Prevalence of depression and anxiety in Dhat syndrome patients attending a psychosexual clinic in the Psychiatry Department of a tertiary health care centre in Ahmedabad

Introduction
The term Dhat comes from the Sanskrit word Dhatu. There have been mentions of various syndromes related to semen loss not only in cultures of developing countries but also in the western world. Dhat syndrome is mentioned in the ancient Sushrut-Samhita. As per DSM-V, Dhat syndrome is considered a cultural explanation of distress for patients who refer to diverse symptoms, such as anxiety, fatigue, weakness, weight loss, impotence, other multiple somatic complaints, and depressive mood.

Aim
To determine the prevalence and severity of depression and anxiety in patients with Dhat syndrome.

Material and methods
All consecutive patients (54) presenting with the complaint of Dhat emission were included. Patients who were non-consensual, having depression and anxiety before onset of Dhat syndrome and those having sexually transmitted infections (STIs) or any organic cause for whitish discharge from the penis were excluded. A semistructured questionnaire of socio-demographic characteristics and variables regarding sexual history related to Dhat was used. Hamilton Depression (HAM-D) Scale and Hamilton Anxiety (HAM-A) Scale were used.

Results
Of the 54 patients about 25.93% had mild symptoms of depression, 14.81% had moderate severity, while 9.26% had severe symptoms of depression, while the remaining 50% of them were normal. While 74% had anxiety of mild severity, 19% had mild to moderate severity and 7% moderate to severe intensity of anxiety. Also 51.85% had comorbid sexual dysfunctions (erectile dysfunction – ED, premature ejaculation – PME).

Conclusions
The primary disease, being depression and anxiety, which are often missed and are resistant to treatment due to their strong basis in cultural misbelief of semen loss, needs to be tackled aggressively.