2022 Volume 62 Issue 2 Pages 167-175
“Hikikomori” (or social withdrawal) which refers to a state in which an individual dose not participate in society for prolonged periods is a significant problem in Japan. Several reports outline the process of medical treatment for Hikikomori, but to our knowledge, there are no case reports of individuals whose parents have died. The purpose of this study is to identify the focus of bio-psycho-social approach for Hikikomori patients whose parents have died.
We reported a case of a 49-year-old woman who had withdrawn to her home for 35 years. After her mother’s death, she became extremely underweight and was admitted to our hospital. She was diagnosed with suspected autism spectrum disorder. She appeared nervous in the first several days after hospitalization. Thus, to ensure she felt secure, we spoke to her briefly and calmly and presented to her a written message. Treatment consisted of dietary therapy to promote weight gain with a doctor, life skills training and facilitation of mourning with a psychologist, and environmental adjustment with a social worker. She was discharged six months later and subsequently improved.
In conclusion, we experienced a case of Hikikomori with extremely low weight who responded to the bio-psycho-social approach. This case study emphasizes the criticality of creating an environment in which the patient can feel safe.
