Characterizing Experiences With Hikikomori Syndrome on Twitter Among Japanese-Language Users: Qualitative Infodemiology Content Analysis.

backgroundHikikomori syndrome is a form of severe social withdrawal prevalent in Japan but is also a worldwide psychiatric issue. Twitter (subsequently rebranded X) offers valuable insights into personal experiences with mental health conditions, particularly among isolated individuals or hard-to-reach populations.

objectiveThis study aimed to examine trends in firsthand and secondhand experiences reported on Twitter between 2021 and 2023 in the Japanese language.

methodsTweets were collected using the Twitter academic research application programming interface filtered for the following keywords: "#きこもり," "#ひきこもり," "#hikikomori," "#ニート," "#ひきこもり," "#," and "#." The Bidirectional Encoder Representations From Transformers language model was used to analyze all Japanese-language posts collected. Themes and subthemes were then inductively coded for in-depth exploration of topic clusters relevant to first- and secondhand experiences with hikikomori syndrome.

resultsWe collected 2,018,822 tweets, which were narrowed down to 379,265 (18.79%) tweets in Japanese from January 2021 to January 2023. After examining the topic clusters output by the Bidirectional Encoder Representations From Transformers model, 4 topics were determined to be relevant to the study aims. A total of 400 of the most highly interacted with tweets from these topic clusters were manually annotated for inclusion and exclusion, of which 148 (37%) tweets from 89 unique users were identified as relevant to hikikomori experiences. Of these 148 relevant tweets, 71 (48%) were identified as firsthand accounts, and 77 (52%) were identified as secondhand accounts. Within firsthand reports, the themes identified included seeking social support, personal anecdotes, debunking misconceptions, and emotional ranting. Within secondhand reports, themes included seeking social support, personal anecdotes, seeking and giving advice, and advocacy against the negative stigma of hikikomori.

conclusionsThis study provides new insights into experiences reported by web-based users regarding hikikomori syndrome specific to Japanese-speaking populations. Although not yet found in diagnostic manuals classifying mental disorders, the rise of web-based lifestyles as a consequence of the COVID-19 pandemic has increased the importance of discussions regarding hikikomori syndrome in web-based spaces. The results indicate that social media platforms may represent a web-based space for those experiencing hikikomori syndrome to engage in social interaction, advocacy against stigmatization, and participation in a community that can be maintained through a web-based barrier and minimized sense of social anxiety.