The clinical presentations of the anxieties about loss of semen among Sri Lankan males were examined. A total of 38 patients referred to a psychiatric clinic with four different types of presenting complaints, but all sharing anxieties about the effects of the excessive loss of seminal jluid, were included in the study. They were assessed by two semi-structured interviews, with the aid of a symptom check-list. It was found that all the patients shared a core set of symptoms providing support for a unitary concept of a loss of semen syndrome. They also displayed a common set of beliefs about seminaljluid and its importance. The main source of these beliefs was the Ayurvedic medical tradition as practised and publicized by local practitioners. The paper also reports data on the effects of the problems on the patients' lives, previous treatment received, and psychiatric diagnoses. Observations are made on the clinical management of the syndrome.
A survey of possession trance states in a semi-urban population of 7653 identified 37 subjects. The manifestations of the trance, and its course and outcome are outlined. The characteristics of the subjects, including presence of psychiatric disorder, are compared with that of the total population, and significant differences are noted. Four psychodynamic syndromes observed are described with illustrative case vignettes. The functions subserved by possession behaviour are reviewed, and comparisons are drawn between personal possession, ritual possession, and altered states of consciousness in Western society.
An epidemiological survey on a population of 7,643 reveals a surprisingly high incidence of alcoholism among males over the age of 25 years (29 per 1,000). Much the largest proportion of the sample professed faith in Buddhism, a religion which condemns alcohol use. Obligation to comply with religious teaching appears to apply only to females and the young. Ninety percent of the alcoholics were over the age of 35 years (mode 45-54 years), and all were spirit drinkers. None showed significant use of other drugs. Re-examination of the schedules showed a close correspondence between a diagnosis of'alcoholism', on a problem-based definition, and the presence of dependence.
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