Hikikomori, a form of pathological social withdrawal, has gained international recognition beyond its initial description in Japan. The COVID-19 pandemic has heightened awareness of social withdrawal behaviors globally, yet data from India remains limited. We present three cases of adolescents aged 16 years who met the updated diagnostic criteria for hikikomori: marked social isolation at home for ≥6 months with significant functional impairment. All three cases presented with concurrent psychiatric comorbidities, including major depressive disorder, obsessive-compulsive disorder, and social anxiety disorder. Duration of social withdrawal ranged from 8 to 24 months. Functional impairment was evident across educational, social, and occupational domains. Treatment response was partial despite multimodal interventions including pharmacotherapy and cognitive-behavioral therapy. These cases met updated hikikomori criteria and fit secondary hikikomori, with persistent withdrawal despite symptom relief, implying need for targeted exposure-based, family-informed, and engagement-focused care. COVID-19 context likely precipitated but did not fully explain persistence, supporting a pathological pattern in a high-expectation family milieu. These cases demonstrate the clinical presentation of hikikomori in the Indian context, highlighting the need for early recognition and specialized interventions for pathological social withdrawal in adolescents.

Adolescents with trauma histories may present with dissociative features resembling dissociative identity disorder (DID) yet diverging from formal diagnostic criteria. This case report describes a 17-year-old female with five distinct alters and a background of sexual abuse, bullying, and punitive parenting. Treated with Janet’s phase-oriented model across 45 sessions in 8 months, she demonstrated marked improvement in mood, reduced self-harming behavior, and decreased disruption from alters while maintaining functional engagement. The presentation was conceptualized descriptively as self-simulated DID, characterized by deliberate switching, intact trauma recall and lack of external incentives, distinguishing it from both genuine DID and malingering. This case spotlights the importance of clinician expertise in differential diagnosis, the utility of phase-oriented treatment, and systemic barriers, particularly ongoing family dynamics, as critical challenges to sustained recovery, reinforcing the value of family-focused interventions.

Background: Happiness is a subjective emotional state, and there lie individual differences in the way happiness is perceived and derived. It is important to understand that the socioeconomic status of families impacts the way children derive happiness, owing to the excess or deficit of exposure and access in a child’s life. However, little research has been done regarding children’s sources of happiness in India. This study aims at exploring the sources of happiness of children in the age group 7–10 years, from different socioeconomic backgrounds. Method: The socioeconomic status was determined using the Kuppuswamy socioeconomic scale. The sources of happiness were explored through drawings made by children in response to the prompt, “Draw any five things that make you happy.” The drawings were analyzed using content analysis and were explored further to understand the differences in the lower and upper socioeconomic groups. The results indicate the possible impact of exposure to worldly experiences on what makes a child happy. Results: The findings revealed that children from the upper socioeconomic group seek happiness mainly through “receiving material things”; on the other hand, for the children from the lower socioeconomic group, family relationships appear to be the main source, with a special mention of their homes being a source of happiness. Conclusion: The findings in the study may help in designing interventions for increasing positive affect by understanding how children perceive their environments based on their contexts.

Introduction: In an era where adolescent mental health challenges are increasingly prevalent, schools are expected to function not only as educational institutions but also as environments that nurture emotional well-being. Psychological well-being (PWB) during adolescence is critical for healthy development, academic success, and resilience. However, many students continue to experience psychological difficulties due to limited peer support and reluctance to seek psychological help. This study investigates the roles of peer support and psychological help-seeking behavior in predicting adolescents’ PWB. Material and Methods: This correlational study involved 1,364 junior and senior high school students aged 11–18 years ( M = 15.67) from multiple districts in Central Java Province, Indonesia. Data were collected using three validated self-report instruments measuring peer support, psychological help-seeking behavior, and PWB. Pearson product–moment correlation analysis was employed to examine the relationships among variables. Results: The findings revealed significant positive correlations between PWB and peer support ( r = 0.547, P < .001) as well as between PWB and psychological help-seeking behavior ( r = 0.429, P < .001). These results indicate that students who perceive stronger peer support and demonstrate greater willingness to seek psychological help tend to report higher levels of psychological well-being. Discussion: The findings highlight the protective role of peer relationships and adaptive help-seeking in adolescent mental health. Peer support emerged as a slightly stronger predictor, suggesting that informal social networks serve as primary coping resources during adolescence. Encouraging supportive peer environments alongside promoting positive help-seeking attitudes may enhance school-based mental health interventions and foster students’ psychological well-being.

Introduction: Adolescents categorized as children in conflict with the law or children involved in legal conflicts (CCL) often present with social and behavioral difficulties that may increase vulnerability to delinquent conduct. This study examines how social intelligence (SI) relates to delinquent and problem behaviors by comparing CCL with typically developing adolescents (TDA) in Karnataka, India, and identifying the SI domains most strongly associated with behavioral concerns. Materials and Methods: A comparative cross-sectional design was used with 143 male adolescents aged 12–18 years (CCL = 68; TDA = 75). SI was measured using the Social Intelligence Scale (SIS), and behavioral difficulties were assessed using the Child Behavior Checklist (CBCL). Between-group differences were examined to determine the nature and extent of SI deficits and their links with behavioral outcomes. Results: Compared with the TDA group, adolescents in the CCL group obtained significantly lower scores across SI domains, including social insight, cooperativeness, sensitivity, and confidence ( P < .001). Notable weaknesses were also observed in recognition of social environment, tactfulness, sense of humor, and memory. CBCL findings indicated that reduced SI was strongly associated with greater social problems, elevated aggression, and increased rule-breaking tendencies among CCL participants. Discussion: Deficits in SI appear to be an important contributor to delinquency-related behavior among CCL. Rehabilitation efforts may benefit from structured interventions that strengthen empathy, interpersonal skills, and relational functioning. Integrating SI-focused training into juvenile rehabilitation services may support pro-social development and potentially reduce recidivism.

Introduction: Young people are inherently susceptible to mental health issues, particularly during their adolescent years. Though suicide is more prevalent among older adults compared to younger individuals, it remains one of the leading causes of death in late childhood and adolescence worldwide. It has become important to understand suicidal ideation and behavior in adolescents to identify the risk factors, including depression, and further facilitate its prevention. The present study aims to explore suicidal ideation and behavior and the presence of depression in adolescents. It also aims to see if younger adolescents differ from older adolescents in terms of suicidal ideation and behavior and depressive symptoms. Material and Methods: A total of 200 individuals of both genders aged 10–17 years were included in the study. A sample was selected from the clinics and different community areas of Kolkata. Suicidal Behaviors Questionnaire-R and Child Depression Inventory were administered to assess the presence of suicidal behavior and depression, respectively. Results: Suicidal behavior was evident in 35.5% of the participants, with younger adolescents being more in proportion. Depressive symptoms were present in 29% of the total sample, with older adolescents being more in proportion. Discussion: The findings implicate a significant number of adolescents at risk for suicidal behaviors, warranting attention for early identification and subsequent psychosocial intervention.

Clozapine discontinuation is known to trigger withdrawal-associated psychosis, but non-psychotic withdrawal symptoms, though clinically significant, are less frequently discussed. Proposed mechanisms include dopaminergic receptor upregulation, cholinergic rebound, and serotonergic dysregulation. No previous reports describe clozapine withdrawal-associated mania in pediatric patients, and only three cases of withdrawal-related mania have been described in adults. We describe a 16-year-old female with schizophrenia who had previously shown limited response and poor tolerability to multiple antipsychotics. Since clozapine is known to be effective in psychotic symptoms nonresponsive to other antipsychotics, it was initiated during hospitalization and titrated to 250 mg/day. It was stopped after 7 days at the target dose due to suspected myocarditis. After 4 days, the patient presented with elated mood, tachypsychia, hypersexuality, and decreased need for sleep, without psychotic symptoms. Symptoms resolved over 10 days with olanzapine. Psychotic symptoms re-emerged post-discharge, in the absence of mood features. This appears to be the first report of clozapine withdrawal-associated mania in an adolescent without a previous mood disorder. Earlier cases have only involved adults with schizoaffective disorder and long-term treatment. While schizoaffective disorder was considered in this case, the brief duration of symptoms, full remission with antipsychotic monotherapy, and close temporal link to clozapine cessation favor a withdrawal-related phenomenon. This case exposes for the first time in the literature the onset of manic symptoms following clozapine withdrawal in an adolescent with only psychotic symptoms before this trial. This report raises awareness for the importance of monitoring different effects during and after psychopharmacologic treatment, other than the reappearance of psychotic symptomatology. It also raises questions about diagnostic evolution in early-onset psychosis.

This case report presents the application of a client-centered approach integrating art and play therapy techniques to support an eight-year-old child exhibiting persistent withdrawal behaviors. Grounded in the Play Therapy Dimensions Model (PTDM), the intervention aimed to facilitate emotional regulation, social engagement, and self-expression. The therapeutic process was guided by non-directive principles, with creative modalities such as painting, sand tray play, and therapeutic storytelling forming the intervention’s core across 12 weekly sessions. Pre- and post-intervention assessments were conducted using the Strengths and Difficulties Questionnaire (SDQ), supported by structured therapist observations and parental interviews. The child, initially characterized by anxiety, avoidance of peer interaction, and emotional inhibition, showed notable progress in emotional expression and social responsiveness. Artwork themes and metaphorical processing through storytelling reflected the child’s evolving internal world and emergent coping strategies. Neuropsychological and attachment-based theories were employed to interpret behavioral and expressive changes, highlighting the hemispheric processing of affect and the therapeutic utility of metaphor. The study underscores the effectiveness of client-centered play-based modalities in addressing internalizing difficulties among children and proposes the PTDM framework as a clinically useful structure for tailoring interventions.