Suicide Motives and Protective Factors - Contributions from a Hikikomori Discussion Board

Predominant affective temperaments in depressive patients with severe social withdrawal

BACKGROUND

Hikikomori (HK) is characterized by self-isolation and social refusal, being more likely also associated with affective disorders, including depression. This case-control study primarily aimed at identifying (if any) predominant affective temperaments are associated with HK in depressed versus not-depressed individuals. Secondary objectives comprise assessing which other psychopathological dimensions (e.g., boredom, anxiety) are associated with the HK specifier in depressed individuals.

METHODS

From the larger SWATCH study, 687 Italian young people were screened for depression, as measured by 9 items-Patient Health Questionnaire (PHQ-9) and HK-like social withdrawal, through the Hikikomori Questionnaire-25 (HQ-25). All subjects were administered a brief-Temperament Evaluation of Memphis, Pisa, Paris and San Diego (TEMPS-M), the 7 items-Generalized Anxiety Disorder (GAD-7) and the Multidimensional State Boredom Scale (MSBS).

RESULTS

Males reported significantly higher scores at HQ-25 total score than females (p = 0.026). In the total sample, HK social withdrawal is positively predicted by MSBS low arousal, disengagement, depressive levels, depressive and irritable affective temperaments, while negatively by anxiety (F(6, 680) = 82.336, p < 0.001, R2 = 0.421). By selecting only depressed sample, HQ-25 is positively predicted by MSBS total score, low arousal and depressive affective temperament, while negatively by MSBS high arousal (F(4, 383) = 48.544, p < 0.001, R2 = 0.336). The logistic regression model found that the likelihood of developing depression with the HK specifier is significantly predicted by depressive and cyclothymic affective temperaments.

CONCLUSIONS

These preliminary findings could help in clinically characterizing the relationship between specific affective temperamental profiles among individuals with depression with/without HK specifier, in order to provide a more tailored and personalized therapeutic approach. Our Italian study should be extensively replicated in larger, longitudinal and multicentric pan-European studies, by specifically assessing the impact of these findings on depression clinical course, prognosis and treatment outcomes.

Prevalence of suicide attempts across the African continent: A systematic review and meta-analysis

BACKGROUND

Over 700,000 people worldwide lose their lives through suicide every year. The prevalence of suicide has increased, especially in low- and middle-income countries such as many African countries. For every fatal suicidal attempt, there are approximately 20 other non-fatal suicide attempts within the population. The purpose of this study is to investigate the prevalence of attempts of suicides in the African continent through a systematic review and meta-analysis.

METHODS

To identify relevant sources, the PubMed, Scopus, Web of Science, Embase, ScienceDirect and Google Scholar repositories and databases were systematically searched without a lower time limit and until July 2023. The heterogeneity of the studies was checked with the I2 index, and accordingly random effects model was adopted to perform the analysis. Data analysis was conducted within the Comprehensive Meta-Analysis software (v.2).

RESULTS

In the review of 48 studies with a sample size of 244,701 people, the prevalence of suicide attempts in Africa was found to be 9.9% (95%CI: 8.5%-11.6%). With the increase in the year of study, the prevalence of suicide attempt in the African continent increases. Also, with the increase in the sample size, the prevalence of suicide attempts in Africa decreases. The suicide attempt prevalence among African men and woman slightly differed with 7.6% and 8.2%, respectively.

CONCLUSION

Suicide attempt is an important public health concern in Africa. The findings of this study are important not only for African health policy making, but also to contribute to the accuracy of global estimates with respect to suicide attempts.

Relationship Between Social Withdrawal (Hikikomori), Personality, and Coping in an Adult Population

OBJECTIVE

The aim of this study was to investigate the relationships between personality dimensions, coping strategies, and Hikikomori while controlling for the presence of depression and anxiety.

METHODS

Two groups, recruited on social networks, were compared: the control group (n=101, mean age±standard deviation [SD]= 36.2±12.8 years) and the Hikikomori group (n=28, mean age±SD=30.1±9.1 years). Participants of both groups completed the Big Five Inventory, the Brief Coping Orientation to Problems Experienced, and the Hospital Anxiety and Depression Scale.

RESULTS

The Hikikomori group had higher depression, anxiety, neuroticism, and dysfunctional coping dimension (self-blame and behavioral disengagement) scores than the control group. Being alone and depression were positively associated with Hikikomori while extraversion and instrumental support were negatively associated with Hikikomori.

CONCLUSION

These findings contribute to a better understanding of the psychological functioning of Hikikomori as well as to treatment elaboration and confirm that some psychological characteristics are transcultural.

A Mapping Review of Netnography in Nursing

People use the Web to seek health-related information and to discuss health issues with peers. Netnography, a qualitative research methodology, has gained the attention of researchers interested in people's health and health issues. However, no previous reviews have accounted for how netnography is used in nursing research. The purpose of this mapping review was to generate a map of netnographic research in nursing. The search was conducted in PubMed, Academic Search Elite, the Cumulative Index to Nursing and Allied Health Literature, Medline, PsycINFO, Scopus, and Web of Science. Data were extracted from 53 original articles. The results show an increasing trend in published netnographies over time; 34% of the total sample was published in 2021. Of the total, 28% originated from Sweden, and 81% had used a covert approach. In studies in which the researchers used more participatory designs, the time spent on online forums ranged between 4 weeks and 20 months. Informed consent is found to be an issue in netnographic studies. We discuss the fact that nursing researchers have used netnography to address a wide range of research topics of concern and interest, from self-care support in an online forum for older adults to nursing students' perspectives on effective pedagogy. In line with the digital transformation in society in general, we discuss the fact that netnography as a research methodology offers great opportunities for nurse researchers to monitor new spaces and places that presuppose online methodological knowledge.

Hikikomori: A Scientometric Review of 20 Years of Research

The Japanese term hikikomori was first used to describe prolonged social withdrawal in the 1990s. Since then, research across the world have reported similar prolonged social withdrawal in many countries outside Japan. This study systematically analyses the evolution of literature on hikikomori in the past 20 years to gain a better understanding of the development of the knowledge base on hikikomori since it garnered attention in Japan. Findings from the scientometric review indicate many perspectives on the etiology of hikikomori including cultural, attachment, family systems and sociological approaches. However, similarities with modern type depression, a novel psychiatric syndrome, have been proposed and there are signs of a recent paradigm shift of hikikomori as a society-bound syndrome rather than a cultural-bound syndrome unique to Japan. As research into hikikomori continues to grow, results from the review also highlight the need for a more universally shared definition of hikikomori in order to better consolidate cross-cultural research for meaningful and valid cross-cultural comparisons which can help to promote evidence-based therapeutic interventions for hikikomori.

Association of Paraphenylenediamine (PPD), with suicidal attempts in Pakistan- A cross-sectional study

OBJECTIVE

This study will provide us the details about the vulnerable population in relation to suicidal attempts by ingesting paraphenylenediamine and will help in designing focused preventive measures to address this serious health issue while reducing the burden on healthcare resources.

METHODS

This descriptive cross-sectional study was carried out from January 1, 2017 to December 31, 2021 at the National Poison Control Centre, Karachi, using a consecutive sampling technique. The sample size was n = 321 reported cases of Paraphenylenediamine poisoning, data was collected from the hospital record. Incomplete records were excluded. The analysis was done using SPSS Statistics (version 22), a statistical software suite developed by IBM. Numerical data was expressed as mean and standard deviation. Categorical data associations were recorded using chi-square. A p-value less than 0.05 was taken as significant.

RESULTS

There were n = 321 patients who reported with paraphenylenediamine poisoning to National Poison Control Centre, of which 53.8% (n = 173) were females. While 55.4%(n = 178) of patients were young post-adolescent adults (aged 20-40 years). Analysis according to months revealed that a maximum number of cases 15.26% (n = 49) were reported in April. The mortality rate was 12.1% (n = 39).

CONCLUSION

Paraphenylenediamine ingestion has a strong association with suicidal attempts, post-adolescent females are most vulnerable. The cases of paraphenylenediamine ingestion were highest in Spring and summer seasons in Karachi. A nationwide ban on the trade of paraphenylenediamine will obviously reduce accessibility and the number of suicides.