Dhat Syndrome: Study of Clinical Presentations in a Teaching Institute of Eastern Nepal

Abstract

Background: “Dhat syndrome” is described as a culture-bound syndrome, common mainly in the Southeast Asian region, including Nepal. We have limited data on this problem from Nepal. Objective: To study clinico-demographic profile of “Dhat syndrome” cases, with the focus on its clinical presentations seen in psychiatry out-patient clinic of B. P. Koirala Institute of Health Sciences (BPKIHS). Methodology: All consecutive out-patients with the diagnosis of “Dhat syndrome” coming into contact of the investigator in psychiatry OPD were enrolled during 12 months of study period. A pretested short questionnaire, including their view about “semen loss” and “masturbation,” was used. Psychiatric diagnoses were made according the International Classification of Diseases, Tenth Revision (ICD-10). Results: Majority of the subjects were of productive ages; average age was 25 years. More of them were of Terai origin and from villages, though there were people also from other ethnic groups and urban settings. Most of them were educated but up to a middle/secondary level only. Most of the cases presented with depressive and anxiety symptoms, and semen loss, and were worried because they had heard or read that semen loss or masturbation was bad for health. They viewed semen as precious, something to be preserved, and masturbation a bad practice. Beside Dhat syndrome, two-thirds of the subjects (68%) had other ICD-10 psychiatric disorders, the most common being depression. Conclusion: Psychiatric diagnoses are common among patients with “Dhat syndrome.” Most of these people view semen loss as a bad sign and masturbation a bad habit. Sex education is warranted for better health.