JMIR Publications

ABSTRACT

Background:

Hikikomori, a condition of severe social withdrawal, is a global public health issue characterised by prolonged social isolation. Although studies have explored mental health conditions and treatment preferences among individuals with hikikomori, research on their unmet healthcare utilization is limited.

Objective:

We aimed to examine the association between hikikomori status and unmet healthcare utilization to guide the development of targeted interventions.

Methods:

Data were obtained from the 2022 Korean Youth Living Conditions Survey, a nationally representative cross-sectional survey of 14,966 participants aged 19–34. Hikikomori status was classified based on self-reported social withdrawal behaviors, with further stratification by severity and duration. Unmet healthcare utilization in physical and mental health was assessed. A generalised estimating equation model was used to estimate the adjusted prevalence ratios (PRs).

Results:

Individuals with hikikomori were 1.31 times more likely to perceive a need for mental health services (95% CI, 1.22–1.42) and had significantly higher PRs for unmet healthcare utilization in both physical (PR, 3.58; 95% CI, 2.51–5.12) and mental health (PR, 4.52; 95% CI, 3.24–6.31) compared with non-hikikomori individuals. These associations became more pronounced with increasing hikikomori severity and duration.

Conclusions:

We highlight a significant association between hikikomori status and unmet healthcare utilization, particularly in mental health. Individuals with severe and prolonged hikikomori are at greater risk of unmet healthcare utilization, emphasizing the need for tailored interventions. These findings provide crucial evidence for developing strategies to address the unmet healthcare utilization of individuals with hikikomori. Clinical Trial: Not applicable.