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Tripathi A. Predatory Advertising and Lack of Sex Education for Sexual Difficulties in India: A Double Whammy for Adolescent and Young Adults. Indian J Psychol Med 2024; 46:181-182. [PMID: 38725726 PMCID: PMC11076930 DOI: 10.1177/02537176231208627] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/12/2024] Open
Affiliation(s)
- Adarsh Tripathi
- Dept. of Psychiatry and In-charge, Sexual Medicine Unit, King George’s Medical University, Lucknow, Uttar Pradesh, India
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2
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Joshi S, Tripathi A, Agarwal S, Singh N, Gupta B, Nischal A, Kar SK. Phenomenology, disability and sexual functioning in female Dhat syndrome: a study of tertiary care gynaecology outpatients. Gen Psychiatr 2022; 35:e100863. [PMCID: PMC9562279 DOI: 10.1136/gpsych-2022-100863] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Accepted: 09/28/2022] [Indexed: 11/07/2022] Open
Abstract
Background Dhat syndrome, a clinical condition related to semen loss in urine often found among males in India, has rarely been described as a separate clinical condition in females. Women with the syndrome complain of passing vaginal discharge and can be excessively concerned and preoccupied with it, often attributing various physical symptoms to the loss of vaginal fluids. Aims This study aimed to assess the sociodemographic and clinical profiles of female patients with Dhat syndrome and their perceived stress, disability and sexual functioning. Methods Sociodemographic details of 70 females with non-pathological vaginal discharge were evaluated with a semistructured sociodemographic assessment. The phenomenology of the vaginal discharge was assessed with the Scale for Assessment of Female Dhat Syndrome Questionnaire. Anxiety and depressive symptoms were measured with the Hospital Anxiety and Depression Scale. Perceived stress in the past month and disability caused by the illness were assessed with the Perceived Stress Scale and the World Health Organization Disability Assessment Scale. In addition, the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Level 2 Somatic Symptoms Scale was administered to rate the severity of somatic symptoms, and sexual functioning was evaluated using the Female Sexual Function Index (FSFI) scale for women who had had sexual intercourse in the past month. Results The mean age of onset vaginal discharge was 23.0 (6.6) years. Biological factors, such as urinary tract infection, were the commonly attributed cause of the loss of vaginal fluids. Psychiatric comorbidity and perceived moderate stress in the past month were found in 38.6% and 68.6% of female patients with Dhat syndrome, respectively. Disability scores tended to be low. Among the females having had sexual intercourse in the past month, 48.3% had FSFI scores indicative of a female sexual disorder. Conclusions The clinical presentation of women with non-pathological vaginal discharge is similar to that of males with Dhat syndrome. It requires comprehensive assessment and management that targets the biological, social and psychological factors and cultural issues.
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Affiliation(s)
- Shubha Joshi
- Department of Geriatric Mental Health, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - Adarsh Tripathi
- Department of Psychiatry, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - Smriti Agarwal
- Department of Gynaecology and Obstetrics, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - Nisha Singh
- Department of Gynaecology and Obstetrics, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - Bandna Gupta
- Department of Psychiatry, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - Anil Nischal
- Department of Psychiatry, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - Sujita Kumar Kar
- Department of Psychiatry, King George's Medical University, Lucknow, Uttar Pradesh, India
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3
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Strong YN, Li A, White ME, Razzak AN, Anderson DJ, Kaye AD, Herron EW, Khater NP, Bradley EC, Urits I. Dhat Syndrome: Epidemiology, Risk Factors, Comorbidities, Diagnosis, Treatment, and Management. Health Psychol Res 2022; 10:38759. [PMID: 36425228 PMCID: PMC9680840 DOI: 10.52965/001c.38759] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2023] Open
Abstract
Dhat syndrome is a culture-bound psychiatric syndrome most commonly found in the Indian subcontinent. It has been characterized as the experiential fear of losing semen through ejaculation, nocturnal emission, or other means. While Dhat syndrome is common in the Indian subcontinent, given the lack of representativeness, generalizability, and closer connection to Ayurvedic system, there have been limited studies or recognition of symptoms among healthcare providers around the world. In this review, we describe Dhat syndrome, its epidemiology, risk factors, comorbidities, diagnosis, treatment, and its management. For patients with Dhat syndrome, it becomes important to appreciate how generalized depression and anxiety may persist alongside the disorder and those symptoms can be common and non-specific. Related to its strong cultural connection with South Asia such as the belief on Dhat's role in health and vitality influence, it also becomes important to recognize that the syndrome can be found in other populations and the importance of cultural humility and nonconfrontational approach for patient care. In summary, this review provides an informative understanding of Dhat syndrome for non-Indian clinicians who may not be prepared for a patient encounter with vague somatic symptoms in the context of semen loss. Treatment for Dhat syndrome is the same as treatments for major depressive disorder.
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Affiliation(s)
| | - Angel Li
- School of Medicine, Medical College of Wisconsin
| | | | | | | | - Alan D Kaye
- Department of Anesthesiology, Louisiana State University Health
| | - Edwin W Herron
- Department of Anesthesiology, Louisiana State University Health
| | - Nazih P Khater
- Department of Urology, Louisiana State University Health
| | - Elyse C Bradley
- Department of Anesthesiology, Louisiana State University Health
| | - Ivan Urits
- Department of Anesthesiology, Louisiana State University Health Shreveport; Southcoast Health, Southcoast Health Pain Management
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Shahi MK, Tripathi A, Singh A, Kar SK, Nischal A, Singh S, Dalal PK. Quality of Life and Disability in Patients with Dhat Syndrome: A Cross-Sectional Study. Indian J Psychol Med 2022; 44:459-465. [PMID: 36157022 PMCID: PMC9460013 DOI: 10.1177/02537176221078422] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Dhat syndrome (DS) is considered a culture-bound syndrome of South East Asia. It is often associated with multiple sexual and psychiatric comorbidities. We aimed to assess the quality of life (QoL) and disability in patients of DS with and without comorbidity. METHODS This cross-sectional study included 117 patients with DS and 117 matched controls. DS was diagnosed based on the International Classification of Diseases, 10 version, Diagnostic Criteria for Research diagnostic criteria. Comorbidities were assessed on MINI 6.0.0, and the patients were divided into two groups (with and without comorbidity). The QoL and disability were estimated and compared between patients with and without comorbidity and their respective control groups consisting of healthy volunteers, using standardized tools. RESULT Most of the patients were unmarried males aged 18 to 25 years and from rural backgrounds. Most of the patients (72.64%) had comorbidities (psychiatric/sexual). The QoL of patients with DS was poor compared to healthy individuals. The QoL of patients with comorbidity was worse than that of those without them (P < o.ooo). The disability of patients with DS was more than that of healthy individuals (significant in all domains of the World Health Organization Disability Assessment Schedule [WHODAS]). CONCLUSION Patients having DS had poor QoL and higher disability than healthy controls. Patients having psychiatric or sexual comorbidities had less QoL and higher disability compared to healthy controls and those without comorbidities.
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Affiliation(s)
- Mohit Kumar Shahi
- Dept. of Psychiatry, Autonomous State Government Medical College, Firozabad, Uttar Pradesh, India
| | - Adarsh Tripathi
- Dept. of Psychiatry, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - Astha Singh
- Dept. of Psychiatry, Hind Institute of Medical Sciences, Safedabad, Barabanki, Uttar Pradesh, India
| | - Sujita Kumar Kar
- Dept. of Psychiatry, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - Anil Nischal
- Dept. of Psychiatry, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - Shweta Singh
- Dept. of Psychiatry, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - Pronob Kumar Dalal
- Dept. of Psychiatry, King George's Medical University, Lucknow, Uttar Pradesh, India
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5
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Salmon M, Sibeoni J, Harf A, Moro MR, Ludot-Grégoire M. Systematic review on somatization in a transcultural context among teenagers and young adults: Focus on the nosography blur. Front Psychiatry 2022; 13:897002. [PMID: 35958663 PMCID: PMC9358691 DOI: 10.3389/fpsyt.2022.897002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Accepted: 06/27/2022] [Indexed: 11/15/2022] Open
Abstract
Aims Somatic complaints are a frequent cause for consultation in primary care. In a transcultural context, somatic complaints are typically associated with psychological distress. A recent review about somatic symptom disorders in adolescence showed some nosographic heterogeneity and outlined various etiological hypotheses (traumatic, environmental, or neurologic), separate from the cross-cultural considerations. Migrants' children encounter specific problems involving cultural mixing-issues of filiation (familial transmission) and affiliation (belonging to a group). This paper aims to provide a systematic review of somatization in transcultural contexts among teenagers and young adults, aged 13 to 24, over the past decade. Methods This review adheres to the quality criteria set forth by the PRISMA guidelines (Preferred Reporting Items for Systematic Reviews and Meta-Analyses). Two authors queried three English databases (Medline, PsycInfo, WebOfScience) about somatization in transcultural contexts (migrant or non-Western population) among teenagers (13-18), young adults (19-24), or both. The methodological process comprised articles selection, data extraction, and then the analysis of emerging themes. Setting selection criteria to limit the transcultural field was difficult. Results The study analyzed 68 articles. We present a descriptive analysis of the results, centered on three main themes. First, the literature highlights a nosographic muddle reflected in the combination of anxious and depressive symptoms together with the highly variable symptomatology. Second, discrimination issues were prevalent among the migrant population. Lastly, the literature review points out possibilities for improving a care pathway and reducing the diagnostic delay induced by migrants' hesitancy about Western care and the recurrent use of inappropriate diagnostic criteria. Conclusion This review discusses the links between the nosographic muddle described here and the diagnostic delays these patients experience and raises concerns about rigid diagnostic compartmentalization. The work of the psychiatrist Frantz Fanon is here useful to understand externalized symptoms resulting from physical and psychological confinement. Discrimination issues raise questions about the cultural counter-transference health professionals experience in dealing with young migrants. Defining healthcare professionals' representations about somatic complaints in a transcultural context might be a fruitful path to explore in future research. Protocol PROSPERO registration number CRD42021294132. Available from: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42021294132.
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Affiliation(s)
- Mathilde Salmon
- APHP, Hôpital Cochin, Maison de Solenn, Paris, France
- Faculté de Médecine, Université Paris-Saclay, Le Kremlin-Bicêtre, France
| | - Jordan Sibeoni
- Service Universitaire de Psychiatrie de l'Adolescent, Centre Hospitalier d'Argenteuil, Argenteuil, France
- ECSTRRA Team, UMR-1153, Inserm, Université de Paris, Paris, France
| | - Aurélie Harf
- APHP, Hôpital Cochin, Maison de Solenn, Paris, France
- Université Paris-Saclay, UVSQ, Inserm, CESP, Team DevPsy, Villejuif, France
| | - Marie Rose Moro
- APHP, Hôpital Cochin, Maison de Solenn, Paris, France
- Université Paris-Saclay, UVSQ, Inserm, CESP, Team DevPsy, Villejuif, France
- Université de Paris, PCPP, Boulogne-Billancourt, France
| | - Maude Ludot-Grégoire
- APHP, Hôpital Cochin, Maison de Solenn, Paris, France
- Université Paris-Saclay, UVSQ, Inserm, CESP, Team DevPsy, Villejuif, France
- Université de Paris, PCPP, Boulogne-Billancourt, France
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Arafat SMY, Mondal F, Ghimire S. A 47‐year‐old man passing putrid semen through saliva and sweat: A case of Dhat syndrome. J Gen Fam Med 2021; 23:177-179. [PMID: 35509340 PMCID: PMC9062537 DOI: 10.1002/jgf2.513] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2021] [Revised: 11/03/2021] [Accepted: 11/18/2021] [Indexed: 11/25/2022] Open
Abstract
Dhat syndrome is a culture‐bound syndrome in which patients believe that they pass Dhat (semen) with their urine, feces, sweat, and saliva that causes lethargy, apathy, dysphoria, and depression. Here, we report a case of a 47‐year‐old man who presented with complaints of burning sensation in the whole body, especially in the pubic region, and insomnia for the last 5 years. This case could be enlightening for clinicians in South Asia in daily clinical practice and family physicians in Western countries where immigrants from Dhat syndrome prevailing countries could present with complex cultural myths and superstitious beliefs. Dhat syndrome is a culture‐bound syndrome in which patients believe that they pass Dhat (semen) with their urine, feces, sweat, and saliva that causes lethargy, apathy, dysphoria, and depression. Here, we report a case of a 47‐year‐old man who presented with complaints of burning sensation in the whole body, especially in the pubic region, and insomnia for the last 5 years. We consider Dhat syndrome as the patient has the belief that he has been losing his semen through his saliva, sweat, feces, and urine, which is the reason for his current illness.
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Affiliation(s)
- S. M. Yasir Arafat
- Department of Psychiatry Enam Medical College and Hospital Dhaka Bangladesh
| | - Firoj Mondal
- Department of Psychiatry Enam Medical College and Hospital Dhaka Bangladesh
| | - Sabina Ghimire
- Department of Psychiatry Enam Medical College and Hospital Dhaka Bangladesh
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Kar SK, Menon V, Arafat SY, Singh A, Das A, Shankar A, Sharma P, Perera S. Dhat syndrome: Systematic review of epidemiology, nosology, clinical features, and management strategies. Asian J Psychiatr 2021; 65:102863. [PMID: 34563955 DOI: 10.1016/j.ajp.2021.102863] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2021] [Revised: 08/20/2021] [Accepted: 09/09/2021] [Indexed: 11/17/2022]
Abstract
BACKGROUND Dhat syndrome is a culture-bound syndrome prevailing in the Indian subcontinent, first described in the 1960s. Over time, newer studies are exploring various aspects of Dhat syndrome, including its epidemiology, nosology, clinical features, and management predominantly in South Asia. We aimed to review the epidemiology, nosology, clinical presentation, and management of Dhat syndrome over the last six decades through a systematic review of studies. METHODS We searched PubMed and Scopus using the following search terms - "Dhat syndrome," "Semen loss syndrome," "Semen loss anxiety" together with the Boolean operator OR. We collected the articles from inception till March 2021. We included articles in the English language published in peer-reviewed journals. RESULTS A total of 89 articles were included in the analysis. Most of the articles were published in the last decade (2011-2020). Most of the publications were cross-sectional studies and of unsatisfactory quality. Most of the studies lack representativeness of the population; hence the generalizability of the findings was poor. Most of the articles discussed phenomenology (64%), overview (52.8%), and cultural basis of Dhat syndrome. The comorbidities associated with Dhat syndrome were discussed in 37.1% of the articles. The nosological status of Dhat syndrome and management of Dhat syndrome was discussed in 18% of publications each; whereas, the outcome of Dhat syndrome was discussed in 5.6% of articles. CONCLUSION Though Dhat syndrome is a commonly diagnosed entity in the South Asian population, the research on Dhat syndrome is sparse and of poor quality.
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Affiliation(s)
- Sujita Kumar Kar
- Department of Psychiatry, King George's Medical University, Lucknow 226003, India.
| | - Vikas Menon
- Dept of Psychiatry, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Dhanvantri Nagar, Puducherry 605006, India.
| | - Sm Yasir Arafat
- Assistant Professor of Psychiatry, Enam Medical College and Hospital, Dhaka 1340, Bangladesh.
| | - Amit Singh
- Department of Psychiatry, King George's Medical University, Lucknow 226003, India.
| | - Anamika Das
- Divisional Railway Hospital, Asansol, Eastern Railway, India.
| | - Akanksha Shankar
- Department of Psychiatry, King George's Medical University, Lucknow 226003, India.
| | - Pawan Sharma
- Department of Psychiatry, School of Medicine, Patan Academy of Health Sciences, Lalitpur, Nepal.
| | - Sayuri Perera
- Department of Psychiatry, Faculty of Medicine, University of Peradeniya, Sri Lanka.
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A Bibliometric Analysis of Dhat Syndrome. PSYCHIATRY INTERNATIONAL 2021. [DOI: 10.3390/psychiatryint2040029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Dhat syndrome is a culture-bound syndrome, mostly prevailed in South East Asia that has been systematically defined approximately six decades ago. Assessment of the published literature would help to identify the research density as well as the gaps. We aim to do a bibliometric analysis of published global scientific literature on dhat syndrome. The Scopus database was systematically searched by using the keywords “Dhat syndrome”, “Semen loss syndrome”, “Semen loss anxiety” from inception to 11th August 2021. A total of 89 articles on dhat syndrome were found in the Scopus database. Most of the articles were from India and were published in the Indian Journal of Psychiatry and Asian Journal of Psychiatry. The majority (>58%) of research on dhat syndrome was published in the last decade. The PGIMER (Chandigarh), AIIMS (New Delhi) & KGMU (Lucknow) are the leading institutes in dhat syndrome research. The year 2004 had the highest number of total citations (n = 135), while the year 1975 had the highest number of citations per article (60 citations per article). This bibliometric review identified that despite dhat syndrome is a common condition in the South East Asian countries, research on the condition is limited.
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Tripathi A, Kumar D, Kar SK, Dalal PK, Nischal A. Sociodemographic and Clinical Profile of Patients Presenting With Erectile Dysfunction: Experience From a Tertiary Care Centre of North India. JOURNAL OF PSYCHOSEXUAL HEALTH 2021. [DOI: 10.1177/26318318211031104] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Background: Erectile dysfunction (ED) is one of the most common psychosexual disorders in clinical practice, and it results in significant distress, interpersonal impairments, poor quality of life, and marital disharmony. However, there is limited research on ED in India. Therefore, this study aimed to assess the sociodemographic and clinical profile of patients presenting with ED. Method: Cross-sectional evaluation of patients with ED presenting to the psychosexual outpatient department (OPD) of psychiatry department in a tertiary care hospital was done on structured clinical pro forma, Mini-International Neuropsychiatric Interview, International Index of Erectile Function-5, Arizona Sexual Experience, Hamilton rating scale for depression, and Hamilton rating scale for anxiety. Results: The sample included 102 patients. The mean age was 33.38 years. The majority of the patients were married (81.4%), Hindu (82.4%), residing in a rural area (60.8%), and belonging to a nuclear family (62.7%). The majority of the patients had a moderate level of ED (50%) followed by mild-to-moderate ED (26.5%) and severe ED (23.5%). Premature ejaculation (46.1%) and depression (28.4%) were the most common sexual and psychiatric comorbidities. Obesity was common (62.7%), and only a minority had other metabolic dysfunction, namely dyslipidemia (7.8%), diabetes (5.9%), and hypertension (4.9%). Tobacco dependence and alcohol dependence were present in 37.3% and 6.9% cases, respectively. Conclusion: Young adults with moderate-to-severe ED were present for treatment at a tertiary center. Comorbidities of other sexual disorders, psychiatric disorders, and substance use are commonly encountered in such patients. Promotion of early help-seeking should be encouraged. Clinicians should thoroughly assess even the young patients for other sexual, psychiatric, and medical comorbidities.
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Affiliation(s)
- Adarsh Tripathi
- Department of Psychiatry, King George’s Medical University, Lucknow, Uttar Pradesh, India
| | - Dhirendra Kumar
- Department of Psychiatry, Government Medical College, Jalaun, Orai, Uttar Pradesh, India
| | - Sujita Kumar Kar
- Department of Psychiatry, King George’s Medical University, Lucknow, Uttar Pradesh, India
| | - P. K. Dalal
- Department of Psychiatry, King George’s Medical University, Lucknow, Uttar Pradesh, India
| | - Anil Nischal
- Department of Psychiatry, King George’s Medical University, Lucknow, Uttar Pradesh, India
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Rao TSS. History and mystery of Dhat syndrome: A critical look at the current understanding and future directions. Indian J Psychiatry 2021; 63:317-325. [PMID: 34456344 PMCID: PMC8363894 DOI: 10.4103/psychiatry.indianjpsychiatry_791_20] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2020] [Revised: 10/23/2020] [Accepted: 06/18/2021] [Indexed: 11/13/2022] Open
Abstract
Sexual health, an essential component of individual's health, is influenced by many complex issues including sexual behavior, attitudes, societal, and cultural factors on the one hand and while on the other hand, biological aspects, genetic predisposition, and associated mental and physical illnesses. Sexual health is a neglected area, even though it influences mortality, morbidity, and disability. Dhat syndrome (DS), the term coined by Dr. N. N. Wig, has been at the forefront of advancements in understanding and misunderstanding. The concept of DS is still evolving being treated as a culture-bound syndrome in the past to a syndrome of depression and treated as "a culturally determined idiom of distress." It is bound with myths, fallacies, prejudices, secrecy, exaggeration, and value-laden judgments. Although it has been reported from many countries, much of the literature has emanated from Asia, that too mainly from India. The research in India has ranged from the study of a few cases in the past to recent national multicentric studies concerning phenomenology and beliefs of patients. The epidemiological studies have ranged from being hospital-based to population-based studies in rural and urban settings. There are studies on the management of individual cases by resolving sexual myths, relaxation exercises, supportive psychotherapy, anxiolytics, and antidepressants to broader and deeper research concerning cognitive behavior therapy. The presentation looks into DS as a model case highlighting the importance of exploring sexual health concerns in the Indian population in general and in particular need to reconsider DS in the light of the newly available literature. It makes a fervent appeal for the inclusion of DS in the mainstream diagnostic categories in the upcoming revisions of the diagnostic manuals which can pave the way for a better understanding and management of DS and sexual problems.
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Affiliation(s)
- T S Sathyanarayana Rao
- Department of Psychiatry, JSS Medical College and Hospital, JSS Academy of Higher Education and Research, Mysore, Karnataka, India
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11
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Innamuri R, Ramaswamy D. Demystifying Dhat Syndrome: A Two-Session Therapy Proposal. JOURNAL OF PSYCHOSEXUAL HEALTH 2021. [DOI: 10.1177/26318318211023876] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Dhat syndrome is a common semen-loss related physical and psychological distress usually reported by young males. The treatment mainly centres around nonpharmacological strategies such as psychoeducation. Most of the patients present as outpatients to alternative medicine or nonpsychiatry branches and treatment is usually not delivered. Some of the reasons may include perceived need for longer duration of sessions with the patient, available literature with complex psychiatric jargon and barriers to treatment due to stigma attached to psychiatry. This article presents a two session therapy proposal for Dhat syndrome that could be useful as a brief intervention over tele-consultations, and in consultation liaison clinics by nonpsychiatrists as well.
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Affiliation(s)
- Raviteja Innamuri
- Department of Psychiatry, Christian Medical College, Vellore, Tamil Nadu, India
| | - Deepa Ramaswamy
- Department of Psychiatry, Christian Medical College, Vellore, Tamil Nadu, India
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Chakraborty A, Mukhopadhyay D, Mandal AK, Ghosh S. Study of Dhat Syndrome in Men in West Bengal: A Clinic-Based Study. JOURNAL OF PSYCHOSEXUAL HEALTH 2020. [DOI: 10.1177/2631831820939000] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Background: Dhat syndrome is a culture-bound syndrome of the Indian subcontinent. Traditional and cultural teachings through generations, and myths and misconceptions about sex are its principal contributing factors. Although prevalent, there is scarcity in studies on Dhat syndrome, particularly from Bengal. Aims and objectives: 1. To study the phenomenology of Dhat syndrome in men attending the out patients department (OPD). 2. To study the comorbid sexual and psychiatric disorders associated with Dhat syndrome. Methodology: This was a cross-sectional observational study conducted in the psychiatric OPD in a tertiary care medical college hospital in West Bengal. The duration of the study was 18 months. 122 patients were included in this study that fulfilled the inclusion and exclusion criteria. The diagnosis of Dhat syndrome was made as per International Classification of Diseases, Tenth Revision, diagnostic criteria for research (DCR) criteria. A semi-structured pro forma was used to obtain sociodemographic variables along with numerous physical and sexual symptoms. Mini International Neuropsychiatric Interview was applied for psychiatric comorbidities. Data were analyzed using Statistical Package for Social Studies 17 by SPSS Inc., Chicago. Results: 122 patients met the inclusion and exclusion criteria. Majority of patients were among age group of 20 to 30 years (60.7%). 56.6% were from the Muslim community and 43.4% were from the Hindu community. 54.1% population was unmarried and 39.3% were newly married. Routes of passage were night falls in 62.3% patients, and 52.5% patients pointed toward passage through urine. Many patients reported passage of semen more than one route. All patients (100%) complained about generalized weakness and thinning of semen. 66.4% had generalized body ache, 55.7% complain about headache, 60.7% decreased body glow, 50% had loss of appetite, 98.4% had decreased self-confidence, sleep disturbance was reported in 34.3% patients, 58.2% reported that their penis was becoming smaller, and 49.2% patients reported decreased sexual capability. The most common comorbid condition was sexual dysfunction (39.3%) followed by depressive disorders (27.9%). Premature ejaculation was found in 54.17% patients and erectile dysfunction in 33.33%. Conclusion: Dhat syndrome is a common culture-bound syndrome in Bengal. It is widespread in the Muslim community also. The importance of exploration of sexual comorbidities in Dhat syndrome is very much needed.
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Affiliation(s)
- Abhijit Chakraborty
- Department of Psychiatry, Calcutta National Medical College and Hospital, Kolkata, West Bengal, India
| | - Debshankar Mukhopadhyay
- Department of Psychiatry, Calcutta National Medical College and Hospital, Kolkata, West Bengal, India
| | - Alok Kumar Mandal
- Department of Psychiatry, Calcutta Pavlov Hospital, Kolkata, West Bengal, India
| | - Srijit Ghosh
- Department of Psychiatry, Calcutta National Medical College and Hospital, Kolkata, West Bengal, India
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Avasthi A, Grover S, Rao TSS. Sexual Disorders: Progress Made and Way Ahead. JOURNAL OF PSYCHOSEXUAL HEALTH 2020. [DOI: 10.1177/2631831819898107] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Although sexuality has a long history in the Indian literature, it is not discussed openly due to various reasons. Although sexual medicine has seen a reasonable growth in the last 70 years, somehow, psychological factors associated with the development of various sexual dysfunctions have not received due importance. Cultural factors which contribute to development and persistence of sexual disorders have not been evaluated properly. In terms of training, there is a wide variation across different centers in this country. There are very few indigenously designed instruments for the assessment of sexual disorders and there is limited data on well-evaluated indigenously designed interventions for the management of various sexual disorders. There is a need to homogenize the training and liaise with other specialists working in this area. Centers with well-developed services for sexual disorders need to start observerships and postdoctoral fellowship programs to train the interested clinicians. There is a need for multicentric studies to generate national-level data.
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Affiliation(s)
- Ajit Avasthi
- Department of Psychiatry, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Sandeep Grover
- Department of Psychiatry, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - T. S. Sathyanarayana Rao
- Department of Psychiatry, JSS Medical College and Hospital, JSS Academy of Higher Education and Research, Mysuru, Karnataka, India
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Psychaesthenic Syndrome: A Review on its Implication in Female Sexual Arousal. JOURNAL OF PSYCHOSEXUAL HEALTH 2019. [DOI: 10.1177/2631831818821542] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Objectives: Psychaesthenic syndrome in the recent classification of DSM-5 comes under ‘Cultural Concepts of Distress.’ This can be the equivalent of Dhat syndrome in males. There is a paucity of literature regarding psychaesthenic syndrome. In this paper, we have tried to review the available literature regarding psychiatric and sexual comorbidities of psychaesthenic syndrome. Our paper also aims to ascertain the role and implication of psychaesthenic syndrome in female sexual arousal. Methods: PubMed, Google Scholar, and other databases were used to conduct the search. Research published in English was included. We searched the databases using the terms ‘psychaesthenic syndrome,’ ‘female Dhat syndrome,’ ‘nonpathological white discharge per vagina (NPWDPV),’ ‘leucorrhea,’ ‘female sexual disorders,’ etc. Results: For this review, we could find around 65 papers pertaining to the subject. These focused on the presence and effect of psychiatric disorders on sexual functioning. The effect of psychaesthenic syndrome on sexual functioning was also explored. The discomfort caused by NPWDPV may itself lead to decreased interest in sex. As inhibited sexual desire and sexual arousal disorder are estimated to be among the most common sexual disorders in women, it is probable that difficulty in sexual arousal is one of the major perceived effects of psychaesthenic syndrome. It has been found that depression often leads to difficulty in sexual arousal, amongst other sexual dysfunctions. Thus, there is an indirect causation of female sexual arousal disorder in psychaesthenic syndrome if depression is the manifestation of the syndrome. Conclusion: Very few studies have been done regarding the role of psychaesthenic syndrome in female sexual arousal till now. We are in the process of a major population-based study to delineate the epidemiological aspects, clinical features, management, and prevention aspects related to psychaesthenic syndrome. This review presents the available literature, issues of concern, and methods to manage NPWDPV.
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Uvais NA. Dhat Syndrome Among the Islamic Populations of India and Pakistan. Oman Med J 2017; 32:442. [PMID: 29026480 DOI: 10.5001/omj.2017.84] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Affiliation(s)
- N A Uvais
- Iqraa International Hospital and Research Center, Calicut, India
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Avasthi A, Grover S, Sathyanarayana Rao TS. Clinical Practice Guidelines for Management of Sexual Dysfunction. Indian J Psychiatry 2017; 59:S91-S115. [PMID: 28216788 PMCID: PMC5310110 DOI: 10.4103/0019-5545.196977] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Affiliation(s)
- Ajit Avasthi
- Department of Psychiatry, PGIMER, Chandigarh, India
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Singh A, Tripathi A, Gupta B, Agarwal V. Pathways to Care for Dhat (Semen Loss Anxiety) Syndrome: A Study from North India. INTERNATIONAL JOURNAL OF MENTAL HEALTH 2016. [DOI: 10.1080/00207411.2016.1238741] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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18
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Affiliation(s)
- Sujita Kumar Kar
- Department of Psychiatry, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - Amit Singh
- Department of Psychiatry, King George's Medical University, Lucknow, Uttar Pradesh, India
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