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Although there are versions where the hikikomori may venture outdoors, [1] the Japanese Ministry of Health, Labour and Welfare defines hikikomori as individuals who refuse to leave their parents' house, and isolate themselves away from society in their homes for a period exceeding six months. While the severity of the phenomenon varies depending on the individual, some youths remain in isolation for years, or in rare cases, decades. Often hikikomori start out as school refusals, or tkkyohi () in Japanese.