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A global phenomenon is emerging among young people: hikikomori. This Japanese term refers to young people who shut themselves in their rooms with their screens and have only virtual contact with the world. During a session on loneliness at the Brain Congress 2026 held from January 21 to 23 in Paris, France, Marie-Jeanne Guedj Bourdiau, MD, a psychiatrist at Sainte-Anne Hospital in Paris, president of the Francophone Association for the Study and Research on Hikikomori (AFHIKI), and author of a book on the subject (see box), defined this new type of disorder and the appropriate course of action.
Global Spread and Prevalence
“It is a form of self-sabotage that is more involuntary than chosen, probably also a new form of transition to adulthood, a new form of passive rebellion against modern societies. It is a disorder at the crossroads of the psychological, the social, and the behavioral. It mainly affects young people aged 15-30 [years], more often males, and generally those from affluent backgrounds,” she said in her opening remarks.
In 1998, a Japanese psychiatrist, Tamaki Saito, described this phenomenon and raised the alarm upon discovering that it affected about 1 million Japanese people. Since then, studies have shown that it affects numerous countries, including Australia, Brazil, China, France, India, Italy, Oman, South Korea, Spain, and the US. “There are no precise figures for France. A mother from a wealthy Paris suburb told me in a consultation, ‘In our building, there is one on every floor. Each time we speak to the media on the subject, we are contacted immediately by an average of 400 families,’” the psychiatrist continued. In France, young people not in education, employment, or training (NEETs) represent 12.5% of 15- to 29-year-olds. The term hikikomori to describe NEETs began to be used in 2025.
Common Patient Presentations
Psychiatrists distinguish between two types of hikikomori. The first, called primary, accounts for half the cases and is not associated with a mental disorder. The second, called secondary, occurs in the context of depression, early-stage schizophrenia, or anxiety disorders.
Hikikomori is defined as a young person isolating themself at home for more than 6 months, refusing social relationships, restricting family ties to parents, and rejecting social rules and customs of social lives, coupled with refusing to seek medical help. This is accompanied by physical distress; pain; self-neglect; eating problems such as having underweight or obesity; sleep disorders such as delayed sleep or sleep-wake inversion; and addictions to the internet, video games, cannabis, alcohol, etc.
However, no organic, psychomotor, or other neurologic disorders are observed. Many testimonies are similar; the situations are roughly the same, with only minor differences, but of course, as in any human situation, each case is unique.
Screens as a Symptom
“A few risk factors have been identified, such as bullying, academic failure, or disappointments in friendships or romantic relationships,” the speaker added. “These may be young people who had autistic traits in childhood, but others were described as cheerful until then by those around them. Low self-esteem is central in hikikomori. These young people and often their parents cannot cope with failure, especially academic failure. Being shut away is a way of protecting oneself from everything — the outside world, disappointments…”
However, screens are not the cause but a consequence of withdrawal. To combat boredom, heavy screen use helps pass the time and allows contact with the outside world. Prevention begins with education, teaching young people and their families not to be devastated by failure, and explaining how to overcome it. Although the phenomenon of seclusion was already described by a French psychiatrist in 1953, usually associated with mental illness, hikikomori exists in the absence of a mental pathology and appears to be increasing to worrying proportions.
First Step: Support Families
According to the initial Japanese recommendations, the first step is to welcome the suffering family and then try to address treatment for the young person if they accept care: psychotherapy, medications, therapeutic groups, resocialization, and mediation.
In France, the approach is similar and is based primarily on “parental guidance,” except in rare psychiatric emergencies, where the cloistered young person threatens their parents, most often in the context of a mental illness.
“The priority is to respond to the parents and guide them. Young people usually refuse to receive care: ‘Leave me alone, I’m not sick,’ they say. The parents are ashamed, hurt, they suffer. In reality, this guidance consists of listening to them, letting them cry…. It is not so much about giving parents a list of specific advice but about listening attentively, making them understand that they need to stop putting pressure on the young person to leave their room, or to see a psychiatrist, to stop telling them, ‘You should do this or that,’” Guedj Bourdiau explained.
The more pressure and anxiety increase in the family — because the young person is in their room, not eating what the family wants, or not registered on Parcoursup (France’s centralized university admissions platform), the more the seclusion increases.
Parents as Primary Intervention
Parents need to relearn how to tell their child, “We’re happy to be living together,” to rediscover moments of shared happiness, to watch a movie together, and to rebuild connection and affection, for this young person who is afraid of emotions and of emotional intimacy. “Some young people come to see us just to say: ‘I’ll do what I want, but take care of my parents!’ Sometimes they accept the consultation and acknowledge that they are struggling,” the psychiatrist said. Therapy then becomes possible, tailored to each individual case.
For information, there is also a blog for families and the AFHIKI website. Going out isn’t the goal in itself but a consequence of psychological improvement. The young person will improve if they resume household participation, go on vacation, play sports, and regain the capacity for giving and generosity. The difficulty lies in the fact that hikikomori isn’t recognized as a psychiatric illness. There isn’t a comprehensive body of psychiatric literature on the subject, with guidelines to follow.
It’s important to know, however, that this isolation at home can last 6 months, 3 years, 5 years…. No one remains locked up for life. When they emerge, these young people experience a complete blackout on that period of their lives.
Hikikomori. Réparer l’isolement, by Marie-Jeanne Guedj Bourdiau
The book is intended for professionals who need tools to assess a young person’s situation and who seek multidisciplinary, integrative solutions.
For families, the book helps identify warning signs, understand behavioral mechanisms, and the suffering of everyone involved, with the aim of encouraging them to take action.
This story was translated from Medscape’s French edition.
