Abstract
Background: A prospective cohort study was conducted to follow-up on 104 participants on their changes of social, psychological and physical health as exposed to the hikikomori lifestyle. Methods: Participants were interviewed at baseline, 6 months and 12 months by administering a set of questionnaires and anthropometric measurements. Results: All three health domains of hikikomori were significantly improved over the follow-up period as evidenced by: (1) increased social network scores from 2.79 ± 1.80 to 3.09 ± 1.87, (2) decreased perceived stress scores from 21.18 ± 5.87 to 20.11 ± 5.79, and (3) reduced blood pressure levels from 118/75 to 115/71 and waist-to-hip ratios. Almost half of the participants have recovered from hikikomori by returning to the workforce in society; however, the health improvements were dominant in those that remained as hikikomori and were associated with the gradual swapping of exercise practices from light to moderate level strength. Conclusions: With intended exposure to social worker engagement, physical assessments of the cohort study triggered the social workers to encourage participants to do more exercises, which in turn enhanced their awareness of health modification towards a better health. Engagement of social workers could be considered as part of the intended exposure for all participants, which suggested social work intervention was effective in helping hikikomori recovery.