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However, estimates of the worldwide Hikikomori prevalence have been inconsistent. This study aimed to provide a comprehensive assessment of the cross\u2010cultural prevalence of Hikikomori through a meta\u2010analysis and systematic review.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We systematically searched multiple databases (including PubMed, EMBASE, PsycINFO, and Web of Science) for relevant studies. Pooled prevalence estimates were calculated using a random\u2010effects model. Subgroup analyses for categorical variables and meta\u2010regression analyses for continuous variables were performed to identify potential moderators of Hikikomori prevalence estimates.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 19 studies based on 58,229 participants were included for analysis. The overall prevalence of Hikikomori was 8.0% (95% CI, 4.9%\u201312.9%). The prevalence of Hikikomori did not differ significantly between regions (East Asia and Western), time periods (pre\u2013 and post\u2013COVID\u201019 pandemic), sex, sample size, or presence versus absence of psychiatric disorders. In contrast, higher prevalence rates were reported in studies using the 25\u2010item Hikikomori Questionnaire (HQ\u201025) (21.7%; 95% CI, 11.8%\u201336.4%) versus other questionnaires (5.0%; 95% CI, 3.1%\u20137.9%, [<jats:italic>P<\/jats:italic> &lt; 0.01]) and nonprobability sampling (12.5%; 95% CI, 7.9%\u201319.2%) versus probability sampling methods (3.1%; 95% CI, 1.4%\u20136.9% [<jats:italic>P<\/jats:italic>\u2009&lt;\u20090.01]). Lower study quality (coefficient = \u22120.45, <jats:italic>P<\/jats:italic> = 0.03) and older age were also linked to higher prevalence (coefficient = 0.10, <jats:italic>P<\/jats:italic> = 0.01).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>This meta\u2010analysis suggests that Hikikomori is a common problem globally. The results highlight the importance of using standardized diagnostic tools as well as further research on moderating factors and intervention methods to alleviate disabling experiences associated with Hikikomori.<\/jats:p><\/jats:sec>","DOI":"10.1111\/pcn.13768","type":"journal-article","created":{"date-parts":[[2025,3,10]],"date-time":"2025-03-10T03:06:33Z","timestamp":1741575993000},"page":"138-146","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":29,"title":["Epidemiology of Hikikomori: A systematic review and meta\u2010analysis of 19 studies"],"prefix":"10.1111","volume":"79","author":[{"ORCID":"https:\/\/orcid.org\/0009-0004-4280-7563","authenticated-orcid":false,"given":"Wei","family":"Zhang","sequence":"first","affiliation":[{"name":"Unit of Psychiatry, Department of Public Health and Medicinal Administration, &amp; Institute of Translational Medicine, Faculty of Health Sciences University of Macau  Macao SAR China"},{"name":"Centre for Cognitive and Brain Sciences University of Macau  Macao SAR China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9971-0787","authenticated-orcid":false,"given":"Meng\u2010Yi","family":"Chen","sequence":"additional","affiliation":[{"name":"Unit of Psychiatry, Department of Public Health and Medicinal Administration, &amp; Institute of Translational Medicine, Faculty of Health Sciences University of Macau  Macao SAR China"},{"name":"Centre for Cognitive and Brain Sciences University of Macau  Macao SAR China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuan","family":"Feng","sequence":"additional","affiliation":[{"name":"Beijing Key Laboratory of Mental Disorders, National Clinical Research Center for Mental Disorders &amp; National Center for Mental Disorders, Beijing Anding Hospital, Capital Medical University  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2005-9504","authenticated-orcid":false,"given":"Zhaohui","family":"Su","sequence":"additional","affiliation":[{"name":"School of Public Health Southeast University  Nanjing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Teris","family":"Cheung","sequence":"additional","affiliation":[{"name":"School of Nursing Hong Kong Polytechnic University  Hong Kong SAR China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Todd","family":"Jackson","sequence":"additional","affiliation":[{"name":"Department of Psychology University of Macau  Macao SAR China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qinge","family":"Zhang","sequence":"additional","affiliation":[{"name":"Beijing Key Laboratory of Mental Disorders, National Clinical Research Center for Mental Disorders &amp; National Center for Mental Disorders, Beijing Anding Hospital, Capital Medical University  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yu\u2010Tao","family":"Xiang","sequence":"additional","affiliation":[{"name":"Unit of Psychiatry, Department of Public Health and Medicinal Administration, &amp; Institute of Translational Medicine, Faculty of Health Sciences University of Macau  Macao SAR China"},{"name":"Centre for Cognitive and Brain Sciences University of Macau  Macao SAR China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,2,27]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/wps.20705"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00127-011-0411-7"},{"key":"e_1_2_9_4_1","first-page":"191","article-title":"The phenomenon of \u201chikikomori\u201d (social withdrawal) and the socio\u2010cultural situation in Japan today","volume":"19","author":"Suwa M","year":"2013","journal-title":"J. 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