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The ‘Hikikomori’ syndrome: worldwide prevalence and co-occurring major psychiatric disorders: a systematic review and meta-analysis protocol
  1. Andrea Pozza1,
  2. Anna Coluccia1,
  3. Takahiro Kato2,
  4. Marco Gaetani1,
  5. Fabio Ferretti1
  1. 1 Department of Medical Sciences, Surgery and Neurosciences, Santa Maria alle Scotte University Hospital of Siena, Siena, Italy
  2. 2 Department of Neuropsychiatry, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
  1. Correspondence to Professor Fabio Ferretti; ferrefa{at}unisi.it

Abstract

Introduction The ‘Hikikomori’ syndrome (HS) consists of prolonged and severe social withdrawal. It has been studied first in Japan and recently has increasingly drawn the attention of researchers and clinicians all over the world. It is unclear whether it exists in other cultural contexts than Asia. The existing systematic reviews did not provide a quantitative synthesis on its prevalence. In addition, a summary of the co-occurring rates of psychiatric disorders is lacking. To provide a more comprehensive understanding of the clinical picture, it seems important to investigate which psychiatric disorders listed in the classification systems are most frequently associated with this psychological condition affecting young people. This paper describes a systematic review and meta-analysis protocol summarising worldwide prevalence of the HS in general population and clinical samples with psychiatric disorders. The review will also assess the co-occurrence between HS and each psychiatric disorder defined by any version of the Diagnostic and Statistical Manual of Mental Disorders (DSM) or International Classification of Diseases (ICD) in any clinical samples with psychiatric disorders.

Methods and analysis A systematic review will be conducted according to Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines. Studies will be included if they use youth aged 12–35 years, recruited from general population or population with psychiatric disorders, if they use international criteria to diagnose HS. No restriction about design or language will be applied. The search will be conducted during the first week of November 2019 by two independent reviewers through the databases Scopus, PubMed, PsycINFO, Web of Science, by examining study references, by looking for conference proceedings/dissertations/theses, by contacting study corresponding authors. Random-effect meta-analysis will be performed by computing effect sizes as logit event rates. Study quality will be assessed through the Newcastle-Ottawa Scale.

Ethics and dissemination The current review does not require ethics approval. The results will be disseminated through conference presentations and publications in peer-reviewed journals.

PROSPERO registration number CRD 42018098747.

  • schizophrenia & psychotic disorders
  • personality disorders
  • child & adolescent psychiatry
  • social withdrawal
  • systematic review
  • depression & mood disorders

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.

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Footnotes

  • Contributors AP designed and conceived the study, wrote the first draft of the paper, will conduct the search, data screening, data extraction and coding. AC designed and conceived the study, critically reviewed the first draft of the paper, will check data screening, data extraction and coding. TK designed and conceived the study, critically reviewed the first draft of the paper, will check data screening. MG designed and conceived the study, critically reviewed the first draft of the paper, will check data screening, data extraction and coding. FF designed and conceived the study, wrote the first draft of the paper, will conduct the search, data screening, data extraction and coding.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement No data are available.

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