Health Services Research & Development

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Teo AR, Chen JI, Kubo H, Katsuki R, Sato-Kasai M, Shimokawa N, Hayakawa K, Umene-Nakano W, Aikens JE, Kanba S, Kato TA. Development and validation of the 25-item Hikikomori Questionnaire (HQ-25). Psychiatry and clinical neurosciences. 2018 Oct 1; 72(10):780-788.
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Abstract: AIM: Hikikomori, a form of severe social withdrawal, is an emerging issue in mental health, for which validated measurement tools are lacking. The object was to develop a self-report scale of hikikomori, and assess its psychometric properties and diagnostic accuracy. METHODS: A sample of 399 participants from clinical and community settings completed measures. Psychometric properties were assessed with factor analysis; diagnostic accuracy was compared against a semi-structured diagnostic interview. RESULTS: The Hikikomori Questionnaire contained 25 items across three subscales representing socialization, isolation, and emotional support. Internal consistency, test-retest reliability, and convergent validity were all satisfactory. The area under the curve was 0.86 (95% confidence interval, 0.80-0.92). A cut-off score of 42 (out of 100) was associated with a sensitivity of 94%, specificity of 61%, and positive predictive value of 17%. CONCLUSION: The 25-item Hikikomori Questionnaire (HQ-25) possesses robust psychometric properties and diagnostic accuracy in an initial sample of Japanese adults. Additional research on its psychometric properties and ability to support clinical assessment of hikikomori is warranted.