Psychodynamic group psychotherapy for hikikomori: The case of a socially withdrawn male with schizoaffective disorder.

Hikikomori, a severe form of social withdrawal, is a condition characterized by the avoidance of social participation and staying at home for more than 6 months. Hikikomori was initially reported in Japan in the 1990s and is now observed worldwide. Here, we introduce specialized psychodynamic group psychotherapy for persons with hikikomori, and illustrate the case of an adult male with schizoaffective disorder. In the present report, the patient initiated an unreasonably difficult job-hunting process, became unwell, and was hospitalized. He began to participate in group psychotherapy as a place of belonging and gradually increased his social interactions. We also consider the specific difficulties exhibited by people with hikikomori, especially focusing on the avoidance around assuming responsibility for decisions and extreme dichotomous thinking. Additionally, we discuss the benefits of dealing with these difficulties in a group structure and propose the applicability of group psychotherapy in therapeutic interventions for persons with hikikomori.

The reliability and validity of the Japanese version of the Temperament and Personality Questionnaire for patients with non-melancholic depression.

BACKGROUND: Parker et al. (2006) proposed a new approach to classify specific sub-types of non-melancholic depression caused by various stress factors and premorbid personality styles: the Temperament and Personality Questionnaire (T&P). The current study aim was to develop the Japanese version of the T&P and evaluate its reliability and validity. METHODS: We studied 114 patients with non-melancholic depression. Reliability was assessed using the test-retest method. Convergent validity of the T&P was compared with the clinician ratings of each patient for the eight personality traits. We also assessed the impact of depressive state on the T&P. RESULTS: The test-retest intraclass correlation coefficients among eight constructs of the T&P ranged from 0.77 to 0.89, indicating good-to-excellent reliability. Anxious Worrying (rho=0.29), Perfectionism (rho=0.17), Personal Reserve (rho=0.18), Irritability (rho=0.38), and Social Avoidance (rho=0.32) showed adequate levels of convergent validity; Rejection Sensitivity (rho=0.16), Self-criticism (rho=-0.02), and Self-focus (rho=0.07) showed relatively weak convergent validity. Perfectionism (rho=-0.06), Social Avoidance (rho=0.17), Anxious Worrying (rho=0.40), Personal Reserve (rho=0.30), Irritability (rho=0.28), Rejection Sensitivity (rho=0.35), Self-criticism (rho=0.49), and Self-focus (rho=0.24) showed minimal sensitivity to mood state effects. LIMITATIONS: Only one site was used. While a Likert scale was used, the clinician-rated personality trait measure had not been validated. CONCLUSIONS: The J-T&P is a reliable and valid measure for assessing temperament and personality in Japanese patients with non-melancholic depression.