{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T13:04:13Z","timestamp":1785416653818,"version":"3.56.0"},"reference-count":48,"publisher":"Royal College of Psychiatrists","license":[{"start":{"date-parts":[[2026,7,20]],"date-time":"2026-07-20T00:00:00Z","timestamp":1784505600000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/www.cambridge.org\/core\/terms"}],"content-domain":{"domain":["cambridge.org"],"crossmark-restriction":true},"short-container-title":["Br J Psychiatry"],"abstract":"<jats:sec id=\"S0007125026106886_as1\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Hikikomori, first recognised and defined in Japan as a culture-bound syndrome of prolonged social withdrawal, is increasingly reported worldwide. There is now a broad consensus that hikikomori is not confined to Japan. Its relevance to the UK context is raised by the presence of approximately one million young adults not in education, employment or training (NEET).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S0007125026106886_as2\">\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>To examine the occurrence of hikikomori and hikikomori-like behaviours among UK university students and to explore the association between mental health difficulties, neurodevelopmental traits and gaming disorder in its development.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S0007125026106886_as3\">\n                    <jats:title>Method<\/jats:title>\n                    <jats:p>A cross-sectional online survey was conducted, with a final sample of 105 students completing validated measures of social withdrawal, psychological distress, functional impairment and associated psychiatric traits.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S0007125026106886_as4\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      One in five students (21.0%) reported some form of hikikomori behaviour; 14.3% met criteria for pathological hikikomori, although no cases of severe hikikomori (home confinement &gt;6 months) were identified. Hikikomori tendencies correlated strongly with psychological distress (\n                      <jats:italic>r<\/jats:italic>\n                      = 0.73,\n                      <jats:italic>p<\/jats:italic>\n                      &lt; 0.001), autism-related traits (\n                      <jats:italic>r<\/jats:italic>\n                      = 0.72\n                      <jats:italic>p<\/jats:italic>\n                      &lt; 0.001) and internet gaming disorder (\n                      <jats:italic>r<\/jats:italic>\n                      = 0.70,\n                      <jats:italic>p<\/jats:italic>\n                      &lt; 0.001). Moderate positive associations were found with depression and anxiety, while weaker negative associations emerged with psychotic-like experiences, agreeableness and conscientiousness. Gaming disorder, underlying mental health difficulties and autistic traits emerged as strong predictors of hikikomori behaviours.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S0007125026106886_as5\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Hikikomori-like behaviour may be more prevalent in the UK student population than previously recognised. The findings underline the importance of screening for social withdrawal in young adults, with particular attention to gaming behaviours, mental health problems and autistic traits. Furthermore, identifying and addressing pre-hikikomori cases (social withdrawal lasting less than three months) may be crucial for early intervention and prevention.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1192\/bjp.2026.10688","type":"journal-article","created":{"date-parts":[[2026,7,20]],"date-time":"2026-07-20T11:00:41Z","timestamp":1784545241000},"page":"1-9","update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":0,"title":["Social withdrawal among university students in the UK: the emerging hikikomori phenomena"],"prefix":"10.1192","author":[{"given":"Ismail","family":"Hassan","sequence":"first","affiliation":[{"id":[{"id":"https:\/\/ror.org\/01qz7fr76","id-type":"ROR","asserted-by":"publisher"}],"name":"Brighton and Sussex Medical School, University of Sussex"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kieran K.","family":"Chumun","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/01qz7fr76","id-type":"ROR","asserted-by":"publisher"}],"name":"Brighton and Sussex Medical School, University of Sussex"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2132-6336","authenticated-orcid":false,"given":"Hussien","family":"Elkholy","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/01qz7fr76","id-type":"ROR","asserted-by":"publisher"}],"name":"Brighton and Sussex Medical School, University of Sussex"},{"name":"Ain Shams University"},{"name":"Sussex Partnership NHS Foundation Trust"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2166-3298","authenticated-orcid":false,"given":"Yoko","family":"Nagai","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/01qz7fr76","id-type":"ROR","asserted-by":"publisher"}],"name":"Brighton and Sussex Medical School, University of Sussex"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"170","published-online":{"date-parts":[[2026,7,20]]},"reference":[{"key":"S0007125026106886_ref8","doi-asserted-by":"publisher","DOI":"10.1002\/jad.12374"},{"key":"S0007125026106886_ref1","doi-asserted-by":"publisher","DOI":"10.1007\/s11013-008-9106-2"},{"key":"S0007125026106886_ref18","doi-asserted-by":"publisher","DOI":"10.1002\/wps.21123"},{"key":"S0007125026106886_ref30","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0312818"},{"key":"S0007125026106886_ref33","doi-asserted-by":"publisher","DOI":"10.3390\/brainsci15050496"},{"key":"S0007125026106886_ref40","doi-asserted-by":"publisher","DOI":"10.4324\/9781351260800"},{"key":"S0007125026106886_ref15","doi-asserted-by":"publisher","DOI":"10.1017\/S0954579404040015"},{"key":"S0007125026106886_ref42","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(11)61475-X"},{"key":"S0007125026106886_ref22","first-page":"11","article-title":"The Psychosis Screening Questionnaire","volume":"5","author":"Bebbington","year":"1995","journal-title":"Int J Methods Psychiatr Res"},{"key":"S0007125026106886_ref3","doi-asserted-by":"publisher","DOI":"10.1002\/wps.20804"},{"key":"S0007125026106886_ref17","first-page":"1","article-title":"Digital dependence in the past decade: a systematic review","volume":"6","author":"Gon\u00e7alves","year":"2023","journal-title":"J Addict Res Adolesc Behav"},{"key":"S0007125026106886_ref36","doi-asserted-by":"publisher","DOI":"10.1177\/0020764014535758"},{"key":"S0007125026106886_ref7","doi-asserted-by":"publisher","DOI":"10.1017\/S2045796018000641"},{"key":"S0007125026106886_ref38","doi-asserted-by":"publisher","DOI":"10.30773\/pi.2021.0050"},{"key":"S0007125026106886_ref47","doi-asserted-by":"publisher","DOI":"10.1007\/s00127-008-0345-x"},{"key":"S0007125026106886_ref23","doi-asserted-by":"publisher","DOI":"10.1016\/j.addbeh.2015.11.005"},{"key":"S0007125026106886_ref2","doi-asserted-by":"publisher","DOI":"10.1192\/bji.2024.38"},{"key":"S0007125026106886_ref35","article-title":"Autism spectrum, hikikomori syndrome and internet gaming disorder: is there a link?","volume":"13","author":"DellOsso","year":"2023","journal-title":"Brain Sci"},{"key":"S0007125026106886_ref28","doi-asserted-by":"publisher","DOI":"10.3389\/fpsyt.2022.986687"},{"key":"S0007125026106886_ref9","doi-asserted-by":"publisher","DOI":"10.1097\/HRP.0000000000000362"},{"key":"S0007125026106886_ref27","doi-asserted-by":"publisher","DOI":"10.1177\/00048674221085917"},{"key":"S0007125026106886_ref19","doi-asserted-by":"publisher","DOI":"10.1017\/S0033291700021644"},{"key":"S0007125026106886_ref29","doi-asserted-by":"publisher","DOI":"10.1016\/j.socscimed.2023.115774"},{"key":"S0007125026106886_ref26","doi-asserted-by":"publisher","DOI":"10.1177\/00207640241245926"},{"key":"S0007125026106886_ref37","doi-asserted-by":"publisher","DOI":"10.1002\/wps.20705"},{"key":"S0007125026106886_ref41","doi-asserted-by":"publisher","DOI":"10.1097\/NMD.0b013e3181e086b1"},{"key":"S0007125026106886_ref43","doi-asserted-by":"publisher","DOI":"10.1111\/j.1467-954X.2008.00790.x"},{"key":"S0007125026106886_ref44","doi-asserted-by":"publisher","DOI":"10.1177\/0004867415581179"},{"key":"S0007125026106886_ref45","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpsychires.2012.11.015"},{"key":"S0007125026106886_ref46","doi-asserted-by":"publisher","DOI":"10.1080\/03069885.2012.743110"},{"key":"S0007125026106886_ref25","volume-title":"Introduction to Mediation, Moderation, and Conditional Process Analysis: A Regression-Based Approach","author":"Hays","year":"2022"},{"key":"S0007125026106886_ref48","doi-asserted-by":"publisher","DOI":"10.1017\/S0033291716001665"},{"key":"S0007125026106886_ref32","doi-asserted-by":"publisher","DOI":"10.1186\/s12991-024-00496-z"},{"key":"S0007125026106886_ref10","doi-asserted-by":"publisher","DOI":"10.3389\/fpsyg.2015.01117"},{"key":"S0007125026106886_ref6","doi-asserted-by":"publisher","DOI":"10.1136\/jech.2009.090621"},{"key":"S0007125026106886_ref4","doi-asserted-by":"publisher","DOI":"10.1556\/JBA.1.2012.1.1"},{"key":"S0007125026106886_ref14","doi-asserted-by":"publisher","DOI":"10.1111\/bjdp.12411"},{"key":"S0007125026106886_ref5","volume-title":"Young People Not in Education, Employment or Training (NEET)","year":"2025"},{"key":"S0007125026106886_ref16","doi-asserted-by":"publisher","DOI":"10.1007\/s12144-021-01865-7"},{"key":"S0007125026106886_ref21","doi-asserted-by":"publisher","DOI":"10.1007\/s10803-007-0380-6"},{"key":"S0007125026106886_ref39","doi-asserted-by":"publisher","DOI":"10.1080\/13676260600805671"},{"key":"S0007125026106886_ref34","doi-asserted-by":"publisher","DOI":"10.1017\/S1092852924002335"},{"key":"S0007125026106886_ref12","doi-asserted-by":"publisher","DOI":"10.1093\/ppar\/prx030"},{"key":"S0007125026106886_ref11","doi-asserted-by":"publisher","DOI":"10.1111\/pcn.12895"},{"key":"S0007125026106886_ref13","doi-asserted-by":"publisher","DOI":"10.1177\/00207640251348058"},{"key":"S0007125026106886_ref20","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0447.1983.tb09716.x"},{"key":"S0007125026106886_ref31","doi-asserted-by":"publisher","DOI":"10.3389\/fpsyt.2024.1378572"},{"key":"S0007125026106886_ref24","doi-asserted-by":"publisher","DOI":"10.1037\/0022-3514.59.6.1216"}],"container-title":["The British Journal of Psychiatry"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.cambridge.org\/core\/services\/aop-cambridge-core\/content\/view\/S0007125026106886","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,20]],"date-time":"2026-07-20T11:00:43Z","timestamp":1784545243000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.cambridge.org\/core\/product\/identifier\/S0007125026106886\/type\/journal_article"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,20]]},"references-count":48,"alternative-id":["S0007125026106886"],"URL":"https:\/\/doi.org\/10.1192\/bjp.2026.10688","relation":{},"ISSN":["0007-1250","1472-1465"],"issn-type":[{"value":"0007-1250","type":"print"},{"value":"1472-1465","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,20]]},"assertion":[{"value":"\u00a9 The Author(s), 2026. Published by Cambridge University Press on behalf of Royal College of Psychiatrists","name":"copyright","label":"Copyright","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}}]}}