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Takegami N, Akeda K, Yamada J, Nishimura A, Sudo A. Association between low back pain and psychological stress response in a Japanese population-based study. J Orthop Sci 2024; 29:749-754. [PMID: 37059621 DOI: 10.1016/j.jos.2023.04.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Revised: 03/30/2023] [Accepted: 04/02/2023] [Indexed: 04/16/2023]
Abstract
BACKGROUND Psychological stress response refers to the negative emotional states generated when an individual perceives that they do not have the resources to cope with or respond to a threat. Low back pain (LBP) is a complex condition with multiple contributors, including psychological factors. However, whether LBP is a stressor that causes a psychological stress response remains unknown. This study aimed to investigate the association between LBP and psychological stress response in a Japanese population-based cohort. METHODS Participants aged >50 years were recruited from inhabitants of a mountain village in Japan. The participants completed the following patient-reported outcome measures. The extent of the psychological stress response was measured using the Stress response scale (SRS)-18, which includes the subscales "Depression/Anxiety", "Irritability/Anger", and "Helplessness". LBP intensity in several situations/positions was measured using a numerical rating scale (NRS). Quality of life (QOL) was measured using the Oswestry Disability Index, EuroQol 5-dimension, and EuroQol visual analog scales. The association between SRS-18 and each parameter was statistically evaluated. RESULTS A total of 282 participants (72.1 years old) were analyzed in this study, and 29.1% had chronic LBP. The SRS-18 total score of all participants ranged from 0 to 43, and the average SRS-18 total score was 7.7 ± 8.8 (depression/anxiety: 2.3 ± 3.2, irritability/anger: 2.4 ± 3.3, helplessness: 2.9 ± 3.2). SRS-18 scores of participants with LBP were significantly higher than those of participants without LBP. SRS-18 scores were significantly correlated with QOL scores (P < 0.01, correlation coefficient = 0.22-0.46). Multiple regression analysis showed that the NRS score of LBP during morning awakening was significantly associated with the SRS-18 total, depression/anxiety, and helplessness scores. CONCLUSIONS Psychological stress responses were associated with LBP and LBP-related QOL among residents of a Japanese mountain village.
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Affiliation(s)
- Norihiko Takegami
- Department of Orthopaedic Surgery, Mie University Graduate School of Medicine, Tsu City, Mie, Japan
| | - Koji Akeda
- Department of Orthopaedic Surgery, Mie University Graduate School of Medicine, Tsu City, Mie, Japan.
| | - Junichi Yamada
- Department of Orthopaedic Surgery, Mie University Graduate School of Medicine, Tsu City, Mie, Japan
| | - Akinobu Nishimura
- Department of Orthopaedic Surgery, Mie University Graduate School of Medicine, Tsu City, Mie, Japan
| | - Akihiro Sudo
- Department of Orthopaedic Surgery, Mie University Graduate School of Medicine, Tsu City, Mie, Japan
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Chan GH. Therapeutic comparison in psychological capital. Front Psychiatry 2023; 14:1114170. [PMID: 37608996 PMCID: PMC10441124 DOI: 10.3389/fpsyt.2023.1114170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Accepted: 07/18/2023] [Indexed: 08/24/2023] Open
Abstract
Aim This study aimed to investigate and compare the therapeutic outcomes of psychological capital between narrative therapy, cognitive-behavioral therapy, and play therapy in the context of hikikomori. Methods This study included 502 hikikomori. Correlation analysis was performed to investigate the relationship between the three forms of therapy and psychological capital, while one-way ANOVA and independent samples t-tests were performed to determine the differences in the outcomes of psychological capital between the three forms of therapies. Results Results indicated that all three forms of therapy were significantly positively related to psychological capital. Moreover, while cognitive-behavioral therapy performed better in psychological capital (overall score) than the other two, cognitive-behavioral therapy performed better in the subscales "self-efficacy" and "resilience," while narrative therapy performed better in the "hope" and "optimism" subscales. Also, combining features of play therapy helped enhance the outcomes of narrative therapy and cognitive-behavioral therapy on psychological capital. Conclusion Owing to the varied outcomes of psychological capital among different therapies, the differential use of therapies to deal with the unique needs resultant of hikikomori helps achieve optimal results.
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Affiliation(s)
- Gloria Hongyee Chan
- Department of Social and Behavioral Sciences, City University of Hong Kong, Kowloon Tong, Hong Kong SAR, China
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Bonnaire C, Roignot Z. Relationship Between Social Withdrawal (Hikikomori), Personality, and Coping in an Adult Population. Psychiatry Investig 2023; 20:740-749. [PMID: 37614013 PMCID: PMC10460979 DOI: 10.30773/pi.2023.0099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Accepted: 05/28/2023] [Indexed: 08/25/2023] Open
Abstract
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.
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Affiliation(s)
- Céline Bonnaire
- Institute of Psychology, Laboratory of Psychopathology and Health Process, Paris Cité University, Boulogne-Billancourt, France
- Addiction Care Center Pierre Nicole, Red Cross, Paris, France
| | - Zoé Roignot
- Paris Cité University, Boulogne-Billancourt, France
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Neoh MJY, Carollo A, Lim M, Esposito G. Hikikomori: A Scientometric Review of 20 Years of Research. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:ijerph20095657. [PMID: 37174175 PMCID: PMC10177810 DOI: 10.3390/ijerph20095657] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Revised: 03/21/2023] [Accepted: 04/17/2023] [Indexed: 05/15/2023]
Abstract
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.
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Affiliation(s)
- Michelle Jin Yee Neoh
- Psychology Program, School of Social Sciences, Nanyang Technological University, Singapore 639818, Singapore
| | - Alessandro Carollo
- Department of Psychology and Cognitive Science, University of Trento, 38068 Rovereto, Italy
| | - Mengyu Lim
- Psychology Program, School of Social Sciences, Nanyang Technological University, Singapore 639818, Singapore
| | - Gianluca Esposito
- Department of Psychology and Cognitive Science, University of Trento, 38068 Rovereto, Italy
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Kubo H, Katsuki R, Horie K, Yamakawa I, Tateno M, Shinfuku N, Sartorius N, Sakamoto S, Kato TA. Risk factors of hikikomori among office workers during the COVID-19 pandemic: A prospective online survey. CURRENT PSYCHOLOGY 2022; 42:1-19. [PMID: 35919757 PMCID: PMC9334542 DOI: 10.1007/s12144-022-03446-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/02/2022] [Indexed: 12/01/2022]
Abstract
The global pandemic of COVID-19 has forced people to restrict their outings. In Japan, self-restraint behavior (SRB) has been requested by the government, and some of those decreasing their outings may shift to pathological social withdrawal; hikikomori. The purpose of this study was to examine the risk factors of hikikomori conducting an online prospective survey. An online survey was conducted in June 2020 and December 2020; (1) SRB-related indicators (degree of SRB, motivation for SRB, stigma and self-stigma toward COVID-19, anxiety and depressive feelings toward COVID-19) and (2) general mental health (hikikomori tendency, depressive symptoms, modern type depression (MTD) tendency, internet addiction) were collected. A cross-lagged effects model was performed to examine the association between these variables. Lack of emotional support and lack of socialization in June 2020 increased isolation in December 2020. Besides, MTD and hikikomori interacted with each other. Interestingly, although hikikomori tendency increased depressive tendencies, SRB itself did not have a significant path on any mental health-related variables. Poor interpersonal relationships, rather than SRB per se, are suggested to be a risk factor for increased isolation among office workers in the COVID-19 pandemic. Appropriate early interventions such as interpersonal or emotional support may prevent the transition to pathological hikikomori. The association between MTD and hikikomori seems to reveal the interesting possibility that MTD is a gateway to increased risk of hikikomori, and that hikikomori is a gateway to MTD as well. Future research is required to elucidate the relationship between hikikomori and MTD.
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Affiliation(s)
- Hiroaki Kubo
- Department of Neuropsychiatry, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi Higashi-Ku, Fukuoka, 812-8582 Japan
| | - Ryoko Katsuki
- Department of Neuropsychiatry, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi Higashi-Ku, Fukuoka, 812-8582 Japan
| | - Kazumasa Horie
- Department of Neuropsychiatry, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi Higashi-Ku, Fukuoka, 812-8582 Japan
| | - Itsuki Yamakawa
- Department of Health and Human Services, Faculty of Medical and Welfare, Tohoku Bunka Gakuen University, Miyagi, Japan
- Department of Psychology, College of Humanities and Sciences, Nihon University, Tokyo, Japan
| | - Masaru Tateno
- Tokiwa Child Development Center, Tokiwa Hospital, Sapporo, Japan
- Department of Neuropsychiatry, School of Medicine, Sapporo Medical University, Sapporo, Japan
| | - Naotaka Shinfuku
- School of Human Sciences, Seinan Gakuin University, Fukuoka, Japan
| | - Norman Sartorius
- Association for the Improvement of Mental Health Programmes, Geneva, Switzerland
| | - Shinji Sakamoto
- Department of Psychology, College of Humanities and Sciences, Nihon University, Tokyo, Japan
| | - Takahiro A. Kato
- Department of Neuropsychiatry, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi Higashi-Ku, Fukuoka, 812-8582 Japan
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Hamasaki Y, Pionnié-Dax N, Dorard G, Tajan N, Hikida T. Preliminary study of the social withdrawal (hikikomori) spectrum in French adolescents: focusing on the differences in pathology and related factors compared with Japanese adolescents. BMC Psychiatry 2022; 22:477. [PMID: 35842596 PMCID: PMC9287690 DOI: 10.1186/s12888-022-04116-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/27/2021] [Accepted: 07/06/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Social withdrawal (hikikomori) has become an internationally recognized phenomenon, but its pathology and related factors are not yet fully known. We previously conducted a statistical case-control study on adolescent patients with hikikomori in Japan, which revealed the non-specificity of pathology in patients with hikikomori. Further, environmental factors, such as the lack of communication between parents and Internet overuse, were found to be significant predictors of hikikomori severity. Here, we aimed to conduct a similar preliminary case-control study in France and to compare the results with those from the study conducted in Japan. METHODS Parents of middle school students who underwent psychiatric outpatient treatment for hikikomori (n = 10) and control group parents (n = 115) completed the Child Behavior Checklist to evaluate their child's psychopathological characteristics and the Parental Assessment of Environment and Hikikomori Severity Scales, as in our previous study in Japan. We compared the descriptive statistics and intergroup differences in France with those from the previous study conducted in Japan. In the multiple regression analysis to find predictors of hikikomori severity in French and also Japanese subjects, the same dependent and independent variables were chosen for the present study (both differed from the previous study). These were used in order to make accurate intercountry comparisons. RESULTS The comparisons revealed no differences in the pathology of hikikomori between Japan and France. Specifically, both studies found similarly increased scores for all symptom scales, with no specific bias. However, the statistical predictors of hikikomori severity in France (lack of communication between parents and child and lack of communication with the community) differed from those in Japan (lack of communication between parents). CONCLUSION Hikikomori in Japan and France could be considered essentially the same phenomenon; moreover, our findings demonstrated the universal non-specificity and unbiasedness of the hikikomori pathology. This suggests that hikikomori is not a single clinical category with a specific psychopathology; instead, it is a common phenotype with various underlying pathologies. However, different strategies may be required in each country to prevent the onset and progression of hikikomori.
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Affiliation(s)
- Yukiko Hamasaki
- Faculty of Contemporary Society, Kyoto Women's University, 35, Kitahiyoshi-cho, Imakumano, Higashiyama-ku, Kyoto, 605-8501, Japan. .,Shigasato Hospital, 1 Chome-18-41 Shigasato, Otsu, Shiga, 520-0006, Japan.
| | - Nancy Pionnié-Dax
- Child and Adolescent Psychiatry Department, EPS ERASME, Antony, France
| | - Géraldine Dorard
- Child and Adolescent Psychiatry Department, EPS ERASME, Antony, France ,grid.508487.60000 0004 7885 7602Université Paris Cité, LPPS, F-92100 Boulogne-Billancourt, France
| | - Nicolas Tajan
- grid.258799.80000 0004 0372 2033Psychopathology and Psychoanalysis Laboratory, Graduate School of Human and Environmental Studies, Kyoto University, Kyoto, Japan
| | - Takatoshi Hikida
- grid.136593.b0000 0004 0373 3971Laboratory for Advanced Brain Functions, Institute for Protein Research, Osaka University, Osaka, Japan
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Hu X, Fan D, Shao Y. Social Withdrawal (Hikikomori) Conditions in China: A Cross-Sectional Online Survey. Front Psychol 2022; 13:826945. [PMID: 35360625 PMCID: PMC8963962 DOI: 10.3389/fpsyg.2022.826945] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Accepted: 02/14/2022] [Indexed: 11/13/2022] Open
Abstract
Objective A form of pathological social withdrawal which is also called hikikomori has been proved its existence in China. But the prevalence and characteristics of hikikomori in China remain unknown. Past studies had investigated the hikikomori phenomenon in three cities of China. The purpose of this study is to discover the prevalence of hikikomori in a convenient online sample in China as well as the difference in demographic characteristics and other possible traits between hikikomori sufferers and the general population. Methods A total of 1,066 youths (mean age = 22.85 years) in China completed the online questionnaire, which consisted of questions about demographics, the 25-item Hikikomori Questionnaire (HQ-25), the Internet Addiction Test (IAT), the Loneliness Scale (UCLA), and the General Health Questionnaire (GHQ). SPSS is used to evaluate the data. Results Of the 1,066 youths, 980 (91.9%) were identified as belonging to group A (be not social isolation nor withdrawn), 46 (4.3%) to group B (marked social isolation in one's home or withdrawn with a duration of at least 3 months), and 40 (3.8%) to group C (marked both social isolation in one's home and withdrawn with a duration of at least 3 months). The hikikomori group (combined group B and group C) accounted for 8.1%. The present data suggest that residence and loneliness are related to the occurrence of hikikomori. HQ-25 score of the hikikomori group was significantly higher than the comparison group. The UCLA score showed that those in the hikikomori group felt lonelier than those in the comparison. The regression model predicted hikikomori risk (χ2 = 38.658, P = 0.000), the Hosmer-Lemeshow test value is 7.114 and P = 0.524 > 0.05. Conclusion The grouping criterion in our present study is reasonable and such a grouping criterion can screen out potential populations of hikikomori. When people develop into hikikomori sufferers in the present, their social withdrawal behaviors and feeling of loneliness are both much more severe than in the past. The possible relationships between hikikomori and loneliness reflect the need to give the youths more social support, to help them connect with society.
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Affiliation(s)
| | | | - Yang Shao
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
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Nonaka S, Shimada H, Sakai M. Individuals with hikikomori and their families’ cognitive behavioral factors: A prospective study. CURRENT PSYCHOLOGY 2022. [DOI: 10.1007/s12144-022-02772-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Panto F, Saito T, Morita N, Ogai Y. The Correlation between Enjoying Fictional Narratives and Empathy in Japanese Hikikomori. F1000Res 2022; 10:776. [PMID: 35342623 PMCID: PMC8921688 DOI: 10.12688/f1000research.55398.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/14/2022] [Indexed: 11/21/2022] Open
Abstract
Background: Hikikomori is a Japanese social withdrawal phenomenon which, in recent years, is spreading in western developed countries as well. Spending a lot of time secluded indoors, watching and playing with fictional narratives may be relatively common for Hikikomori people and may represent a protective factor for their psychological well-being. Method: We evaluated the role of enjoying fictional narratives on empathy, relaxation, depression, and anxiety in people with Hikikomori experience, in relation to their daily consumption of fictional narratives and their emotional transportation toward fictional narratives. Hikikomori from one psychiatric clinic and three different support facilities were enrolled in this study. Multidimensional empathy scale, CES-D, STAI questionnaire, and relaxation inventory self-report scale were used as outcome measures. Results: We found a significant correlation between empathy and emotional transportation toward fictional narratives and between relaxation during watching and reading fictional narratives and consumption frequency of fictional narratives. We failed, however, to find any significant correlation with depression and anxiety. Conclusions: These findings suggest a possible correlation between fiction and empathy/relaxation response; however, any causal relationship is not proven, consequently we deem that further investigations with a larger sample size are required for a better understanding.
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Affiliation(s)
- Francesco Panto
- Social Psychiatry and Mental Health, University of Tsukuba , Faculty of Medicine, Tsukuba, Japan, 3058577, Japan
| | - Tamaki Saito
- Social Psychiatry and Mental Health, University of Tsukuba , Faculty of Medicine, Tsukuba, Japan, 3058577, Japan
| | - Nobuaki Morita
- Social Psychiatry and Mental Health, University of Tsukuba , Faculty of Medicine, Tsukuba, Japan, 3058577, Japan
| | - Yasukazu Ogai
- Social Psychiatry and Mental Health, University of Tsukuba , Faculty of Medicine, Tsukuba, Japan, 3058577, Japan
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Setoyama D, Matsushima T, Hayakawa K, Nakao T, Kanba S, Kang D, Kato TA. Blood metabolic signatures of hikikomori, pathological social withdrawal. DIALOGUES IN CLINICAL NEUROSCIENCE 2021; 23:14-28. [PMID: 35860171 PMCID: PMC9286746 DOI: 10.1080/19585969.2022.2046978] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Background A severe form of pathological social withdrawal, ‘hikikomori,’ has been acknowledged in Japan, spreading worldwide, and becoming a global health issue. The pathophysiology of hikikomori has not been clarified, and its biological traits remain unexplored. Methods Drug-free patients with hikikomori (n = 42) and healthy controls (n = 41) were recruited. Psychological assessments for the severity of hikikomori and depression were conducted. Blood biochemical tests and plasma metabolome analysis were performed. Based on the integrated information, machine-learning models were created to discriminate cases of hikikomori from healthy controls, predict hikikomori severity, stratify the cases, and identify metabolic signatures that contribute to each model. Results Long-chain acylcarnitine levels were remarkably higher in patients with hikikomori; bilirubin, arginine, ornithine, and serum arginase were significantly different in male patients with hikikomori. The discriminative random forest model was highly performant, exhibiting an area under the ROC curve of 0.854 (confidential interval = 0.648–1.000). To predict hikikomori severity, a partial least squares PLS-regression model was successfully created with high linearity and practical accuracy. In addition, blood serum uric acid and plasma cholesterol esters contributed to the stratification of cases. Conclusions These findings reveal the blood metabolic signatures of hikikomori, which are key to elucidating the pathophysiology of hikikomori and also useful as an index for monitoring the treatment course for rehabilitation.
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Affiliation(s)
- Daiki Setoyama
- Department of Clinical Chemistry and Laboratory Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Toshio Matsushima
- Department of Neuropsychiatry, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Kohei Hayakawa
- Department of Neuropsychiatry, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Tomohiro Nakao
- Department of Neuropsychiatry, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Shigenobu Kanba
- Department of Neuropsychiatry, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Dongchon Kang
- Department of Clinical Chemistry and Laboratory Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Takahiro A. Kato
- Department of Neuropsychiatry, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
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