74. Characteristics of social withdrawal in adolescent patients treated at the national institute of mental health - Bach Mai Hospital

Do Thuy Dung, Le Thi Thu Ha, Nguyen Van Tuan, Nguyen Thanh Long

Main Article Content

Abstract

Social withdrawal refers to a state of social isolation involving the intentional avoidance of interactions in social relationships or contact with others, and difficulty to properly engage in social situations. Social withdrawal poses a significant threat to the development of adolescents as members of society. This study was conducted on 330 adolescent patients aged 10 - 19 years old treated at the National Institute of Mental Health - Bach Mai Hospital from September 2024 to May 2025. The results showed that the prevalence of social withdrawal behavior was 26.36%, with the most common motivation being a lack or decrease in motivation to participate in activities (83.9%). The average duration of social withdrawal behavior was 14.72 ± 11.88 months. The most common manifestations of social withdrawal included eye contact avoidance (83.9%) and self-isolation (62%). The most frequently reported consequences of social withdrawal were gradual loss of relationships (80.5%) and increased self-doubt or lower self-esteem (72.4%).

Article Details

References

1. M S, J R, M O, et al. Age at onset of mental disorders worldwide: large-scale meta-analysis of 192 epidemiological studies. Mol Psychiatry. 2022; 27(1). doi:10.1038/s41380-021-01161-7.
2. Cerrai S, Silvia B, Molinaro S. Hikikomori: indagine sul ritiro sociale volontario dei giovani Italiani.; 2023. Accessed July 13, 2025. https://iris.cnr.it/handle/20.500.14243/432254.
3. Kato TA, Kanba S, Teo AR. Defining pathological social withdrawal: proposed diagnostic criteria for hikikomori. World Psychiatry. 2020; 19(1): 116-117. doi:10.1002/wps.20705.
4. Núñez-Regueiro F, Núñez-Regueiro S. Identifying Salient Stressors of Adolescence: A Systematic Review and Content Analysis. J Youth Adolesc. 2021; 50(12): 2533-2556. doi:10.1007/s10964-021-01492-2.
5. Van Droogenbroeck F, Spruyt B, Keppens G. Gender differences in mental health problems among adolescents and the role of social support: results from the Belgian health interview surveys 2008 and 2013. BMC Psychiatry. 2018; 18(1): 6. doi:10.1186/s12888-018-1591-4.
6. Campbell OLK, Bann D, Patalay P. The gender gap in adolescent mental health: A cross-national investigation of 566,829 adolescents across 73 countries. SSM - Popul Health. 2021; 13: 100742. doi:10.1016/j.ssmph.2021.100742.
7. Fukuya Y, Fujiwara T, Isumi A, et al. Association of Birth Order With Mental Health Problems, Self-Esteem, Resilience, and Happiness Among Children: Results From A-CHILD Study. Front Psychiatry. 2021; 12. doi:10.3389/fpsyt.2021.638088.
8. Biswas T, Scott JG, Munir K, et al. Global variation in the prevalence of bullying victimisation amongst adolescents: Role of peer and parental supports. EClinicalMedicine. 2020; 20: 100276. doi:10.1016/j.eclinm.2020.100276.
9. Ngo AT, Nguyen LH, Dang AK, et al. Bullying experience in urban adolescents: Prevalence and correlations with health-related quality of life and psychological issues. PLoS ONE. 2021; 16(6): e0252459. doi:10.1371/journal.pone.0252459.
10. Zhou F, Huang P, Wei X, et al. Prevalence and Characteristics of Social Withdrawal Tendency Among 3-24 Months in China: A Pilot Study. Front Psychiatry. 2021; 12: 537411. doi:10.3389/fpsyt.2021.537411.
11. Teo AR, Fetters MD, Stufflebam K, et al. Identification of the hikikomori syndrome of social withdrawal: Psychosocial features and treatment preferences in four countries. Int J Soc Psychiatry. 2015; 61(1): 64-72. doi:10.1177/0020764014535758.
12. Coplan RJ, Armer M. A “multitude” of solitude: A closer look at social withdrawal and nonsocial play in early childhood. Child Dev Perspect. 2007; 1(1): 26-32. doi:10.1111/j.1750-8606.2007.00006.x.
13. Amendola S, Cerutti R. Examining the relationship between social withdrawal motivations and symptoms of hikikomori. J Child Adolesc Ment Health. 2023; 35(1-3): 25-41. doi:10.2989/17280583.2023.2291180.
14. Kim J, Rapee RM, Ja Oh K, et al. Retrospective report of social withdrawal during adolescence and current maladjustment in young adulthood: cross-cultural comparisons between Australian and South Korean students. J Adolesc. 2008; 31(5): 543-563. doi:10.1016/j.adolescence.2007.10.011.
15. Hamasaki Y, Pionnié-Dax N, Dorard G, et al. Preliminary study of the social withdrawal (hikikomori) spectrum in French adolescents: focusing on the differences in pathology and related factors compared with Japanese adolescents. BMC Psychiatry. 2022; 22(1): 477. doi:10.1186/s12888-022-04116-6.
16. Hebert KR, Fales J, Nangle DW, et al. Linking social anxiety and adolescent romantic relationship functioning: indirect effects and the importance of peers. J Youth Adolesc. 2013; 42(11): 1708-1720. doi:10.1007/s10964-012-9878-0.
17. Gazelle H, Shafer Lundin JK, Lei H, et al. Child and adolescent social withdrawal predict adult psychosocial adjustment: A meta-analysis. Front Dev Psychol. 2024; 2. doi:10.3389/fdpys.2024.1408166.
18. Kljakovic M, Kelly A, Richardson A. School refusal and isolation: The perspectives of five adolescent school refusers in London, UK. Clin Child Psychol Psychiatry. 2021; 26(4): 1089-1101. doi:10.1177/13591045211025782.