Dhat Syndrome: Depression, Help-Seeking and Patient Beliefs About Causation and Consequences

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Introduction: Dhat syndrome is a culture-bound syndrome seen in the Indian subcontinent and also similar syndrome has been described in another part of the world.Aims: To explore socio-demographic characteristics, associated depression, prior help-seeking, and beliefs regarding causation and consequences in patients with Dhat syndrome.Method: Prospective study on 100 patients of dhat syndrome attending Psychiatry department as an outpatient in a tertiary care general hospital in western India.Depression was assessed by the Patient Health Questionnaire (PHQ 9).Patients were interviewed for beliefs about dhat, prior help-seeking, and explanations of dhat offered by the helpers.Patients' views why they have dhat syndrome and opinions about the consequences of dhat syndrome were explored.Results: The majority were the young adult, migrant workers from neighbouring states with education up to high school, and belonging to lower socioeconomic status.Depression was found in 38 % case.Patients reported a significant decline in sexual functioning after the onset of dhat-18 had premature ejaculation, 28 had erectile dysfunction and 20 had small penis size as associated complaints.Most patients had consulted non-psychiatry 'experts'-quacks, general practitioners or practitioners of Ayurved/homoeopathy/ Unani, and dermatologist-venereologist.Most patients believed that dhat can cause somatic symptoms are commonly seen in depression as well as sexual dysfunctions. Conclusion:The study largely confirms the findings of earlier studies on dhat syndrome.A significant proportion of patients are having depression and decline in sexual satisfaction and sexual dysfunctions.They also believe sexual myths often propagated by quacks.

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