1):73–78. https://doi.org/10.1177/0020764011423184

23. Katsuki R, Inoue A, Indias S, Kurahara K, Kuwano N, Funatsu F, et al. Clarifying Deeper Psychological Characteristics of Hikikomori Using the Rorschach Comprehensive System: A Pilot Case-Control Study. Front Psychiatry. 2019;10:412. https://doi.org/10.3389/fpsyt.2019.00412

24. Hemming K, Javid I, Taljaard M. A Review of High Impact Journals Found That Misinterpretation of Non-Statistically Significant Results from Randomized Trials Was Common. Journal of Clinical Epidemiology. 2022;145: 112–120. https://doi.org/10.1016/j.jclinepi.2022.01.014

25. Smith RJ. P>.05: The Incorrect Interpretation of “Not Significant” Results is a Significant Problem. American Journal of Physical Anthropology. 2020;172(4):521–527. https://doi.org/10.1002/ajpa.24092

26. Visentin DC, Cleary M, Hunt GE. The Earnestness of Being Important: Reporting Non-Significant Statistical Results. Journal of Advanced Nursing. 2020;76(4):917–919. https://doi.org/10.1111/jan.14283

Authors

Danang Nur Adiwibawa
adiwibawa.dr@gmail.com (Primary Contact)
Ayu Anulus
Fahriana Azmi
Chee Kok Yoon
Trisakti Halimah Delimasari
Author Biographies

Danang Nur Adiwibawa, Faculty of Medicine, Universitas Islam Al-Azhar, Indonesia & Patut Patuh Patju General Hospital, West Lombok, Indonesia

Faculty of Medicine, Universitas Islam Al-Azhar, Indonesia & Patut Patuh Patju General Hospital, West Lombok, Indonesia

Ayu Anulus, Faculty of Medicine, Universitas Islam Al-Azhar, Indonesia

Faculty of Medicine, Universitas Islam Al-Azhar, Indonesia

Fahriana Azmi, Patut Patuh Patju General Hospital, West Lombok, Indonesia

Patut Patuh Patju General Hospital, West Lombok, Indonesia

Chee Kok Yoon, Ministry of Health Malaysia, Malaysia & Department of Psychiatry & Mental Health, Kuala Lumpur Hospital, Malaysia

Ministry of Health Malaysia, Malaysia & Department of Psychiatry & Mental Health, Kuala Lumpur Hospital, Malaysia

Trisakti Halimah Delimasari, Politeknik Negeri Jember, East Java, Indonesia

Politeknik Negeri Jember, East Java, Indonesia         

Adiwibawa, D. N., Anulus, A., Azmi, F., Yoon, C. K., & Delimasari, T. H. (2025). Gender, Anxiety, and Depression in Connection to Hikikomori. Media Kesehatan Masyarakat Indonesia, 21(1), 80–87. https://doi.org/10.30597/mkmi.v21i1.37014

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