Predominant affective temperaments in depressive patients with severe social withdrawal

Laura Orsolini; Giulio Longo; Silvia Bellagamba; Takahiro A Kato; Umberto Volpe

doi:10.1186/s12991-024-00496-z

Predominant affective temperaments in depressive patients with severe social withdrawal

Ann Gen Psychiatry. 2024 Mar 19;23(1):12. doi: 10.1186/s12991-024-00496-z.

Authors

Laura Orsolini¹, Giulio Longo², Silvia Bellagamba², Takahiro A Kato³, Umberto Volpe²

Affiliations

¹ Unit of Clinical Psychiatry, Department of Neurosciences/DIMSC, Polytechnic University of Marche, Via Conca 71, 60126, Ancona, Italy. l.orsolini@staff.univpm.it.
² Unit of Clinical Psychiatry, Department of Neurosciences/DIMSC, Polytechnic University of Marche, Via Conca 71, 60126, Ancona, Italy.
³ Department of Neuropsychiatry, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.

Abstract

Background: Hikikomori (HK) is characterized by self-isolation and social refusal, being more likely also associated with affective disorders, including depression. This case-control study primarily aimed at identifying (if any) predominant affective temperaments are associated with HK in depressed versus not-depressed individuals. Secondary objectives comprise assessing which other psychopathological dimensions (e.g., boredom, anxiety) are associated with the HK specifier in depressed individuals.

Methods: From the larger SWATCH study, 687 Italian young people were screened for depression, as measured by 9 items-Patient Health Questionnaire (PHQ-9) and HK-like social withdrawal, through the Hikikomori Questionnaire-25 (HQ-25). All subjects were administered a brief-Temperament Evaluation of Memphis, Pisa, Paris and San Diego (TEMPS-M), the 7 items-Generalized Anxiety Disorder (GAD-7) and the Multidimensional State Boredom Scale (MSBS).

Results: Males reported significantly higher scores at HQ-25 total score than females (p = 0.026). In the total sample, HK social withdrawal is positively predicted by MSBS low arousal, disengagement, depressive levels, depressive and irritable affective temperaments, while negatively by anxiety (F(6, 680) = 82.336, p < 0.001, R² = 0.421). By selecting only depressed sample, HQ-25 is positively predicted by MSBS total score, low arousal and depressive affective temperament, while negatively by MSBS high arousal (F(4, 383) = 48.544, p < 0.001, R² = 0.336). The logistic regression model found that the likelihood of developing depression with the HK specifier is significantly predicted by depressive and cyclothymic affective temperaments.

Conclusions: These preliminary findings could help in clinically characterizing the relationship between specific affective temperamental profiles among individuals with depression with/without HK specifier, in order to provide a more tailored and personalized therapeutic approach. Our Italian study should be extensively replicated in larger, longitudinal and multicentric pan-European studies, by specifically assessing the impact of these findings on depression clinical course, prognosis and treatment outcomes.

Keywords: Affective temperament; Hikikomori; Social withdrawal; Temperaments; Youth; Youth mental health.