Orsolini Laura, Longo Giulio, Bellagamba Silvia, Kato Takahiro A, Volpe Umberto
Unit of Clinical Psychiatry, Department of Neurosciences/DIMSC, Polytechnic University of Marche, Via Conca 71, 60126, Ancona, Italy.
Department of Neuropsychiatry, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
Ann Gen Psychiatry. 2024 Mar 19;23(1):12. doi: 10.1186/s12991-024-00496-z.
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.
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).
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, R = 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, R = 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.
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.
茧居症（HK）的特征是自我隔离和社交回避，也更有可能与包括抑郁症在内的情感障碍有关。这项病例对照研究主要旨在确定（如果存在的话）抑郁个体与非抑郁个体中与茧居症相关的主要情感气质。次要目标包括评估抑郁个体中茧居症特质还与哪些其他精神病理学维度（如无聊、焦虑）相关。
从规模更大的SWATCH研究中，通过9项患者健康问卷（PHQ - 9）和类似茧居症的社交回避情况（通过茧居症问卷 - 25（HQ - 25）进行测量）对687名意大利年轻人进行抑郁症筛查。所有受试者都接受了孟菲斯、比萨、巴黎和圣地亚哥气质简短评估量表（TEMPS - M）、7项广泛性焦虑症量表（GAD - 7）和多维状态无聊量表（MSBS）的测试。
男性在HQ - 25总分上的得分显著高于女性（p = 0.026）。在总样本中，茧居症社交回避由MSBS低唤醒、脱离、抑郁水平、抑郁和易怒情感气质正向预测，而由焦虑负向预测（F(6, 680) = 82.336，p < 0.001，R = 0.421）。仅选择抑郁样本时，HQ - 25由MSBS总分、低唤醒和抑郁情感气质正向预测，而由MSBS高唤醒负向预测（F(4, 383) = 48.544，p < 0.001，R = 0.336）。逻辑回归模型发现，抑郁和环性情感气质显著预测了伴有茧居症特质的个体患抑郁症的可能性。
这些初步发现有助于从临床角度描述有/无茧居症特质的抑郁个体中特定情感气质特征之间的关系，以便提供更具针对性和个性化的治疗方法。我们的意大利研究应在更大规模、纵向和多中心的泛欧洲研究中广泛重复进行，具体评估这些发现对抑郁症临床病程、预后和治疗结果的影响。
