Prolonged social withdrawal ("hikikomori") and its associations with depressive symptoms and suicidal ideation among young adults in Korea: Findings from the 2022 Youth Life Survey

Abstract

Background: Hikikomori syndrome (HS) is a public health concern. We investigated the prevalence of HS and its association with depressive symptoms and suicidal ideation among young Korean adults. Methods: Young adults aged 19-34 years was obtained from the 2022 Youth Life Survey, with a total of 14,870 participants. HS was defined as a condition characterized by >= six months of social withdrawal, including lack of employment or school engagement, lack of social interaction, and confinement to one's home or room, which causes distress to the individual or impairs social functioning. Depressive symptoms were assessed using the Patient Health Questionnaire-9. The presence of suicidal ideation within the past year was evaluated. Logistic regression was performed to calculate odds ratios (ORs) and 95 % confidence intervals (CIs). Results: The prevalence of HS in the sample was 1.4 % (n = 871). Individuals with HS exhibited a higher prevalence of both depressive symptoms (20.9 % vs. 5.9 %) and suicidal ideation (11.0 % vs. 2.3 %) compared to those without HS. The OR (95 % CI) of the association between HS and depressive symptoms was 3.91 (2.47-6.18) compared with non-HS after adjusting for sociodemographic features. Similarly, the adjusted OR (95 % CI) of the association between HS and suicidal ideation was 5.24 (2.88-9.52) compared with non-HS. A further analysis indicated that depressive symptoms partially mediates the association between HS and suicidal ideation. Limitation: The cross-sectional study design limits the ability to infer causality. Conclusion: HS was linked to poor mental health. Policy efforts aimed at identifying young adults with HS and protecting their mental health are required.