Hikikomori, is it a Culture-Reactive or Culture-Bound Syndrome? Nidotherapy and a Clinical Vignette from Oman

Hikikomori, a form of acute social withdrawal, is becoming a silent epidemic in Japan. As it has not been reported from other parts of the world, hikikomori fulfills the criteria for "a culture-bound syndrome." We report a case from Oman, in the southern part of Arabia, with all the essential features of hikikomori. We speculate that the social environment of Japanese and Omani society could reinforce behavior akin to hikikomori although this condition may also transcend geography and ethnicity.