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Dhat

The word dhat comes from the Sanskrit language and means 'metal', 'elixir', or 'constituent part of the body'.^[1]

The syndrome of "dhat" is found in the DSM-IV TR ^[2]

'Dhat' is a culture bound syndrome that is characterized by vauge symptoms of fatigue, weakness, anxiety, guilt and sexual dysfunction, loss of appetite, which is preceded by the patient loosing semen through urine and masturbation.^[3]

Symptoms

Common symptoms include:

weakness
fatigue
palpitations
sleeplessness.

Most significantly, patients attribute these symptoms to a white discharge in their urine (which they claim is a ‘vital substance’ – semen). Losing such a vital substance thus generates anxiety and dysphoria. The condition has no known organic aetiology. Medical literature commonly refers to dhāt as a sex neurosis of the Indian subcontinent that is widely regarded as a culture-bound syndrome, and it continues to be extensively reported despite a prediction that the syndrome will ‘become less common with increasing literacy and progress in sex knowledge'.

The ancient Ayurvedic describe the process of semen production as: food converts to blood, which converts to flesh, which converts to marrow, and the marrow is eventually converted into semem. Also, it describes a process that assumes it takes 40 days for 4 drops of food to be changed into one drop of blood. It goes on to calculate 40 drops of blood into one drop of flesh. These ancient beliefs create a sense of great fear in these individuals if they lose one drop of semen. ^[4]

Dhat syndrome is a condition which inflicts people from the Indian subcontinent with various symptoms such as fatigue and keeps the individual preoccupied with semen loss. There are some differences and similarities with other conditions with somatic symptoms. When under stress the individual may focus on physiological changes such as turbidity of urine and tiredness, which in many cultures is attributed to semen loss.

Occurance

Dhat is a condition that is seen most frequently among young men (age range: 20–38 years), presenting at medical and psychiatric clinics in South Asian countries. Prevalence rates of 11.7% (India) to 30% (Pakistan), suggest the disorder is pervasive.

Dhat is a syndrome which occurs mostly in the Southern Asian countries. This disorder occurs most frequently among young men. This disorder has a high rate of prevalence in India and Pakistan and appears to be pervasive.

The ancient Ayurvedic describe the process of semen production as: food converts to blood, which converts to flesh, which converts to marrow, and the marrow is eventually converted into semem. Also, it describes a process that assumes it takes 40 days for 4 drops of food to be changed into one drop of blood. It goes on to calculate 40 drops of blood into one drop of flesh. These ancient beliefs create a sense of great fear in these individuals if they lose one drop of semen. This in turn leads to person to suffer from anxiety.

Similarities with other conditions

There are some differences and similarities with other conditions with somatic symptoms. When under stress the individual may focus n physiological changes such as turbidity of urine and tiredness, which in many cultures is attributed to semen loss. ^[5]

There are many similarities found between "dhat" and other functional somatic syndromes. These similarities include symptoms such as anxiety and fatigue.Chronic fatigue is a common symptom in developing cultures, and leads us to the idea that fatigue as a symptoms is universal but the illness that is attributed to this symptoms appears to relate specifically to cultural and societal attitudes.

Furthermore, the unusual presentation may be unique expression of the illness which is specified to the culture. Chronic fatigue syndrome (CFS), irritable bowel syndrome, and fibromyalgia are considered to be distinctly different disorders, but many similarities exist between these and lead researchers to believe that these syndromes should be classified together as functional somatic syndromes.

Treatments

Often, suffers tend to consult a number of healers such as medical doctors and venereologists in order to tend to symptoms. The majority of patients seem to respond to simple reassurance and placebo treatments. Although counseling has not been shown to be effective and patients often tend to drop out. In any case, a condition with no clear medical explanation often follow a randomized pattern of course and outcome.

References

^ Sushrut Jadhav (2004). "Dhat Syndrome: A Re-evaluation" [www.indianpsychiatry.com/dhat..pdf]
^ Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision. Washington, DC: American Psychiatric Association.
^ Medical Geek (2007).[1]
^ Ranjith G; Mohan R (2006). "Psychiatry: Interpersonal & Biological Processes"[[2]
^ Meenakshi, Gautham (March 2008)."Socio-cultural, psychosexual and biomedical factors associated with genital symptoms experienced by men in rural India" [3]

[1] Sushrut Jadhav (2004). "Dhat Syndrome: A Re-evaluation" [www.indianpsychiatry.com/dhat..pdf]

[2] Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision. Washington, DC: American Psychiatric Association.

[3] Medical Geek (2007).[1]

[4] Ranjith G; Mohan R (2006). "Psychiatry: Interpersonal & Biological Processes"[[2]

[5] Meenakshi, Gautham (March 2008)."Socio-cultural, psychosexual and biomedical factors associated with genital symptoms experienced by men in rural India" [3]

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