Exploring the Extent of the Hikikomori Phenomenon on Twitter: Mixed Methods Study of Western Language Tweets

Victor Pereira-Sanchez   ^{1 *} , MD ;   Miguel Angel Alvarez-Mon   ^{1 *} , MD ;   Angel Asunsolo del Barco   ^{2, 3, 4} , MD, PhD ;   Melchor Alvarez-Mon   ^{3, 5, 6} , MD, PhD ;   Alan Teo   ^{7, 8, 9} , MD, MS

¹ Department of Psychiatry, Clinica Universidad de Navarra, Pamplona, Spain

² Department of Surgery, Medical and Social Sciences, University of Alcala, Madrid, Spain

³ Instituto Ramon y Cajal de Investigaciones Sanitarias, Madrid, Spain

⁴ Department of Epidemiology & Biostatistics, Graduate School of Public Health and Health Policy, University of New York, New York, NY, United States

⁵ Department of Medicine and Medical Specialities, University of Alcala, Alcalá de Henares, Spain

⁶ Service of Internal Medicine, Autoimmune Diseases and Rheumatology, Hospital Universitario Principe de Asturias, Madrid, Spain

⁷ Department of Psychiatry, Oregon Health & Science University, Portland, OR, United States

⁸ School of Public Health, Oregon Health & Science University and Portland State University, Portland, OR, United States

⁹ Center to Improve Veteran Involvement in Care, Veterans Affairs Portland Health Care System, Department of Veterans Affairs, Portland, OR, United States

*these authors contributed equally