Comprehensive Questionnaire for Assessment of Dhat Syndrome: Development and Use in Patient Population

Abstract

Introduction Dhat syndrome is a culture-bound syndrome, characterized by the core belief of loss of semen accompanied by symptoms of general weakness, lack of energy and concentration, impaired sexual functions, and vague somatic troubles, often associated with an anxious or dysphoric mood state. Although many studies have described the clinical picture of Dhat syndrome, there is lack of availability of an instrument which can comprehensively assess patients presenting with Dhat syndrome. Aim The aim of this article is to develop a questionnaire that can comprehensively assess Dhat syndrome and guide the clinicians in managing such patients. Methods Initially, an extensive literature review was done to prepare a comprehensive list of clinical features, beliefs associated with the passage of “Dhat,” and attribution of the symptoms by the patients. These items were converted into a questionnaire for investigational interview. The questionnaire thus developed was administered to 54 patients and was also sent to eight subject experts for their opinion on the questionnaire. Main Outcome Measure To develop and evaluate the content validity of the Comprehensive Questionnaire for Assessment of Dhat Syndrome. Results As per the opinion of experts, the questionnaire had good content validity and was useful for not only clinicians dealing with patients of Dhat syndrome but was also considered useful for the patients presenting with Dhat syndrome. All the experts found the questionnaire to be comprehensive, and two-third of the experts regarded the length to be adequate. Although none of them suggested any deletion of items, yet some additions were suggested. The language of the questionnaire was rated from simple to very simple. Results of administration of the questionnaire on 54 patients of Dhat syndrome established that the questionnaire was helpful in providing comprehensive clinical picture of Dhat syndrome. Conclusion The questionnaire designed for the purposes of this study is a useful instrument for comprehensive assessment of the clinical picture of Dhat syndrome.

Dhat Syndrome and its Social Impact

“…Few previous studies conducted by Chaddha, et al, 14 Grover S, et al 15 and Gautam M, et al 16 reported that patients complaining of Dhat Syndrome are typically more likely to be young people, who are recently married or single; of average or low socio-economic status, coming from a rural area and belonging to a family with conservative attitudes towards sex while a study conducted by Verma R, et al 17 reported more prevalence from urban area.…”

Analysis of Patients Presenting with Dhat Syndrome and its Impact on Society

“…Few previous studies conducted by Chaddha et al 12 , Grover S et al 13 and Gautam M et al 14 reported that patients complaining of Dhat Syndrome are typically more likely to be young people, who are recently married or single; of average or low socio-economic status, coming from a rural area and belonging to a family with conservative attitudes towards sex while a study conducted by Verma R et al 15 reported more prevalence from urban area…”

Comorbidity, knowledge and attitude towards sex among patients with Dhat syndrome: A retrospective study

“…mass media, magazines, or Lay practitioners. Indigenous practices of medicine including Ayurveda reinforce the beliefs which increase distress associated with semen loss (Behere and Natraj, 1984;Bhatia et al, 1989;Bhatia and Malik, 1991;Deb and Balhara, 2013;Grover et al, 2014;Jhanjee et al, 2011;Malhotra and Wig, 1975;Nakra et al, 1977;Singh, 1985). As such it is assumed that patients with Dhat syndrome are misinformed about various aspects of semen formation.…”

“…The belief that loss of semen is the factor responsible for underlying physical and mental illness and sexual problems is the common thread in these subjects (Behere and Natraj, 1984;Bhatia et al, 1989;Bhatia and Malik, 1991;Grover et al, 2014;Jhanjee et al, 2011;Malhotra and Wig, 1975;Nakra et al, 1977;Singh, 1985). Patients attribute passage of Dhat to reasons such as masturbation and/or excessive indulgence in sexual activities, venereal diseases, urinary tract infections, overeating, constipation or worm infestation, disturbed sleep, or genetic factors (Bhatia and Malik, 1991;Grover et al, 2014;Jhanjee et al, 2011;Patil et al, 1996) Majority of the patients have been found to harbour associated masturbatory guilt (Behere and Natraj, 1984). Nakra et al (1977) found that patients with Dhat syndrome considered loss of semen as harmful, when compared to patients with sexual dysfunction.…”

“…It is commonly accompanied by anxiety or depressive symptoms. These patients may also present with or without psychosexual dysfunction (Grover et al, 2014;Singh, 1985).…”