The complex sexuality of “Italian” Hikikomori and the need for better nosographic framing of psychopathological evidence

Objective: The definition of “hikikomori” evokes dysfunctional personality pictures already known in the literature and medical practice. The aim is to refute the hypothesis of the need to identify this clinical condition in a new descriptive framework. Materials and methods: Pubmed checklist, clinical interview, and psychometric tests. Results: In the entirety of the selected population, it emerges that the primary disorder is schizoid personality disorder; this is followed by depressive disorder, narcissistic covert disorder, bipolar disorder with depressive prevalence, obsessive disorder, avoidant disorder, and somatic disorder as secondary dysfunctional personality traits. Childhood and/or family trauma, capable of impacting the sexual and affective sphere, is present in almost the entire population. Conclusion: The syndrome should be framed as a specific phenomenon and not as a new psychopathological disorder, as the symptomatological descriptions are similar to the already known schizoid personality disorder; the symptomatological differences among patients should be framed according to a logic of correctives determined by the presence of one or more secondary psychopathological traits that draw a more complex personality picture than the simple nosographic diagnosis of the DSM-V.