These requirements are that it “(1) must be a discrete and well-defined syndrome. . . (2) recognized as a specific disease in the culture. . . (3) expected, recognized and, to a certain extent, sanctioned. . . [and] (4) higher incidence or prevalence. . . must exist in societies in which the disorder is culturally recognized” (Teo and Gaw 446). The first requirement for a culture-bound syndrome, that it must be a “discrete and well-defined syndrome,” has been met. Although consensus has not been reached regarding a distinct definition of hikikomori, the Japanese Ministry of Health, Labor and Welfare has stated that the following criteria constitute the defining characteristics of hikikomori: "(1) a home-centered lifestyle; (2) no interest or desire to attend school or work; (3) duration of symptoms of at least 6 months; (4) schizophrenia, mental retardation, or other mental disorders were excluded; . . . (5) those with personal relationships (e.g. friendships) were excluded” (Teo and Gaw