In 1998 the Japanese psychiatrist Tamaki Sait¯o invented the term hikikomori, 
referring to a condition characterised by a state of social withdrawal and 
avoidance (education, work, friendships) combined with a persistent isolation 
and confinement in the own home for at least 6 months, due to various factors. 
Initially it undoubtedly regarded a disorder related to a specific 
socio-cultural context, however in the last couple of years some cases of 
hikikomori behaviour have also been observed in other countries far from Japan, 
both geographically and culturally. By way of hypothesis this diffusion can 
probably be attributed to the cultural revolution represented by mass 
communication in the internet era; in particular, it seems to be closely related 
to the immediateness and diffusion of web 2.0, i.e. of social networks. 
Therefore, we report a case of hikikomori behaviour, who was referred to our 
ward. M. is a 28-year-old man, who has lived the last 10 years in a state of 
almost complete isolation. He has maintained contacts with the outside world 
almost exclusively via internet. He started several therapies with psychiatrists 
and psychologists, without achieving significant results. The case of M. 
represents, to our knowledge, the first case of hikikomori described in Italy.