{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,26]],"date-time":"2026-06-26T09:50:31Z","timestamp":1782467431652,"version":"3.54.5"},"reference-count":20,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2026,6,15]],"date-time":"2026-06-15T00:00:00Z","timestamp":1781481600000},"content-version":"vor","delay-in-days":14,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T00:00:00Z","timestamp":1780272000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["PCN Reports"],"published-print":{"date-parts":[[2026,6]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Hikikomori is a condition characterized by remaining predominantly at home for at least 6 months, with marked social withdrawal and functional impairment. In prolonged cases, reduced self\u2010care and physical comorbidities are common; however, access to necessary medical care is often limited. When a distrust of medical services and the refusal of psychiatric care are pronounced, psychiatric interventions alone may be insufficient. In such cases, it is important to use general medical care as an entry point to subsequent psychiatric and community\u2010based support.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Case Presentation<\/jats:title>\n                    <jats:p>We herein report a case of hikikomori for more than 15 years in a man in his 50s. He first presented to general medical services after developing wound myiasis. Thereafter, while receiving physical treatment, he received stepwise support in a psychiatric ward, including support for hygiene behaviors, family support, and discharge planning. His resistance to bathing and grooming gradually decreased. After discharge, he moved into supported housing and began attending a supported employment program. During the 3\u2010month follow\u2010up, no recurrence of hikikomori was observed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This case shows that in patients with long\u2010term hikikomori for whom psychiatric interventions alone are difficult, a structured support process that links general medical, psychiatric, and community care in a stepwise manner may facilitate social reintegration. The process may be conceptualized in terms of the entry point, transition phase, and outcome.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/pcn5.70363","type":"journal-article","created":{"date-parts":[[2026,6,15]],"date-time":"2026-06-15T11:09:01Z","timestamp":1781521741000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["A structured support process for social reintegration of a patient with long\u2010term hikikomori: A case report"],"prefix":"10.1002","volume":"5","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-3366-1895","authenticated-orcid":false,"given":"Kana","family":"Tsunoda","sequence":"first","affiliation":[{"name":"Department of Neuropsychiatry, Graduate School of Medical Sciences Kyushu University Fukuoka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3997-6823","authenticated-orcid":false,"given":"Keitaro","family":"Murayama","sequence":"additional","affiliation":[{"name":"Department of Neuropsychiatry Kyushu University Hospital Fukuoka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shuichi","family":"Isomura","sequence":"additional","affiliation":[{"name":"Department of Neuropsychiatry National Hospital Organization Kokura Medical Center Kitakyushu Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tomohiro","family":"Nakao","sequence":"additional","affiliation":[{"name":"Department of Neuropsychiatry, Graduate School of Medical Sciences Kyushu University Fukuoka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,6,15]]},"reference":[{"key":"e_1_2_16_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/wps.20705"},{"key":"e_1_2_16_3_1","doi-asserted-by":"publisher","DOI":"10.1177\/00207640241310189"},{"key":"e_1_2_16_4_1","doi-asserted-by":"publisher","DOI":"10.2196\/79043"},{"key":"e_1_2_16_5_1","doi-asserted-by":"publisher","DOI":"10.1177\/00207640211009266"},{"key":"e_1_2_16_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2215-0366(15)00277-1"},{"key":"e_1_2_16_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/pcn.13154"},{"key":"e_1_2_16_8_1","doi-asserted-by":"publisher","DOI":"10.3390\/geriatrics3030041"},{"key":"e_1_2_16_9_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12888-018-1725-8"},{"key":"e_1_2_16_10_1","doi-asserted-by":"publisher","DOI":"10.1192\/bjp.bp.115.165092"},{"key":"e_1_2_16_11_1","doi-asserted-by":"publisher","DOI":"10.5334\/ijic.2477"},{"key":"e_1_2_16_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2934.2006.00702.x"},{"key":"e_1_2_16_13_1","doi-asserted-by":"publisher","DOI":"10.1186\/1741-7015-8-31"},{"key":"e_1_2_16_14_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF03392173"},{"key":"e_1_2_16_15_1","doi-asserted-by":"publisher","DOI":"10.1037\/hea0000387"},{"key":"e_1_2_16_16_1","doi-asserted-by":"publisher","DOI":"10.1037\/bul0000025"},{"key":"e_1_2_16_17_1","doi-asserted-by":"publisher","DOI":"10.1186\/s40359-021-00605-7"},{"key":"e_1_2_16_18_1","doi-asserted-by":"publisher","DOI":"10.1111\/pcn.12230"},{"key":"e_1_2_16_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.heliyon.2019.e03011"},{"key":"e_1_2_16_20_1","doi-asserted-by":"publisher","DOI":"10.1002\/pcn5.70120"},{"key":"e_1_2_16_21_1","volume-title":"From loneliness to social connection: charting a path to healthier societies: report of the WHO Commission on Social Connection [Internet]","author":"World Health Organization","year":"2025"}],"container-title":["Psychiatry and Clinical Neurosciences 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