Psychological correlates and psychiatric morbidity in patients with Dhat syndrome

Abstract

Aim:The aim of this study was to examine psychological factors in the form of somatosensory amplification, alexithymia and hypochondriasis in patients with Dhat syndrome. Secondary aims of the study were: (1) To evaluate the influence of psychiatric comorbidity on the psychological correlates; (2) to compare the prevalence of psychological correlates in those with Dhat syndrome and in those with depression and somatoform disorders.Materials and Methods:A total of 106 subjects diagnosed with Dhat syndrome as per International Classification of Diseases-10 (ICD-10) criteria were assessed on Toronto Alexithymia Scale (TAS-20), Somatosensory Amplification Scale (SSAS) and Whitely Index (WI). Psychiatric comorbidity was diagnosed as per ICD-10. Data on 50 patients with depression and 119 patients with somatoform disorder was used for comparison.Results:The age at onset of Dhat syndrome was 22.54 (standard deviation [SD] - 7.5) years, and duration of illness was 5.04 (SD - 4.2) years. Depressive disorders were diagnosed in 13.2%, anxiety disorders in 15.1%, erectile dysfunction in 14.2% and premature ejaculation in 17% of cases. The mean SSAS total score was 23.12 (SD - 7.99), mean total TAS-20 score was 63.3 (SD - 13.3) and mean WI score was 8.23 (SD - 2.7). About two third of the patients had alexithymia (n = 67; 63.2%) and hypochondriasis (n = 69; 65.1%). Comparison of the psychological correlates between those with Dhat syndrome alone (n = 59) and those with comorbid psychiatric disorder (n = 47) revealed no significant differences. Patients with only Dhat syndrome had significantly higher scores for somatosensory amplification when compared with those with somatoform disorders, but no difference was seen between those with depression and Dhat syndrome alone. Compared to patients with Dhat syndrome alone, those with depression had higher prevalence of alexithymia and hypochondriasis.Conclusion:There are differences in the prevalence of somatosensory amplification, hypochondriasis and alexithymia between those with Dhat syndrome alone and those with depression and somatoform disorders.

Burden of Misconception in Sexual Health Care Setting: A Cross-Sectional Investigation among the Patients Attending a Psychiatric Sex Clinic of Bangladesh

“…The distribution of misconception was found more in the younger age (Figure 1) and that is supported by previous literature of Dhat syndromes and/or cultural bound syndrome [6–8]. Dhat syndrome is a culture bound syndrome of the Indian subcontinent which is characterized by preoccupation with loss of “Dhat” (semen) and attribution of different physical and psychological symptoms [6–8]. Dhat syndrome is placed in the classificatory system (DSM-IV and ICD-10) earlier, but in DSM 5 it is placed in the glossary section [6, 11–13].…”

“…The results revealed that total of about 55% patients visited for their problems along with sexual misconception and about 29% patients visited for their problem caused only for their misconception (Tables 2 and 3). Previous available studies and articles revealed similar pattern of presentation and services consumptions [6–8]. Arafat SMY mentioned Dhat syndrome is a frequently presented but underaddressed misconception in the primary care level of Bangladesh and the syndromal presentation is well recognized in this culture [6–8].…”

“…Previous available studies and articles revealed similar pattern of presentation and services consumptions [6–8]. Arafat SMY mentioned Dhat syndrome is a frequently presented but underaddressed misconception in the primary care level of Bangladesh and the syndromal presentation is well recognized in this culture [6–8]. Depression was found as most common psychiatric comorbidity and the result can be explained by the pathophysiology and symptom presentation of depression [9, 10].…”

Dhat Syndrome: A Review and Update

“…32 Patients of Dhat syndrome with comorbid depression have more features of hypochondriasis and high somatosensory amplification than those having Dhat syndrome without comorbidity. 17 High scores of neuroticism are also reported in patients with Dhat syndrome. 18 Rarely, Dhat syndrome may be associated with recurrent brief depressive disorder.…”

“…Patients with Dhat syndrome are often young males from rural background with poor level of education. 2, 17 The onset of symptoms often occurs in the second or the third decade of life. 18 Oftentimes, they harbor the belief that semen is precious and its loss may have several adverse consequences.…”