ʻO ka hoʻomana pūnaewele, Hikikomori Syndrome, a me ka Phadromal Phase of Psychosis (2016)

Emmanuel Stip^1,2*, Alexis Thibault¹, Alexis Beauchamp-Chatel¹ a ʻO Steve Kisely^3,4,5

• ¹Département de Psychiatrie, Faculté de Médecine, Université de Montréal, Montréal, QC, Kanada
• ²Center Hospitalier de lʻUniversité de Montréal, Hôpital Notre-Dame, Montréal, QC, Canada
• ³Kula o ke Kauka Lapaʻau, University of Queensland, Brisbane, QLD, Australia
• ⁴Keʻena o Psychiatry, University Dalhousie, Halifax, NS, Canada
• ⁵Ke Keʻena ʻOihana Ola a me nā Epidemiology, ke Kulanui Dalhousie, Halifax, NS, Kanada

ʻO nā kamepiula, nā pāʻani wikiō a me nā ʻenehana loea i ʻāpana o ka poʻe ʻōpio i kēlā me kēia lā. ʻO Hikikomori kahi ʻōlelo Kepani e wehewehe ana i kahi ʻano e pili ana i ka wā ʻōpio a i ʻole nā ​​ʻōpio'ōpiopio e noho kaʻawale mai ka honua aku, a kākau ʻia i loko o nā hale o ko lākou mau mākua, ua laka ʻia i loko o ko lākou mau wahi moe no nā lā, mau mahina, a he mau makahiki paha ma hope loa, a hōʻole hoʻi i ka kamaʻilio ʻana me ʻO kā lākou ʻohana. Hoʻohana pono kēia mau mea maʻi i ka Pūnaewele, a hoʻoikaika wale i ka lawelawe ʻana i ko lākou pono o ke kino. ʻOiai ʻoiai ua wehewehe mua ʻia ma Iapana, ua hōʻike ʻia nā hihia mai nā wahi a puni. ʻO kēia ka moʻolelo mua loa mai Kanada. Hoʻololi ka maʻi i nā hiʻohiʻona me ka psychromosis prodromal, nā hōʻailona maikaʻiʻole o ka schizophrenia, a i ʻole ka hoʻohui honua pūnaewele, i ka hopena maʻamau a i ʻole nā ​​hopena comorbid. Eia nō naʻe, ʻaʻole hele kekahi mau hihia me ka maʻi noʻonoʻo. ʻO ka Psychotherapy ke mālama ʻana i ke koho inā ʻo nā hihia he nui ke hōʻole i kēia manawa. ʻO kahi kahi e kūpono ai ka hikikomori ma ka psychologyʻo psychology. ʻImi mākou iā Medline a hiki i 12th Mei, 2015 hoʻohui ʻia e ka ʻimi lima o nā bibliographies o nā ʻatikala. Ua hoʻohana mākou i kēia mau huaʻōlelo e pili ana: Hikikomori OR (hoʻolaʻa loa a me ke kāʻei ʻana i ka lehulehu). Ua ʻike mākou he pepa pepa 97. ʻO kēia 42 ma Iapana, a ʻo 1 ma Korean. Akā, ua haua ka nui o kēia mau mea e nā pepa ʻōlelo Pelekane ma hope o ka loiloi. Ma hope o ka nānā pono ʻana o nā poʻo a me ka abstract, ua hoʻoponopono ʻia ʻo 29 e kūpono. Pono e noiʻi hou ʻia ka hoʻokaʻawale ʻana ma waena o ka hikikomori mua a me ke kula ʻelua a hoʻopaʻa ʻia inā he hou aila hui hou ʻia, a i ʻole kekahi ʻano kuʻuna a i ʻole nā ​​ʻano kaiāulu o nā maʻi i hoʻopaʻa ʻia.

Introduction

ʻO ka wā'ōpiopio ka manawa o ka hoʻololi a me ka wā o ka hoʻomaka ʻana o nā maʻi psychiatric he nui. ʻO ka maʻamau, ʻo ka maʻi maʻamau i loko o ka ʻeha a me nā pono ʻole, e like me ka waiho ʻana o ka nohona a me kahi kaʻawale. I ka manawa e hoʻonāukiuki ai ka ʻenehana hou i ka ola o nā kānaka a me nā ʻano maʻamau o nā pilina a me nā mea ʻē aʻe, paʻakikī paha ka hoʻokaʻawale ʻana ma waena o nā mea maʻamau a me ka mea e hōʻike ai i ka hoʻomaka ʻana o kahi maʻi maʻamau, e pili ana i ka minamina, ka phobia, nā maʻi kūlohelohe, schizophrenia , Pākuʻi pūnaewele, a i ʻole hikikomori. ^ E Ha yM. ʻOiai ʻo 1970s, ua ʻike ʻo Iapana i ka manawa e puka mai ai kekahi ʻano ʻano hoʻoneʻe koʻikoʻi i kapa ʻia hikikomori, He hua ʻōlelo Kepani e wehewehe nei i nā hana psychosocial a me ka familial pathology (1, 2). Hikikomori mai ka haʻiʻōlelo Blo, i ho? i e ho? i i hope, a komoru, i manaʻo e komo ana i loko (3). ʻO ka hona e pili nui ana i nā ʻōpio a i ʻole nā ​​ʻōpio a pau e noho ʻoki ʻia mai ka honua, i hoʻopaʻa ʻia i loko o nā hale o ko lākou mau mākua, i laka ʻia ma ko lākou wahi moe no nā lā, mau mahina, a he mau makahiki paha o ka hopena. Hōʻole lākou i ka kamaʻilio ʻana me ko lākou ʻohana, hoʻohana i ka Pūnaewele, a ʻimi wale nō i nā hana o ko lākou pono ponoʻī kino. Nui hikikomori huli i ka Pūnaewele, a i kekahi manawa ka manawa ma mua o 12 ha ka lā i mua o ke kamepiula. A ʻo ka hopena, ʻoi aku ka hapa o ka poʻe maʻi e ʻeha i ka hoʻohui ʻana i ka Pūnaewele, a no ka hapaʻumi hoʻi e kūpono i nā hōʻailona diagnostic no kēlā ʻano hoʻohui.4).

I ka manaʻo o hikikomori he hihia. ʻO kahi pilikia nui loa ka ʻike ʻole ʻana o ka wehewehe wehewehe a ʻaʻole kuikahi ka hopena o ka maʻi diagnostic ma waena o nā noi ʻana (5). Aia ka hoʻopaʻapaʻa e pili ana i kēia maʻi hōʻailona i kahi pane kūloko o ka moʻomeheu i Iapana (6) a i ʻole he ulia pōpilikia kū i hope aia i kekahi wahi (7). Aoikeia no nae hikikomori hiki paha i ia mea ke lilo i kēia mau kanaka i hiki ai iā ia ke kōkua i ka hoʻihoʻi hou 'ana i ka' ike 'ana a me ka pilina pili' ana ma o ke ala hou i kūpono iā lākou (6). ʻO kahi ʻāpana ʻē aʻe o ka hoʻopaʻapaʻa paha hikikomori pono e hoʻopaʻa ʻia inā hiki i kekahi maʻi psychiatric ke hōʻike no nā hōʻailona. Puhi kekahi poʻe kākau ʻōlelo ʻo ka huaʻōlelo “lua hikikomori"E hoʻohana inā he comorbidity ma ka manawa a i ka liʻiliʻi e wehewehe i ka maʻi, ʻoiai ke kaohi ʻana o ka maʻi psychiatric intercurrent, pono e hoʻohana ʻia ka huaʻōlelo" hikikomori ma mua.5).

ʻOiai ʻoiai ua wehewehe mua ʻia ma Iapana, ua hōʻike ʻia nā hihia mai nā wahi a puni. ʻO kēia ka moʻolelo mua loa mai Kanada.

Hōʻikeʻike

ʻO kēia ka hihia o kahi ʻōpio e noho ana ma Montréal i kona makahiki 21, Caucasian, ʻaʻohe o nā antecedents olakino ʻē aʻe ma mua o nā kuʻina moe moe ma ke ʻano o ke ʻano o ke ʻano hoʻomālamalama (rocking) no ka mea i ʻimi ʻo ia i ka hoʻomaʻamaʻa e pili ana i ka hoʻomaʻamaʻa ʻana ma ka makahiki 13. ʻO kāna mea hana pilikino. Puhi ʻo ia i hoʻokahi ʻeke o ka paka i ka lā a ʻaʻole i lawe i nā lāʻau lapaʻau ʻē aʻe. E aʻo ʻo ia i ka ʻenehana i ke kulanui; he mālamalama kula maikaʻi nō ia. Pāʻani ʻo ia i nā haʻuki.

Ua hoʻomaka nā pilikia ma muli o ka nalowale o ka hoʻokūkū kula 1 makahiki, ma hope o ka hoʻomaʻamaʻa mau ʻana i kāna mau haʻawina. ʻOiai ʻaʻole ia i pīhoihoi, a ua ʻoi aku ke ʻano ʻōpio i kēlā me kēia manawa i loko o kona lumi. ʻAʻoleʻo ia i hui pū me kona ʻohana no nā meaʻai e like me ka ma mua, makemake ʻia e hopu i kahi mea mai ka friji a hoʻi hou i kona lumi, kahi ʻo ia i noho nui ai ma ka lā o ka kamepiula. ʻO ka makahiki mua, ua noho ʻo ia ma kahi lumi moe me ka keʻena hoʻoluʻu maikaʻi, i ka ʻai ʻana i nā mea i hoʻomākaukau ʻia no ia akā ua hōʻole e hui pū me ka ʻohana i ka papaʻaina. Eia naʻe, ua haʻalele hope ʻo ia i ka home no ka noho wale ʻana i kahi hale liʻiliʻi. Ma laila, hoʻopau ʻo ia i kahi ʻokiʻohana ʻana me kāna ʻohana akā naʻe no ka hana ʻana i ka holoi ʻana a me ka ʻimi ʻana i kahi hōʻoia a me kahi pāʻina paha mai kēlā manawa kēia manawa. Akā naʻe, holoi pinepine ʻo ia.

Ua hoʻohana ʻo ia i kona manawa ma ka Pūnaewele a ke pāʻani ʻana paha i nā pāʻani wikiō i ka noho kaawale ʻana o ka nohona, ʻoiai naʻe ua ʻōlelo ʻo ia e hele nei i kāna mau papa kulanui. Ua hopohopo ke kūlana i kona ʻohana a me nā hoaaloha, ka poʻe i hoʻāʻo e hoʻopaʻa i kāna kamepiula no nā pule he nui, no ka mea ʻoi ʻoi ʻoi ʻoi ʻo ia ʻo 12 ma ka lā ma mua o ke kamepiula, ʻoi aku ke pāʻani i nā pāʻani a i ʻole e nānā i nā kiʻi wikiō. ʻAʻole loaʻa kahi hopena i kēia neʻe ʻana i kona noho kaʻawale a me ka haʻalele ʻana o ka nohona. Koi aku kona ʻohana iā ia e hele no ke kūkākūkā ʻana, ʻaʻole ʻo ia e hōʻole, a makemake wale nā ​​ʻohana ʻohana ke kōkua. ʻAʻole hōʻeha ka mea maʻi ma ke kaumaha a me ka suicidal a hōʻole i ka ʻimi ʻana i ke kōkua.

A laila, ua ʻike ʻo ia i kekahi hemahema ma ke kulanui. Ua hoʻoholo ʻia, me ka ʻōpio a ke ʻōpio - ʻoiai, ua kokoke loa iā ia e noi, ua hāʻawi ʻia i kona ʻano ʻo ka hemahema - e noho hou ʻo ia me kekahi lālā o kona ʻohana. Ua hoʻomaikaʻi maikaʻi kāna ʻano, akā ma ka makahiki ʻelua, hoʻomaka hou ʻo ia e hoʻolilo ma mua o ka lā 15 ha ma ka kamepiula. Ua ho'ōki ʻo ia i ka hele ʻana i ka papa ʻoiai ua maopopo ʻo ia e alakaʻi ai i ka holomua. Ua lilo ʻo ia i huhū a huhū pinepine i ka wā e hoʻāʻo ʻo kona ʻohana e kūkākūkā i kāna hana, a hōʻole hou i nā noi e ʻimi ana e mālama iā ia. Pau kēia mau mea i ka hoʻomaha piha loa me kāna ʻohana, kahi i hana ai i nā hana hoʻomalu.

Ma hope o ka hoʻoluhi ʻana i ke kula a me ka wī e pili ana i nā kālā, ua ʻoi aku ke ʻano o ke ʻōpiopio e loli. Hiki i kona ʻano noʻonoʻo noʻonoʻo ke hoʻohālikelike ʻia e like me ka maʻamau, ʻoi aʻe ma mua o kekahi mau hiʻohiʻona-obsitive-compulsive, nā hōʻailona o ka hōʻino ʻana a me ka hōʻaia ʻana o ka nohona, a me nā ʻano o ka phobia a me ka hopohopo e pili ana i nā mea hou. ʻAʻohe mea i hōʻike i ke kaumaha, ka suicidal ideation, psycho-sensory phenapy, a i ʻole delirium. Maʻalahi kona ʻanekona, a he ʻāpana ʻo ia i ke kumu no kona haʻalele ʻana. Ua hoʻāpono ʻo ia iā ia he ala no ke kaʻawale a ua kapa ʻia i ka manaʻo kuhihewa ʻole intergenerational. He mea maʻamau nā hopena o kāna hōʻike neʻe, me kahi MRI. Me ka nānā ʻana, ua hoʻomau ʻo ia i kāna hana a me nā haʻawina me ka pono ʻole o ka lāʻau lapaʻau a ma ka psychotherapy maʻamau.

Pūʻulu Moʻomanaʻo

ʻImi mākou iā Medline a hiki i 12th Mei, 2015 hoʻohui ʻia e ka ʻimi lima o nā bibliographies o nā ʻatikala. Ua hoʻohana mākou i kēia mau huaʻōlelo e pili ana: Hikikomori OR (hoʻolaʻa loa a me ke kāʻei ʻana i ka lehulehu). Ua ʻike mākou he pepa pepa 97. ʻO kēia 42 ma Iapana, a ʻo 1 ma Korean. Akā, ua haua ka nui o kēia mau mea e nā pepa ʻōlelo Pelekane ma hope o ka loiloi. Ma hope o ka nānā pono ʻana o nā poʻo a me ka abstract, ua hoʻoponopono ʻia ʻo 29 e kūpono. ʻAʻole hiki iā mākou ke loaʻa i ʻeono mau pepa. Ua loaʻa kekahi iā mākou i kahi puke kūpono ma Farani (8).

ʻO ke kuhikuhina

Hikikomori ua ho'ākāka ʻia e kahi hui pākani Kepanī e like me kēia mau ʻano: (1) ka hoʻolilo ʻana i ka hapa nui o ka manawa ma ka home; (2) ʻaʻole makemake e hele i ke kula a hana paha; (3) ka hoʻomau nei no ka hoʻoneʻe ʻana i ʻoi aku ma mua o nā mahina 6; (4) ka haʻaleleʻana o ka schizophrenia, ke kaumaha o ka noʻonoʻo, a me ka maʻi bipolar; a me (5) ka haʻalele o ka poʻe e mālama i ka pilikino pilikino (e laʻa, nā hoa aloha) (9, 10). ʻO nā kulekele ʻē aʻe nā mea ʻē aʻe. ʻO kēia ka komo ʻana a i ʻole haʻalele ʻana o ka comorbidity psychiatric (ʻoi mua ma mua o ka lua hikikomori) ka lōʻihi o ka haʻalele ʻana o ka lehulehu, a me ka hele ʻana a me ka ʻole o ka pilikia a me ka hoʻokaumaha hana.5).

Ma kahi o 1-2% o nā ʻōpio a me nā ʻōpio ʻōpio hikikomori i nā ʻāina ʻĀina, e like me Japan, Hong Kong, a me Korea ((4, 9, 11). ʻO nā hapa nui nā kāne (8-13) me ka manawa lōʻihi o ka hoʻopaʻa ʻana i nā kaiāulu e hele ana mai 1 a hiki i 4 mau makahiki, e pili ana i ka papa hana noi a me ka hoʻonohonoho (5, 8, 13, 14). ʻO ka comorbidity me nā maʻi maʻi psychiatric he ʻano ʻē loa ia, e mai ana i kekahi (13), hapalua o nā hihia (11), i nā hihia āpau (12, 13). Hiki ke wehewehe ʻia kēia ʻano like me ka nele o ka ʻae ʻana ma ka wehewehe o hikikomori a no ka mea ua hoʻohana ʻia nā ʻano loiloi like ʻole ma nā wahi noiʻi. Eia naʻe naʻe, he mana e kū nei i kahi ʻikepili i loaʻa i ka hapa nui o hikikomori nā hihia he comorbid psychiatric diagnoses (5).

Hikikomori ua wehewehe mua ʻia ma Iapana, akā ua hōʻike ʻia nā hihia ma Oman (15), Kepania (13, 16, 17), Ikalia (18), Kōlea Hema (4, 14), Hong Kong (19), Inia (20), Palani (8, 21), iʻAmelika (19, 22). Ma waho aʻe o nā hōʻike i nā hihia, hōʻike ʻia nā noiʻi o nā psychiatrists mai nā ʻāina e like me ka Australia, Bangladesh, Iran, Taiwan, a me Thailand hikikomori ʻike ʻia nā hihia ma nā ʻāina a pau.23).

He nui nā hana nānā mālama pono ʻia o hikikomori. ^ E Ha yM. ʻO ka hapa nui o nā mea i ʻike ʻia mai nā haʻawina liʻiliʻi me nā kumu laikini ʻole i koho ʻia. ʻO ka mea nui, ʻoi aku ka liʻiliʻi o ka ʻikepili i ka hanana ākea a i ʻole nā ​​ʻano hikikomori ma waho o kekahi mau ʻāina i Asia.

Ma waho aʻe o ka hoʻākāka ʻole o ka wehewehe ʻana o ka maʻi, ka hopena o ka noho kaʻawale kanaka.11) a ʻo ka hilahila a me ka hewa o ka ʻohana, aia nā mea āpau i ka ʻike a me keʻano o kēia mau kanaka. ʻO ka hoʻomanaʻo, ke kumu like nā kumu like i ka lohi i ka loaʻa ʻana o ka hoʻomaʻamaʻa (1, 4, 5, 10, 13).

Hoʻolaha o Hikikomori a me nā loulou i ka hoʻohana pūnaewele

ʻEnslelo i ka etiology o hikikomori ʻaʻole i hoʻokō ʻia, a nui paha nā wehewehe wehewehe ʻana. Ma kahi pae noʻonoʻo, nui nā hōʻike a me nā ʻatikala e haʻi ana i ka pilina ma waena hikikomori a ʻoiai, he mau waʻeha, e ʻike nei i ka wā kamaliʻi. ʻIke ʻia nā hihia he nui i ka hoʻowalewale ʻana i ka nohona kamaliʻi.4-6, 8, 10, 12, 15, 24, 25).). Hiki i ke kanaka kikowaena, ʻano hoʻohilahila, a ʻano hoʻi i kahi kāohi ke pale ʻia a pale ʻole paha. hikikomori (5, 20, 25).

Ma kahi pae ʻohana a me ke kaiāulu, aia kahi loulou ma waena o ka ulu ʻana o ka huehue a me ka dinamics family dysfunctional (4, 8, 10, 19, 26), hōʻole i ka makua (25) ai ʻole nānā nānā (5), a me ka makua psychopathology (13, 27).). ʻO ka loaʻa o ka haʻawina maikaʻi, i hui pū ʻia me ka manaʻolana kiʻekiʻe, a i kekahi manawa ke hōʻole ʻia ma hope o ke hōʻole ʻia o nā kula, he ʻano nō ia o ke ʻano o ka hiki ʻana o hikikomori (3-6).

ʻO nā wehewehe kaiāulu, ʻo ia hoʻi ka wāwahi i ka ʻāʻulu pili kaiaulu, ka ʻana o ka hale, holomua ʻenehana, ʻenehana, a me nā kao ʻana i lalo o ke ola, he ʻano nui i ka wā i hiki mai ai hikikomori (5, 8, 11, 16, 28, 29).). Hiki i kēia mau loli ke hoʻoneʻeneʻe a haʻalele paha i ke kaiāulu i nā poʻe predisposed e hōʻike i ka maʻi psychic i nā hōʻeha hōʻeha. E like me ke ʻano e hana nei i kekahi o nā kikoʻī o nā pilikia pili i nā kānaka pili ʻole mai ka hoʻohemo ʻana mai nā kuleana kaiāulu.makeinu) i ka hōkē ʻana i ke kula (futoko) a kau i ke hoʻopau ʻana i ka launa ʻana (hikikomori).

ʻO ka hoʻowalewale o ka Pūnaewele a me nā hoʻololi hou e pili ana i ke ʻano o ka launa pū ʻana a me loko o ke kaiāulu kekahi mau kumu nui hoʻi e kōkua i ka hikikomori (26).). No kahi laʻana, makemake paha ka makemake i ke kamaʻilio pūnaewele me ka nui o ka hoʻomohala ʻana i ka hūnā i kekahi i kekahi.26).

ʻĀina Hoʻohālikelike o Hikikomori

ʻOkoʻa i waena o hikikomori a he mea paʻakikī paha ka hele mua ʻana o nā maʻi psychiatric no ka mea ʻaʻole nui nā hōʻailona he nui a ʻike ʻia ma nā kūlana like ʻole (21, 30).). Hoʻopili kēia o ka kaawale, ka pio ʻana o ka nohona, ka nalowale o ka holo, ke ʻano dysphoric, ka hiamoe ʻana, a me ka hoʻohaʻahaʻa ʻana (21, 30, 31).). E like me ka mea i ʻōlelo ʻia ma mua, ʻoiai ke comordibity me ka maʻi noʻonoʻo ma muli o ke ʻano loiloi a me ka sampling, nā mau ʻike ʻike liʻiliʻi a me nā hala hou o ka puke nūpepa e kūlike nei i ka hapa nui o nā maʻi like ʻole. ʻO kēia ka maʻamau schizophrenia, nā maʻi psychotic ʻē aʻe, a me ke ʻano a me ka hopohopo paha e hopohopo nei, e like me ke kaumaha nui a me ka phobia social (2, 8, 9, 12, 13, 32).). Ua manaʻo kekahi i nā autism spectric disorder, nā maʻi pilikino, e like me ka schizoid a i ʻole nā ​​pale aku, a i ʻole hōʻino manuahi a me ka ʻAmotivational syndrome, a i ʻole kekahi addiction pūnaewele.5, 8-10, 23).). Ma nā ʻāpana aʻe, ʻO ka hikikomori e hoʻohālikelike i ka hoʻohui honua a me ka psychosis.

Hoʻohālikelike ma waena o Hikikomori a me ka Pūnaewele Hoʻohālikelike

like me hikikomori, Ka mea i hoʻohui ʻia ma ka pūnaewele he mea hoʻohālikelike psychiatric e ulu mai nei, a me ka wehewehe a me nā hiʻohiʻona maʻi ke kū nei i ka hoʻopaʻapaʻa. Pākaukau 1 hōʻike i nā hoʻokolohua diagnostic hāpai ʻia i hōʻoia ʻia i loko o kahi ʻāpana nui o nā mea komo Kina (ua hōʻike ʻia.n = 405) (34).

 

ʻ Xlelo 1. Internet addiction diagnostic mau hoʻokolohua (33).

Ke mau nei nō kēia mau ʻōpiopio no ka mea ʻaʻole i hoʻohana kekahi ʻōpiopio nosografical nui iā lākou a hiki i kēia manawa. Ua hoʻolauna ʻo DSM-5 i kahi like me like, ka mea i kapa ʻia ʻo ka maʻi pāʻani ʻoihana Pūnaewele, ʻo ia ke ʻano e koi ai hou aku. Ke kaʻana o ka pāʻani i nā mea mua eono o nā pae i luna, akā hoʻohui i ʻehā mau mākaʻikaʻi: hoʻomau ka hoʻohana ʻana i ka wā e ʻike ana ka mea maʻi pilikia, e wahaheʻe ana i ka ʻohana e pili ana i ka hoʻohana ʻana, ka hoʻohana ʻana i ka Pūnaewele e pakele ai i ka manaʻo ʻino, a me nā pilikia lehulehu / interpersonal / leo. i ka ʻeha (35).). ʻO nā ʻokoʻa ʻē aʻe, ʻaʻohe i ka criterion wehe i ka papa helu DSM, ʻo ka manawa ʻo 12 mau mahina ma kahi o 3 mau mahina, pono e loaʻa i nā mea maʻi nā ʻelima no ka loaʻa ʻana o ka maʻi a, ʻoi aku ka nui o ka maʻi, ua palena ʻia ka pākuhi ʻo ka pūnaewele a ʻaʻole ia. e nānā i nā hana ʻē aʻe pūnaewele.

ʻAʻole maopopo ke kaohi maʻi o ka pili ʻana i ka Pūnaewele no ka mea ke hoʻopaʻapaʻa mau nei nā loina, ʻike ʻia nā haʻawina epidemiological a puni ka iwi, a nui ka hoʻohana ʻana o ka pūnaewele me ka nui o ka wā i wehewehe mua ʻia. Tao et al. ((33) ua hōʻike i ka prevalence mai ka 1 a i 14%, e hōʻike ana i nā haʻawina i hana ʻia ma 2008 a me 2009. Mai ia manawa mai, ua hoʻohana pū ʻia ka pāʻoihana pūnaewele (Instagram, Facebook, etc.) a a YouTube ua lilo i ulu a hiki i ke alakaʻi no ka hoʻonui hou ʻana ma ka hoʻohana ʻana i ka pūnaewele pilikia. Shek et al. ((36) ua loaʻa i ka prevalence o 17-26.8% i nā wā'ōpiopio ma Hong Kong. Heʻoi aku i ka nui hikikomori ua manaʻo e pili ana i ka 1-2% o ka heluna o Asia (e nānā ma luna). He mea paʻakikī ke ʻike he aha kēia makahiki o ka hoʻomaka ʻana mai ka hana ʻana o ka nui o nā haʻawina me nā ʻōpio a ʻo nā ʻōpio a me nā ʻōpio a me nā keiki i kēia manawa i ka Pūnaewele mai ka wā ʻōpio loa. Hiki i ka hoʻohana pilikia ʻana ke hoʻomaka ma mua o ka wā ʻōpio. ʻO ia, i ka hoʻohālikelike ʻana me hikikomori e nui ana i ka wā ma o ke wā ʻōpio o nā ʻōpio ʻōpio [makahiki o ka makahiki o ka hoʻomaka ʻana o 22.3 mau makahiki ma Ref. ((9)). Ua ʻike ʻia kahi haʻawina kūloko ma Korea ua ʻoi aku ka nui o nā keiki ʻōpio i kona wā ʻōpio (3.6 ahe 1.9%) (37), e kū pū me ka hikikomori. ^ E Ha yM. I nā kūlana ʻelua, ʻike ʻia nā ʻāina ʻĀina ma mua o ka noiʻi.

ʻO ke koho o ka huaʻōlelo "addiction" e hōʻike i kahi pilina ma waena o ka hoʻohana ʻana i ka pilikia pilikia o ka pūnaewele a me nā mea e hoʻowalewale ʻē aʻe (e like me ka pili āpau) a me ka waiwai addict. ʻEkolu mau manawa i ka poʻe i hoʻohui ʻia i ka pūnaewele ma mua o nā mea i hoʻohui ʻole i ka lawena wai (38).). Brand and Laier (39) loiloi i nā haʻawina neuroimagery i ka hoʻohui i ka Pūnaewele a loaʻa i kahi ʻano like ʻole o ka nucleus accumbens / orbitofrontal cortex overstimulation ma mua o nā mea i hoʻohui ʻia. Hōʻikeʻike ʻia nā hiʻohiʻona maʻamau etiological o ka hoʻohui ʻana i ka pūnaewele e kēia ʻano like ʻole. In Ref. ((40), ʻehā mau hiʻohiʻona nui i hoʻokaʻawale ʻia mai ka palapala: nā haʻawina hoʻonaʻauao (ʻo nā mea hoʻoikaika maikaʻi a maikaʻi ʻole), ke ʻano hoʻohālike cognitive-behavior, ka pākēlani puʻuwai pāpaho, a me ka hoʻohaʻahaʻa uku-hemahema (ʻo ka Pūnaewele e hāʻawi i ka hoʻoulu hou ʻana ma ke ola maoli. ka hoʻihoʻi ʻana i nā poʻe e pono ai ka hoʻoikaika ikaika. ʻO nā mea e pili ana i ka Intrapersonal (e like me ka manaʻo a me ka naʻau, ka pilikia o ka naʻau, ka mana hoʻoluhi, a me nā mea ʻē aʻe). anal-analion41).). Ua manaʻo ʻia na ʻōmaʻomaʻo ʻelua e hōʻike i ka pane kuʻikahi me nā kūlana ʻehaʻeha.33, 42).). ʻOiai hiki i ka mea hoʻoikaika ke hana i ka hikikomori pū kekahi, ua hōʻike pinepine ʻia nā mea interpersonal i ka hikikomori, ʻokoʻa ka ʻike me ka loaʻa ʻana o ka pūnaewele. Hiki ke wehewehe ʻia kēia ʻokoʻa ma ke ʻano he ʻokoʻa i ka mana o nā mea ʻelua a i ʻole he epistemological artifact hopena mai ka a priori ka ho'ākāka ʻana o hikikomori kahi maʻi maʻi ma ka ʻatikala Kepani. Eia nō naʻe, ʻo ka mea i hoʻokumu ʻia e ka holikomori ma mua o ka pūnaewele i hoʻohana ʻia e kekahi mau makahiki he nui ka ʻike ʻokoʻa i waena o nā mea ʻelua. I ka ʻike o ka poʻe kākau, ʻaʻohe neuroimagery i hana ʻia e hoʻokolokolo hikikomori.

ʻO Hikikomori a me ka hoʻohui pūnaewele i kekahi mau mea i kū i kā lākou mau manaʻo i manaʻo ʻia. Hoʻomaopopo ka ʻelua i kahi hoihoi i ke kula a hana a me nā pilikia me ka pilina interpersonal. ʻOkoʻa kahi hikikomori a me ka hoʻohui ʻole pūnaewele i ka wehewehe ʻana, ʻo ia ka makemake i ka ʻae a hoʻihoʻi i nā hōʻailona ma ka wā hope a me ka manaʻo e hiki mai ka hana hōʻino mai ke kaā ʻana mai, a ʻaʻole i nā ala ʻē aʻe. ʻO nā syndromes ʻelua e hūnā i kekahi mau hihia, e like me ka nalowale o ka hoihoi i nā hana ʻē aʻe, ka hoʻohana ʻana o ka Pūnaewele i pakele ai i ka ʻano dysphoric, a me ka hana kūpono (4, 18, 20).). E piʻi i ka 56% o hikikomori poino paha ka poʻe i ka hoʻohui ʻana ma ka Pūnaewele a ʻo 9% i hoʻohui ʻia ma Kina Hema (4).). ʻO kahi laʻana, hōʻike ʻia kahi noi ma South Korea e hōʻike ʻia ana e kekahi mau psychiatrists i ka addiction pūnaewele i loko o kahi hihia-vignette o ka mea maʻi maʻi Kepani me ka maʻi. hikikomori (23).). Ma ka hoʻohālikelike ʻana i nā hihia o ka hopu, hiki i ka Pūnaewele ke pōmaikaʻi maoli no ka maikaʻi o ka holikomori o ke ola ma ka hāʻawi ʻana iā ia i ala e hālāwai ai me nā poʻe like ʻole a me nā pilikia like (42).). Kahi hiki ke hoʻomohala ʻia kahi ʻōmaʻomaʻo no ka holomua a ʻaʻole i kahi hoʻopiʻi (a comorbidity paha). A ʻo ka hopena, hoʻohana nā keʻena lāʻau e mālama i ka Pūnaewele e hoʻokele hikikomori no ka mea, ʻo ia ka mea i loaʻa i ke ala i hiki ai ke launa pū me nā limahana olakino (43).). Ma ka hihia o ka Pūnaewele, ua kuhikuhi mai nā mākaukau e like me ka egodystonic ka mea e alakaʻi ai i ka ʻeha, ʻaʻole pono ia no ka hikikomori e hiki ke ʻike i kā lākou ʻano ma ke ʻano o kā lākou ʻike (egosyntonic).

Hiki i nā hihia hikikomori ke hōʻike i nā maʻi hoʻohuihui pūnaewele me ka comorbid. Akā, e like me ka mea i manaʻo nui i mua, lehulehu hikikomori maoli ka hoʻohana ʻana i ka Pūnaewele maikaʻi loa no ka launa pū ʻana o ka lehulehu.20) i mea e hiki ai iā lākou ke hoʻomaopopo me ka poʻe ʻē aʻe i nā kūlana like ʻole a mālama ʻē iā lākou iho e pili ana i ka honua o waho.43).). Mai kahi hiʻohiʻona pragmatic, hiki i ke nīnau ke aha ka mea i hoʻohui ʻia e ka Internet me ka hoʻohui ʻana i kahi hikikomori. ^ E Ha yM. He mea maikaʻi paha inā hāʻawi ia i nā mea maʻi i hiki i nā lawelawe hou aku, akā hāʻawi ʻia i ka liʻiliʻi o ka noiʻi e pili ana i ka mālama ʻana i ka hoʻohui i ka Pūnaewele (44) a me ka mea i ka maʻi o ka maʻi maʻi, e kahaha nui ia. A laila e noʻonoʻo pono ʻole nā ​​loiloi e hoʻomaikaʻi ʻole i ke ʻano o ka ʻano i loko o ka pūpū, ʻoi loa me nā hōʻoki e hoʻowahāwahā a me ka hakakā (45).

Ke noʻonoʻo nei i ke ʻano ʻē aʻe, ʻike ʻia paha ka mea hiki i kahi mea maʻi e hōʻike ana no ka hana ʻake Pūnaewele ma waho o ʻAsia e loaʻa i ka maʻi hikikomori no ka mea aia kahi mea hōʻike pilikino i hōʻike ʻia i ka hikikomori i ʻike ʻia i kaupalena ʻia ma kēia kuʻina. Eia nō naʻe, ʻo ka hoʻohui ʻana i nā mea ʻōnaehana i manaʻo ʻia he kuleana nui o ka hikikomori (nā hakakā ʻohana, hoʻololi i ka launa pūlima, hilahila no ka ʻike ʻole ʻia, a me nā mea ʻē aʻe).

ʻO kekahi ʻano maʻi nui e ae no ka haʻalele ʻana, ʻo ia ka pili me nā maʻi ʻelua hikikomori (12) a me ka hoʻohui ʻōlelo pūnaewele (46).). ʻO ka schizophrenia piha piha i hele mua ʻia e kahi hapa o ka hua, kahi i like ai hikikomori (47, 48).). Nā hōʻailona ʻomaʻomaʻo e pili ana i nā kūlana ʻelua i ka haʻalele ʻana i ka nohona, nā hōʻino ʻana o nā hana e pili ana i ka hana a ka ʻohana, ka hōʻino ʻana o ka hoʻomaʻemaʻe, ka luhi ʻana o ka holo ʻana, ka hopohopo, ke kahu ʻole, ka huhū ʻeha, nā manaʻo kaumaha, ka hiamoe hiamoe, a me ka nalowale ʻana o ka manaʻo.5, 10, 49).). ʻO ka pili pono, ʻo ia ka ICD-10 subtype o nā schizophrenia maʻalahi (50), ka mea e hōʻike nui nei i nā hōʻailona maikaʻi ʻole a me nā ʻano ʻino a i ʻole nā ​​kuhi ʻole a i ʻole nā ​​ʻano hoʻokolokolo (51), ʻoiai he hoʻonāukiuki kēia maʻi a ua hoʻokuʻu ʻia mai ka papa ʻana o ka DSM no ka ʻike maikaʻi ʻole a me ka nele o ka hoʻohana (51).

ʻElua mau ʻāpana i kōkua i ka ʻokoʻa ʻana ma waena o nā ʻano ʻelua. ʻO ka mea mua, ʻaʻole pono ke ʻano o ka hoʻomaʻamaʻa hikikomori a me ka lua, ua hoʻomanawanui me hikikomori ʻaʻole paha ke loaʻa i nā pōʻino ʻē aʻe i hoʻohui ʻia i ka noho kaʻawale ʻana o ka nohona, e like me nā cognitive deficits. E like me ka mea i hōʻike mua ʻia, ʻaʻole i ʻike ka maʻi ʻino i ka psychosis a hiki ke kuhikuhi i nā maʻi ʻē aʻe e like me ke kaumaha ʻana a i ʻole ʻo amotivational syndrome kekona i ka hoʻohana ʻana i ka cannabis (52).

Sensory kahiki ma hikikomori ka mea e noho ana no nā manawa lōʻihi i ko lākou lumi me ka hoʻohana ʻana i ka Pūnaewele, hiki iā ia ke alakaʻi i kahi hōʻike e like me ka psychosis. ʻOiai paha i ka heluna nui, 13.2-28.4% o nā kānaka e ʻike paha i nā hōʻailona like psychotic-like i ko lākou ola (53, 54), hōʻike i kahi hōʻike hou i loko o kahi cohort o nā haumāna o ke kulanui 170 mau haumāna-psychotic like like psychotic-like like me ke ʻano ma ke ʻano he 2 mahina hoʻokahi me ka pilikia o ka hoʻohana pūnaewele.46).). Ua paio nā mea kākau e hiki i ke hoʻohana ʻana i ka Pūnaewele ke hoʻopilikia i ka neʻe ʻana o kahi nāwaliwali, a i ʻole, ke hiki ke kūpaʻa ka poʻe me ka poʻe kūleʻaleʻa i ka poʻe interpersonal i kekahi manawa ma ka pūnaewele e hālāwai me nā poʻe (46, 55).). ʻO kēia wehewehe hou ua like ia me nā mea i ʻōlelo ʻia ma mua hikikomori a me ka hoʻohana i ka Pūnaewele (43).). Eia nō kekahi, ua pili ka luhi ʻana i ka ʻike me nā maʻi psychotic no nā mau makahiki he mau ma ka poʻe maʻamau.56).). Ma muli o ka lilo ʻana o ka naʻau i ka hopena i ka neʻe ʻana o ka lehulehu e hoʻonui i nā hōʻailona psychotic i hikikomori kekahi, ke lulu nei i ka laina ma waena o ka maʻi ʻelua. ʻO ka hala ʻole o nā maʻi psychotic piha piha i manaʻo mai i kahi hanana koʻikoʻi o ka psychosis, hoʻololi i ke kaiāulu (e hōʻemi ana i ka sensory deprivation a me ka hoʻohana ʻana i ka Pūnaewele, no ka laʻana) e kōkua i ka hoʻokaʻawale ʻana ma waena o waena. hikikomori, nā maʻi noʻonoʻo, a me nā hoʻohui pūnaewele. ʻO ka hoʻolālā holomua o nā hōʻailona hiki i kahi hōʻailona hou kahi o ke kūlana i hele mua a "hoʻoweliweli" i kekahi.

I ka ʻike lāʻau lapaʻau o kekahi o nā mea kākau (Emmanuel Stip), ʻike ʻia kekahi mau mea maʻi ma kekahi manawa kahi hanana psychotic kūpaʻa me kahi kumumanaʻo e pili ana i nā kamepiula a me ka hūnā e pili ana i ka honua o nā pāʻani kūlohelohe (57).). ʻO kekahi mau hiʻohiʻona obsitive-compulsive. Hōʻike kekahi he nui i nā mauʻeha ʻino e pili ana i nā kaulike psychiatric i hōʻoia ʻia e like me ka PANSS me ka loaʻa ʻana o ka helu 60 ma ka subscale hewaʻole, kahi kūpaʻa i ka mālama ʻana (57).). ʻO ka hoʻopauʻana i nā maʻi comorbid no laila he mea nui loa. Eia nō naʻe, ʻaʻole nā ​​hihia āpau i hui pū ʻia me kekahi maʻi noʻonoʻo ʻē ʻole a i ʻike ʻia kahi maʻi, ʻaʻole lawa ka wehewehe ʻana o ka comorbid i ka manawa i hoʻokuʻu ʻia a i ʻole ka hopena i loko o ka lehulehu (58).

Hoʻokele o Hikikomori

Kūleʻa ke kūkākūkā ʻana e hiki ke hopena i ka wā o ka hikikomori, ʻo kekahi hapa ma muli o ke ʻano o ka maʻi - ka hoʻihoʻi ʻana i ka hopena - a ma kekahi hapa ma muli o ka kūʻē o ka ʻohana e hālāwai i nā kumu kumu o ka hala, ka hilahila, ka makaʻu, ka stigma kūloko, a me ka nele i ka ʻike. Ma ke komo ʻana me ka hana hoʻihoʻi i ka hana maʻamau hiki ke hoʻāʻo i ka paʻakikī a me ka hoʻopiʻi ʻana hikikomori ʻo nā hihia pinepine kekahi o nā mea nui i ka hoʻokele kūpono.4, 5, 10, 12, 13).

Aiaʻekolu mau ʻano ākea o ka lawelawe e kōkua ai hikikomori ma Iapana: (1) nā wahi olakino noʻonoʻo e hoʻohana ana i nā pilikia psychological / clinical; (2) nā kaiāulu hana e hoʻohana ana i nā hoʻokūkū ʻole ʻole lapaʻau a ʻole psychosocial paha; a (3) i kekahi mau ʻano ʻē aʻe e hāʻawi ana i ke ʻano lapaʻau ʻē aʻe (e laʻa, ʻo ke kōkua kōkua ʻana i ka lio, ke kime kai i loko o kahi pāmu, a me nā pūnaewele pūnaewele) (19).). Hoʻokumu pinepine nā lawelawe i ka pehea hikikomori ka ho'ākāka ʻia a hoʻomaopopo ʻia akā akā ʻo kahi hoʻolālā hoʻokō āpau e pono e komo i nā lāʻau lapaʻau a me nā hanana maʻi.19).). ʻO ka pahuhopu o ka hoʻokele e hōʻino i ko lākou hoʻoneʻe ʻana i ke kino (ʻo ka hoʻihoʻi ʻana iā lākou mai ko lākou lumi a i ʻole nā ​​wahi ʻē aʻe) a me ka noho kaʻawale ʻana a me ka hoʻoilina ʻana, a laila e koi iā lākou e hana i ka hana i loko o ka nohona, ʻo ia hoʻi ka hoʻi i ke kula. ka mīkini hana (5).

I ka hoʻomaka mua, hoʻokele o hikikomori e hoʻopili i kahi loiloi hoʻopukapuka piha e hoʻokaʻawale i ke alo o ka comorbidity psychiatric. Inā hele mai kahi comorbidity, pono e hāʻawi ʻia i nā lāʻau lapaʻau kūpono. Hiki paha i ke hoʻokipa mālama ʻia i kekahi mau mea pili i ka hoʻopiʻi ikaika ʻana, a me nā lāʻau lapaʻau kūpono a me / a me nā psychotherapy no nā maʻi like ʻole, e like me ka schizophrenia, ʻehaʻeha, a me nā phobia. Pono paha nā ʻano psychosocial a me ka psychotherapeutic no ka hoʻomohala ākea a me nā mea kūlohelohe kanaka. Nui nō naʻe i ka nele o ka maʻi maʻi ma kēia manawa a ua manaʻo ʻia he "hikikomori kumu." Ma kēia mau hihia, a i nā hihia ʻaʻole he pilikia nui ka maʻi kuhihewa a i ʻole ke kumu o ka hoʻopulapula hana, nā lawelawe ʻōlelo, nā papahana kipa i ka home e hoʻopili pū i ka psychotherapy pōkole. interventions, a me 'ohana' ole 'a hui paha e hōʻike i ka hapanui loa i ka manawa' oe e pili ana i nā pilikia metema me nā hōʻike 'oukou (4, 5, 10, 12, 49).). Ua hoʻohana pū ʻia ka psychodynamic psychotherapy a me nidotherapy, ka hoʻolālā'ōnaehana'ōnaehana o ka pono olakino a me ke olakino e kōkua i ka hoʻokō ʻoi aku ka maikaʻi no nā maʻi, ua hoʻohana pū ʻia.14, 57, 59).). ʻO ka hōʻike ma ka lāʻau lapaʻau ʻoi aku ka paʻakikī. Ua hana hoʻopiʻi ʻo Paroxetine i hoʻokahi mea maʻi me ka maʻi obsitive-compulsive ka mea i hoʻi i kona lumi no 10 mau makahiki akā ʻaʻole i maopopo ʻole inā he hōʻailona maoli kēia hikikomori (10).

Hiki ke lōʻihi ka lawelawe ʻana, ʻo ka hoʻopiha piha a me ka hoʻomau i ka hoʻopalike ʻana i ke kaʻina hana he mea maʻamau a he liʻiliʻi wale nō ia o nā hihia e hoʻokō i ka komo piha ʻana o ka nohona.4, 12, 13, 32).

ʻO ke kumu holoʻokoʻa, ʻo ka hōʻike hōʻike e pili ana i ka mālamaʻana i ka hanana alikaʻi a me ka hōʻike hihia, me ka loaʻa ʻole o nā hanana hoʻokolokolo pākolo.5).). He mea palekana paha e haʻi aku e pono e hāʻawi ʻia i ka lāʻau lapaʻau inā ʻike ʻia kahi comorbidity psychiatric, akā ʻaʻohe kumu no ka neʻe o nā ʻano lāʻau ʻē aʻe, ʻoiai ʻo ka pale ʻole kekahi i kēlā. Ke hoʻohana nei i kahi paradigm eclectic me ka mālama kino (me kona ʻike hohonu e pili ana i ka maʻi olakino noʻonoʻo) a me nā hana maʻi psychosocial (me kona manaʻo ʻana i ka hoʻāliʻi ʻana i ke kūlohelohe, outreach a me ka moʻomeheu ʻano moʻomeheu) hiki ke pono i ka hikikomori me ka hapa (19).). Pūnaewele hikikomori e pōmaikaʻi paha nā hihia i ka maʻi psychosocial, akā ʻo ka loiloi hou e ka mea lapaʻau ma hope o kekahi manawa e hiki ai ke hōʻoia i ka mea maʻi ʻaʻole i hōʻike mai i nā hōʻailona o nā hōʻailona psychiatric.

Hōʻikeʻike

Eia hou, eia kēia e noʻonoʻo ai i ka lalo o ke kuhi a i ʻole comorbid. Ua hōʻike ʻia hoʻokahi haʻawina ʻo nā maʻi me nā maʻi kaumaha ʻoihana ʻē aʻe a hikikomori ua loaʻa ka hopena ʻoi aku ka maikaʻi ma mua o ka poʻe me ka phobia sosolo wale nō, e hōʻike ana i kēlā hikikomori he ʻano ʻokoʻa nui o ka wā kahiko.

ina he hikikomori hope hope nā mea i hala ʻole i loko o ka lehulehu - pinepine ma hope o kekahi mau makahiki - he pilikia nui ʻo ia: e hopu ana i nā makahiki i hala ʻole ke kula a hana paha. ʻOiʻoi aku ka paʻakikī o ka hoʻi ʻana i ka hui. Nā hopena no nā poʻe me hikikomori Ua ʻoi aku ka maikaʻi inā ʻaʻole lākou e ʻimi i ke kōkua, ʻoiai inā he kākoʻo nā ʻohana.13).

Nā pane hope

ʻAʻole kūpono kēia hihia i ka wehewehe ʻana o “hikikomori ʻ ”leloola "a i ʻole" līwina hoʻowalewale lohi i kāu maʻi "a ke manaʻoʻiʻo nei mākou ʻo ia ka mea i hōʻike mua ʻia ma Kanada. ʻAʻole i ʻike koʻikoʻi ka mea maʻi i kekahi maʻi psychiatric ʻē aʻe, e like me kahi episode depressive nui, kahi hopohopo kaumaha, a i ʻole kekahi hōʻino pilikino, e like me nā kuleana DSM-5. He mea hiki nō paha kāna mau maʻi maʻi ma muli o kahi prodromal phase o ka psychosis a i ʻole nā ​​hopena maikaʻi ʻole o ka schizophrenia ʻoiai inā he liʻiliʻi iki no ka hōʻike ʻana i kēia maʻi ma ka hōʻike a ma hope paha. Ua noʻonoʻo ʻia ka pono o ka hoʻopili pūnaewele ma muli o kēia hihia, ua nui ke kaha a me ka lōʻihi o ka hoʻohana ʻana i ka Pūnaewele i kēlā me kēia mea i ka lua o kona hoʻokuʻu ʻia ʻana. Eia kekahi, ʻaʻole ka mea i lawe ai i kāna kamepiula a me ka ʻike pūnaewele i kahi mea i loli ai i kāna ʻano a i ʻole hoʻi i loko o kāna hana ʻōnaehana. ʻO ka mea nui, hiki iā ia ke hoʻomau i kāna hana a me nā noi ʻana me ka pono ʻole o ka lāʻau lapaʻau a me ka psychotherapy paha.

ʻO kahi kahi hikikomori ma ka psychiatric nosology a hoʻoholo ʻole. ʻO kekahi o nā nīnau i hāpai ʻia inā he kaʻokoʻa ka moʻomeheu kūʻokoʻa. Ke ʻōlelo nei kekahi poʻe kākau, ʻaʻole ia he maʻi, akā he luhi o ke kaumaha, i hiki ke wehewehe i ka hala ʻana o kahi ʻano kumu a me ka ʻae ʻana o ka ʻikepili a me nā ʻekekema i kūwaha i nā puke ʻepekema (58, 60).). Kūʻē kekahi ʻo ia hikikomori aia paha he pane no-pathological a dissociative paha kekahi no ka hoʻopilikia.42) a lilo i mea e pōmaikaʻi ai i ka ʻōlelo o ka ulu a me ke kūkulu ʻana i ka ʻike (6).). Nā hanana hoʻohālikelike e like me hikikomori e noʻonoʻo paha i ka loli ʻana o ka ʻōpio me ka kaiāulu a me ka ʻohana, ʻoiai ka ʻike o ka hopena o ka hopena o ka nohona a me ka hōʻeha a me ka ʻaʻohe o ka ʻohana. ʻOiai he paio e like me paha hikikomori pono he maʻi psychiatric a i ʻole. hikikomori ua manaʻo pinepine ʻia he "haunaele" e nā kaukaʻi ma Iapana ((Japan)20).). Eia naʻe, ʻaʻohe maopopo o ka mea inā paha hikikomori he maʻi maʻamau a i ʻole ke kaulike (haʻalele i ka pili ʻana i ka pili i kekahi pilikia ma lalo o ke ʻano maʻi psychiatric), a i ʻole he kauaka maʻi kūlohelohe paha, kahi e pili ai ka hoʻihoʻi ʻana ma ke ʻano o nā kūlana psychiatric ʻē aʻe. Eia naʻe, e like me ka mea i hoʻolaha nui ʻia ma ka palapala (58), ke kāhea ʻana i kahi hiʻohiʻona haʻahaʻa a i ʻole ke ʻano ʻānō paha paha ia he hewa nosological a me ka etiological, a ʻo ka manaʻo nui ʻana i ka hōʻike heterogeneous a me ka palapala palena ʻole me ka pili ʻole o ka pilina correlational me kekahi maʻi psychiatric a i ʻole he hanana hanana. Kūleʻa hoʻokololei i nā papahana no nā hanana mua a i ʻole kūkākūkā paha e pili ana i kahi maʻi maʻi o ka psychromodie prodromal e alakaʻi iā mākou e noʻonoʻo i nā hōʻike like ʻole, e pili ana i kēlā me kēia poʻe ʻōpio o ka hanauna a ua kapa ʻia ʻo filosofia ʻo Michel Serres "Thumbelina": kahi hui kanaka hou i hopena i ka hiki e paani me ko lakou manamana lima (61).). Ke hele nei nā haumāna a me nā haumāna i kekahi neʻe o ke hoʻololi a hoʻopau i ka manawa ʻoi aku ka manawa ma ka ʻike maoli ma mua o ka honua maoli.

No laila, ʻoiai hikikomori hiki ke wehewehe ʻia i kēia manawa ʻo ka hopena o ka hopena ma waena o ke ʻano noʻonoʻo, ʻano kaiaulu, a me nā mea e pono ai, e noiʻi hou ʻia e hoʻokaʻawale i waena o ke kula a me ke kula kiʻekiʻe. hikikomori a hoʻokū inā he hui hou hou kēia, a i ʻole kahi ʻano kuʻuna a i ʻole nā ​​hōʻike ʻano kūloko o nā hoʻokolohua paʻa. Hiki paha i nā haʻawina Cohort ke kōkua i ke hoʻokumu ʻana i nā mea pilikia kūlohelohe a kūloko paha, ʻoiai nā hoʻokolohua kinipōpō e hiki ai ke hoʻonui i ko mākou ʻike i ka mālama maikaʻi ʻana. Ma kēiaʻano, hiki i nā hōʻike hihia mai ka honua a puni ke kōkua i ko mākou ʻike ma kēia ʻano a no laila e kōkua i ka hana ʻana i ka manaʻo.

Ka'ōlelo Kaumaha

Loaʻa ʻia ka ʻikepili i kākau ʻia mai ka kumuhana ma hope o ka wehewehe ʻana o ka noi ʻana. Ua ʻae ʻia ka haʻawina e ke Komite Ethics o Fernand Seguin Research Center, ma Montréal, QC, Kanada. ʻO ke hōʻike ʻana i hōʻike ʻia i ka ʻatikala ua pili i kahi kumuhana kanaka.

Nā mea kōkua i kākau

ʻO ES ka mea kākau mua a me ka mea kākau e pili ana. Ua komo ka AC, AT, a me SK i ke kākau kākau ʻana ma ka pauku a hōʻike i kahi hana mua.

Kōkua o ka'Āina Kuleana

Ua haʻi aku nā mea kākau i ka hanaʻana o ka noiʻiʻana ma ka nele o nāʻoihana pāʻoihana aʻoihana kālā paha i hiki ke manaʻoʻia he hopena kūpono e pili ana.

hoʻolako 'ia o

ʻO ES ka luna noiʻi o ka schizophrenia ma ke Kulanui o Montreal a hoʻohana kālā ʻia mai ia.

E hoʻomaopopo '

Huaʻōlelo: hikikomori, mea hoʻoili pūnaewele, schizophrenia, hoʻihoʻi pāpaho, ʻenehana prodromal

Citation: Stip E, Thibault A, Beauchamp-Chatel A a me Kisely S (2016) Pākuʻi Pūnaewele Pūnaewele, Hikikomori ʻO Syndrome, a me ka Mana Hoʻohālau o ka Psychosis. ʻO mua. ʻO ka hauā 7: 6. hana: 10.3389 / fpsyt.2016.00006

Loaa: 23 Sepatemaba 2015; ʻAe ʻia: 11 Ianuali 2016;
Hoʻopuka: 03 Malaki 2016

Kuleana kope: © 2016 Stip, Thibault, Beauchamp-Chatel lāua ʻo Kisely. He kumuhana kahi i wehe ʻia ma lalo o nā ʻōlelo o ka Lulā Lahui Creative Commons (CC BY). Hāʻawiʻia ka hoʻohana, ka hāʻawiʻana a iʻole kopeʻiaʻana ma nā hui'ē aʻe, inā hoʻolakoʻia ka mea kākau a mea laikini paha a ua kākauʻia ka puke ma mua ma ka puke pai, e like me ka hana hoʻonaʻauao kūpono. ʻAʻole hoʻohanaʻia, hoʻolaha a hoʻoponopono paha iʻole e mālama i kēia mau hua'ōlelo.

* ʻOlelo: Emmanuel Stip, [pale ʻia ka leka uila]