ABSTRACT
Diagnosing hikikomori, a form of severe and prolonged social withdrawal, is challenging. Conceptually speaking, some authors differentiate “primary” and “secondary” hikikomori. The latter term has been used when there is co-morbidity that at least partially explains the syndrome, whereas in the absence of a psychiatric diagnosis it is called “primary hikikomori”. The authors present a Portuguese case report with the same sociodemographic and clinical characteristics described in Japan. This case illustrates that hikikomori can potentially be explained by an underlying psychiatric disorder that is not always clear at the presentation and the importance of careful and continuous assessment, in order to achieve diagnostic clarification and adequate therapeutic intervention.
Hikikomori; social withdrawal; secondary hikikomori