Executive Dysfunction and Memory Impairments in Hikikomori: A Neuropsychological Case-Control Study from Oman

Al Kharusi N, Al-Farsi YM, Chan MF, Al-Adawi S, Al-Mandhari M, Al-Sibani N

2026

Abstract

Background: : Hikikomori, a form of prolonged social withdrawal, has been widely studied in East Asia but remains underexplored in the Middle East. Cultural and social factors may influence its cognitive profile, necessitating localized research. Aim To compare cognitive performance between Hikikomori cases and non-cases in Oman using the Cambridge Neuropsychological Test Automated Battery (CANTAB), focusing on executive function, memory recall, and processing speed. Methods A case-control study was conducted in 2024 with 150 participants (54 Hikikomori cases, 96 controls) recruited from a tertiary hospital in Oman. Hikikomori cases were classified using a broad HiDE-I definition, which included pathological, at-risk, and resemblance Hikikomori categories. CANTAB was used to assess key cognitive domains. Independent t-tests and linear regression analyses were performed to compare outcomes. Results Hikikomori cases showed significant impairments in visual processing accuracy (p < 0.001), response latency (p = 0.004), immediate recall (p = 0.031), delayed recall (p = 0.009), and planning efficiency (p < 0.001) compared to non-cases. Adjusted regression analyses—controlling for age, gender, education, income, employment, marital status, and governorate—confirmed that Hikikomori status was significantly associated with lower visual processing accuracy (β = −0.453, p = 0.001), slower response latency (β = 0.266, p = 0.001), poorer immediate (β = −0.201, p = 0.019) and delayed…

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