Zhang Wei, Chen Meng-Yi, A Li-Ya, Jiang Yuan-Yuan, Huang Hui-Ting, Liu Shou, Ma Yi, Su Zhaohui, Cheung Teris, Ungvari Gabor S, Jackson Todd, Xiang Yu-Tao
Unit of Psychiatry, Department of Public Health and Medicinal Administration & Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, Macao SAR, China.
Centre for Cognitive and Brain Sciences, University of Macau, Macao SAR, China.
Int J Soc Psychiatry. 2025 Sep;71(6):1114-1126. doi: 10.1177/00207640251325059. Epub 2025 Mar 21.
Subclinical Hikikomori and depression are common among college students, yet gender differences in their prevalence and interrelationships are under-explored. This study evaluated gender differences in prevalence and symptom networks of these disturbances.
A large-scale, multi-center study was conducted across Xinjiang, Qinghai, and Guangdong provinces, China between September and December 2023. Subclinical Hikikomori and depression were assessed with the 1-month 25-item Hikikomori Questionnaire (HQ-25M) and the Patient Health Questionnaire-9 (PHQ-9), respectively. Gender differences in prevalence were tested with univariate analyses, while network analyses assessed symptom structures within each gender. Expected Influence (EI) identified the most central symptoms, with higher EI indicating greater impact. Bridge EI identified specific symptoms that linked Hikikomori and depression symptom communities.
Among 6,222 college students, no significant gender differences were found in the prevalence of subclinical Hikikomori (males: 11.4% and females: 13.3%) or depression (males: 19.1% and females: 18.3%). Network analysis revealed 'I avoid talking with other people' (HQ18) as the most central symptom for both males (EI = 1.60) and females (EI = 1.73), followed by 'It is hard for me to join in groups' (HQ13, EI = 1.442) and 'I have little contact with other people' (HQ19, EI = 1.437) in males, and followed by 'Loss of energy' (PHQ4, EI = 1.17) and 'I have little contact with other people' (HQ19, EI = 1.09) in females. The key bridge symptoms were identified as 'Guilt feelings' (PHQ6) for males (Bridge EI = 0.14) and 'Suicidal ideation' (PHQ9) for females (Bridge EI = 0.13). Significant overall gender differences in networks were observed ( = 0.12, = .01).
Depression and subclinical Hikikomori are common among Chinese college students although we observed no significant gender differences in its prevalence. The most influential central and bridge symptoms from network models are viable targets for intervention for both genders.
亚临床的蛰居族现象和抑郁症在大学生中很常见，但它们在患病率和相互关系上的性别差异尚未得到充分研究。本研究评估了这些障碍在患病率和症状网络方面的性别差异。
2023年9月至12月在中国新疆、青海和广东省进行了一项大规模、多中心研究。分别用25项1个月蛰居族问卷（HQ - 25M）和患者健康问卷 - 9（PHQ - 9）评估亚临床蛰居族现象和抑郁症。用单因素分析检验患病率的性别差异，而网络分析评估每种性别的症状结构。预期影响（EI）确定最核心的症状，EI值越高表明影响越大。桥梁EI确定了连接蛰居族现象和抑郁症症状群落的特定症状。
在6222名大学生中，亚临床蛰居族现象（男性：11.4%，女性：13.3%）或抑郁症（男性：19.1%，女性：18.3%）的患病率未发现显著性别差异。网络分析显示，“我避免与他人交谈”（HQ18）是男性（EI = 1.60）和女性（EI = 1.73）最核心的症状，男性其次是“我很难融入群体”（HQ13，EI = 1.442）和“我很少与他人接触”（HQ19，EI = 1.437），女性其次是“精力丧失”（PHQ4，EI = 1.17）和“我很少与他人接触”（HQ19，EI = 1.09）。关键的桥梁症状被确定为男性的“内疚感”（PHQ6，桥梁EI = 0.14）和女性的“自杀观念”（PHQ9，桥梁EI = 0.13）。观察到网络中存在显著的总体性别差异（ = 0.12， = 0.01）。
抑郁症和亚临床蛰居族现象在中国大学生中很常见，尽管我们观察到其患病率没有显著的性别差异。网络模型中最具影响力的核心症状和桥梁症状是两性干预的可行目标。
