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Functions were categorized into \u2018body functions\u201d; \u201cstructure\u201d; and \u201cactivity and participation\u2019, which were further classified into subcategories.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Of the 8,181 studies screened, 24 studies with 1,769 individuals with Hikikomori were included. Twelve, three, and four indicators from six studies on depression and anxiety, three on addiction, and two on thought problem symptoms, respectively, were higher in the Hikikomori group than in the comparison group, with at least moderate effect sizes. Three indicators from three studies on interpersonal relationships were worse in the Hikikomori group, with at least moderate effect sizes. The meta-analyses showed that internalizing symptoms, externalizing symptoms, and thought disorders were significantly higher in the Hikikomori group than those in the comparison group with moderate-to-high effect sizes. Contrastingly, communication\/interpersonal interactions were significantly lower in the Hikikomori group than those in the comparison group. No significant differences were observed in daily life\/social life and the families\u2019 communication\/interpersonal interactions and relationship.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>The study limitations include a high risk of bias and heterogeneity. Overall, individuals with Hikikomori often have impaired mental and interpersonal interaction functions; thus, comorbidities of this condition should be carefully assessed.<\/jats:p>\n                    <jats:p>PROSPERO: CRD42022320592.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/00207640241310189","type":"journal-article","created":{"date-parts":[[2025,1,22]],"date-time":"2025-01-22T05:49:04Z","timestamp":1737524944000},"page":"622-641","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":19,"title":["Functioning, disability, and health of individuals with Hikikomori (prolonged social withdrawal) and their families: A systematic review and meta-analysis of case-control studies"],"prefix":"10.1177","volume":"71","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9040-4436","authenticated-orcid":false,"given":"Shunsuke","family":"Nonaka","sequence":"first","affiliation":[{"name":"School of Child Psychology, Tokyo Future University, Tokyo, Japan"},{"name":"Faculty of Human Sciences, Musashino University, Tokyo, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7725-527X","authenticated-orcid":false,"given":"Hiroaki","family":"Kubo","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, University of Miyazaki, Miyazaki, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tomoya","family":"Takeda","sequence":"additional","affiliation":[{"name":"Department of Psychological Sciences, University of Human Environments, Ehime, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7944-3001","authenticated-orcid":false,"given":"Motohiro","family":"Sakai","sequence":"additional","affiliation":[{"name":"Faculty of Education, University of Miyazaki, Miyazaki, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2025,1,22]]},"reference":[{"key":"e_1_3_3_2_1","doi-asserted-by":"crossref","unstructured":"Achterbergh L. 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