Hikikomori Is Most Associated With Interpersonal Relationships, Followed by Suicide Risks: A Secondary Analysis of a National Cross-Sectional Study

There have been few population studies of hikikomori (that is, prolonged social withdrawal and isolation), and the basic correlating factors of hikikomori are yet to be identified. Therefore, this study aimed to identify the associated basic characteristics and psychiatric factors of hikikomori. Data were obtained from the Survey of Young People’s Attitudes of 5,000 residents (aged 15–39 years) who were randomly selected from 200 urban and suburban municipalities in Japan in February 2010. The chi-square test and multiple logistic regression were used in the analysis. The data contained 3,262 participants (response rate: 65.4%); 47.7% were men (n = 1,555) and 52.3% were women (n = 1,707). Its prevalence was 1.8% (n = 58), and 41% had been in the hikikomori state for more than 3 years. There were fewer hikikomori people in neighborhoods filled with business and service industries. Significantly more men were in the hikikomori group (65.5%) than in the non-hikikomori group (47.3%). The hikikomori group was more likely to drop out of education (p < .001) and to have a psychiatric treatment history compared with non-hikikomori (37.9% vs 5%, p < .001). The multiple logistic regression analyses revealed that interpersonal relationships were significantly associated with hikikomori across three models (Model 1 adjusting for all basic characteristics, OR = 2.30, 95% CI = 1.92–2.76; Model 2 further adjusting for mental health-related factors, OR = 2.1, 95% CI = 1.64–2.68; Model 3 further adjusting for a previous psychiatric treatment history, OR = 1.95, 95% CI = 1.52–2.51). Additionally, the hikikomori group was more likely to have suicide risk factors (Model 1: OR = 1.85, 95% CI = 1.56–2.20; Model 2: OR = 1.33, 95% CI = 1.05–1.67), obsessive–compulsive behaviors (Model 1: OR = 1.57, 95% CI = 1.20–2.05), and addictive behaviors (Model 1: OR = 1.93, 95% CI = 1.37–2.70). This is the first study to show that hikikomori is associated with interpersonal relationships, followed by suicide risks. Hikikomori people are more likely to be male, have a history of dropping out from education, and have a previous psychiatric treatment history