title: Home visitation program for detecting, evaluating and treating socially withdrawn youth in Korea.
abstract: OBJECTIVE
  The problems of youth social withdrawal (or hikikomori) became a hot-button social issue in Japan in the 1990s. Unfortunately, current nosology in the DSM-IV may not adequately capture the concept of socially withdrawn youth (SWY) or hikikomori. This study aimed to investigate core SWY issues, evaluate SWY's psychopathologies, and approach them therapeutically through a home visitation program.
  
  
  METHODS
  Participants were 65 youth referred by community mental health centers and psychiatric clinics around Seoul and Kyongki-Do province. Among them, only 41 participants (31 male, 10 female, mean age 15 ± 3.6 years) fit our SWY criteria. In addition, 248 middle and high school students in Seoul were recruited as a baseline control group. Caseworkers interviewed the SWY participants and their parents in their homes, using our structured interview manual and a number of psychiatric scales. Caseworkers also approached the participants therapeutically.
  
  
  RESULTS
  Participants' Depression Inventory, Trait Anxiety Inventory, Social Anxiety Scale, and Internet Addiction Scale scores were significantly higher than those of baseline controls. Participants' mean number of psychotherapeutic sessions was 2.8, and the mean number of parental interview sessions was 3.4. After the therapeutic sessions, Global Assessment Functioning scores and social activities had improved somewhat in 68.3% of participants.
  
  
  CONCLUSIONS
  These findings suggest that SWY is a complex phenomenon, so an individual psychopathologic process is very important for treatment. The most difficult problem in SWY treatment was therapeutic access. Hence, the home visit approach with a structured manual may be a good gateway for solving this problem.
authors.affiliation: Department of Psychiatry, Chung Ang University College of Medicine, Seoul, Korea.
authors.forename: Young Sik
authors.initials: YS
authors.lastname: Lee
authors.forename: Jae Young
authors.initials: JY
authors.lastname: Lee
authors.forename: Tae Young
authors.initials: TY
authors.lastname: Choi
authors.forename: Jin Tae
authors.initials: JT
authors.lastname: Choi
mesh_terms: D000293:Adolescent; D016739:Behavior, Addictive / Q000175:diagnosis* / Q000523:psychology / Q000628:therapy; D002648:Child; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005260:Female; D018577:Homebound Persons / Q000523:psychology*; D006792:House Calls; D006801:Humans; D020407:Internet; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis* / Q000523:psychology / Q000628:therapy*; D056910:Republic of Korea; D012919:Social Behavior; D012934:Social Isolation / Q000523:psychology*; D055815:Young Adult