Pathological social withdrawal, named “Hikikomori,” is a Japanese culture-bound syndrome and a serious social problem in Japan. The number of Hikikomori cases in Japan was estimated at about 563,000 in 2016 according to governmental surveys. However, no studies have reported how many people with Hikikomori have access to community-based psychiatry clinics, and how different they are from non-Hikikomori patients regarding their baseline characteristics and outcomes. The aim of the present study is to evaluate the baseline characteristics, clinical attendance, and social functioning of community psychiatric clinic patients treated for social withdrawal at one-year follow-up. Participants (n = 304) were all patients (aged under 65) of a psychiatric clinic in a one-year period. Baseline patient characteristics were compared among “current” Hikikomori patients, “past” Hikikomori,” and “other” patients. Logistic regression analysis of clinic attendance status and social functioning at one-year follow-up was used to assess patient outcomes. Independent variables were age, gender, Hikikomori status, and support from clinical staff. Numbers of “current”, “past” Hikikomori, and “other” patients were 60 (19.7%), 81 (26.6%), and 163 (53.6%), respectively. The percentage of “current” Hikikomori who attended in person (56.7%) was significantly smaller than for “past” (92.6%) and “other” (92.6) (p < .001). The age distribution of “current” Hikikomori patients was bimodal, peaking at 20 and 40–45 years. The “current” state predicted significantly fewer regular visits (OR = 0.43; 95% CI = 0.22–0.83; p = .012); support from psychiatric social workers increased visits (OR = 2.35; 95% CI = 1.14–4.86; p = .021). Among the “current” Hikikomori patients, first visit attendance in person predicted regular attendance; no factor consistently predicted working/schooling status. A sizable percentage of community clinic patients experienced Hikikomori. The “current” Hikikomori state corresponded with low clinic attendance and social function; “support from clinical staff” may increase visit regularity; no factors consistently improved social functioning. Further multi-site study is warranted to examine the generalizability of the findings from the current single-center study.

中文翻译：

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在二级保健机构中，病理性社交退出的特征和社会功能“ Hikikomori”：一项为期一年的队列研究。

病理性社会退缩被称为“ Hikikomori”，是一种受日本文化束缚的综合症，在日本是一个严重的社会问题。根据政府调查，2016年日本的Hikikomori案件数量约为563,000。但是，尚无研究报告有多少名患有Hikikomori的人可以去社区精神病诊所就诊，以及他们与非Hikikomori病人在基线特征和预后方面有何不同。本研究的目的是评估在一年的随访中接受社会退缩治疗的社区精神病临床患者的基线特征，临床出勤率和社会功能。参与者（n = 304）是一年内所有精神科诊所的患者（65岁以下）。比较了“当前” Hikikomori患者，“过去” Hikikomori患者和“其他”患者的基线患者特征。对一年随访的门诊就诊状况和社会功能进行逻辑回归分析，以评估患者的预后。自变量为年龄，性别，Hikikomori状态以及临床人员的支持。“当前”，“过去” Hikikomori和“其他”患者的数量分别为60（19.7％），81（26.6％）和163（53.6％）。亲自就诊的“当前” Hikikomori的百分比（56.7％）显着小于“过去”（92.6％）和“其他”（92.6）的百分比（p <.001）。“当前” Hikikomori患者的年龄分布是双峰的，在20岁和40-45岁达到峰值。“当前”状态预测定期造访会明显减少（OR = 0.43； 95％CI = 0.22-0.83； p = 0.012）；精神科社会工作者的支持增加了就诊次数（OR = 2.35； 95％CI = 1.14–4.86； p = .021）。在“目前”的Hikikomori患者中，亲自就诊预计会定期就诊。没有任何因素能够一致地预测工作/就学状况。相当大比例的社区诊所患者经历了Hikikomori。“当前”的Hikikomori状态与门诊率和社会功能低有关。“临床人员的支持”可能会增加就诊的规律性；没有任何因素能够持续改善社会功能。有必要进行进一步的多地点研究，以检查当前单中心研究结果的普遍性。没有任何因素能够一致地预测工作/就学状况。相当大比例的社区诊所患者经历了Hikikomori。如今的“小森”状态与门诊率和社会功能低有关。“临床人员的支持”可能会增加就诊的规律性；没有任何因素能够持续改善社会功能。有必要进行进一步的多地点研究，以检查当前单中心研究结果的普遍性。没有任何因素能够一致地预测工作/就学状况。相当大比例的社区诊所患者经历了Hikikomori。“当前”的Hikikomori状态与门诊率和社会功能低有关。“临床人员的支持”可能会增加就诊的规律性；没有任何因素能够持续改善社会功能。有必要进行进一步的多地点研究，以检查当前单中心研究结果的普遍性。