Comorbidity Between Hikikomori and Autistic Traits May Be Identified as a Phenotypical Presentation Characterized by Greater Severity

<b>Objectives</b>: Hikikomori is a condition characterized by extreme social withdrawal, functional impairment, and mental distress, which has gained increasing recognition worldwide. While it can be associated with comorbid psychiatric disorders, hikikomori shares similarities with auti...

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Main Authors: Liliana Dell’Osso, Benedetta Nardi, Dario Muti, Chiara De Felice, Valeria Tognini, Francesca Parri, Federico Giovannoni, Filippo Del Grande, Chiara Bonelli, Gabriele Massimetti, Stefano Pini, Andrea Fiorillo, Barbara Carpita
Format: Article
Language:English
Published: MDPI AG 2025-05-01
Series:Brain Sciences
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Online Access:https://www.mdpi.com/2076-3425/15/5/496
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author Liliana Dell’Osso
Benedetta Nardi
Dario Muti
Chiara De Felice
Valeria Tognini
Francesca Parri
Federico Giovannoni
Filippo Del Grande
Chiara Bonelli
Gabriele Massimetti
Stefano Pini
Andrea Fiorillo
Barbara Carpita
author_facet Liliana Dell’Osso
Benedetta Nardi
Dario Muti
Chiara De Felice
Valeria Tognini
Francesca Parri
Federico Giovannoni
Filippo Del Grande
Chiara Bonelli
Gabriele Massimetti
Stefano Pini
Andrea Fiorillo
Barbara Carpita
author_sort Liliana Dell’Osso
collection DOAJ
description <b>Objectives</b>: Hikikomori is a condition characterized by extreme social withdrawal, functional impairment, and mental distress, which has gained increasing recognition worldwide. While it can be associated with comorbid psychiatric disorders, hikikomori shares similarities with autism spectrum, prompting investigations into their relationship. Given that hikikomori commonly manifests in early adulthood, this study aimed to explore the relationship between autistic features and hikikomori tendencies among university students. <b>Methods</b>: A total of 2037 university students were recruited via an online survey and assessed with the Adult Autism Subthreshold (AdAS) Spectrum and the Hikikomori Questionnaire (HQ-25). Participants were categorized into four groups: healthy controls (HCs), subjects with hikikomori tendencies (HKs), subjects with significant autistic traits (ATs), and subjects with both significant ATs and hikikomori tendencies (AT-HKs). <b>Results</b>: Results showed significant effects of both hikikomori presence and significant ATs on AdAS Spectrum and HQ-25 scores, while a significant effect of their interaction was detected on AdAS Spectrum scores. The AT-HK group consistently scored higher on both AdAS Spectrum and HQ-25 compared to other groups, with the AT and HK groups outperforming HCs in specific domains. HQ-25 Socialization and Isolation domains predicted higher AdAS Spectrum scores in hikikomori subjects, while various AdAS Spectrum domains served as predictors of HQ-25 scores in AT subjects. <b>Conclusions</b>: This study highlights a significant relationship between ATs and hikikomori tendencies in university students, suggesting that their comorbidity may represent a more severe phenotype, where each condition may exacerbate the other.
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spelling doaj-art-2d96ebeaf8cb4b88a3a35e6be237bf332025-08-20T03:14:30ZengMDPI AGBrain Sciences2076-34252025-05-0115549610.3390/brainsci15050496Comorbidity Between Hikikomori and Autistic Traits May Be Identified as a Phenotypical Presentation Characterized by Greater SeverityLiliana Dell’Osso0Benedetta Nardi1Dario Muti2Chiara De Felice3Valeria Tognini4Francesca Parri5Federico Giovannoni6Filippo Del Grande7Chiara Bonelli8Gabriele Massimetti9Stefano Pini10Andrea Fiorillo11Barbara Carpita12Department of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, ItalyDepartment of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, ItalyDepartment of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, ItalyDepartment of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, ItalyDepartment of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, ItalyDepartment of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, ItalyDepartment of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, ItalyDepartment of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, ItalyDepartment of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, ItalyDepartment of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, ItalyDepartment of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, ItalyDepartment of Psychiatry, University of Campania “Luigi Vanvitelli”, 80138 Naples, ItalyDepartment of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, Italy<b>Objectives</b>: Hikikomori is a condition characterized by extreme social withdrawal, functional impairment, and mental distress, which has gained increasing recognition worldwide. While it can be associated with comorbid psychiatric disorders, hikikomori shares similarities with autism spectrum, prompting investigations into their relationship. Given that hikikomori commonly manifests in early adulthood, this study aimed to explore the relationship between autistic features and hikikomori tendencies among university students. <b>Methods</b>: A total of 2037 university students were recruited via an online survey and assessed with the Adult Autism Subthreshold (AdAS) Spectrum and the Hikikomori Questionnaire (HQ-25). Participants were categorized into four groups: healthy controls (HCs), subjects with hikikomori tendencies (HKs), subjects with significant autistic traits (ATs), and subjects with both significant ATs and hikikomori tendencies (AT-HKs). <b>Results</b>: Results showed significant effects of both hikikomori presence and significant ATs on AdAS Spectrum and HQ-25 scores, while a significant effect of their interaction was detected on AdAS Spectrum scores. The AT-HK group consistently scored higher on both AdAS Spectrum and HQ-25 compared to other groups, with the AT and HK groups outperforming HCs in specific domains. HQ-25 Socialization and Isolation domains predicted higher AdAS Spectrum scores in hikikomori subjects, while various AdAS Spectrum domains served as predictors of HQ-25 scores in AT subjects. <b>Conclusions</b>: This study highlights a significant relationship between ATs and hikikomori tendencies in university students, suggesting that their comorbidity may represent a more severe phenotype, where each condition may exacerbate the other.https://www.mdpi.com/2076-3425/15/5/496hikikomoriautismautistic traitssocial withdrawal
spellingShingle Liliana Dell’Osso
Benedetta Nardi
Dario Muti
Chiara De Felice
Valeria Tognini
Francesca Parri
Federico Giovannoni
Filippo Del Grande
Chiara Bonelli
Gabriele Massimetti
Stefano Pini
Andrea Fiorillo
Barbara Carpita
Comorbidity Between Hikikomori and Autistic Traits May Be Identified as a Phenotypical Presentation Characterized by Greater Severity
Brain Sciences
hikikomori
autism
autistic traits
social withdrawal
title Comorbidity Between Hikikomori and Autistic Traits May Be Identified as a Phenotypical Presentation Characterized by Greater Severity
title_full Comorbidity Between Hikikomori and Autistic Traits May Be Identified as a Phenotypical Presentation Characterized by Greater Severity
title_fullStr Comorbidity Between Hikikomori and Autistic Traits May Be Identified as a Phenotypical Presentation Characterized by Greater Severity
title_full_unstemmed Comorbidity Between Hikikomori and Autistic Traits May Be Identified as a Phenotypical Presentation Characterized by Greater Severity
title_short Comorbidity Between Hikikomori and Autistic Traits May Be Identified as a Phenotypical Presentation Characterized by Greater Severity
title_sort comorbidity between hikikomori and autistic traits may be identified as a phenotypical presentation characterized by greater severity
topic hikikomori
autism
autistic traits
social withdrawal
url https://www.mdpi.com/2076-3425/15/5/496
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