Dhat Syndrome with mixed depression and anxiety: A case report from North India

BACKGROUND: Dhat Syndrome,term coined by Dr.N.N.Wig, also described under ‘semen loss syndrome’ or ‘semen loss anxiety’, is a culture bound syndrome predominant in the South Asian sub continent. The patient believes that he is incurring energy loss (physical and psychological) through loss of semen by various ways which leads to depressive or anxiety features. AIM: To discuss Dhat Syndrome and associated symptoms in a young male patient. METHODOLOGY: A 26yr old male hailing from rural background presented with generalized weakness,feeling tense,low mood,decreased concentration and sleep since 5yrs. Detailed exploration revealed the apparent cause behind patient’s complaints to be loss of semen through masturbation (Arizona Sexual Experience Scale showed no sexual dysfunction). His systemic physical examination and blood investigations showed no abnormality though patient was convinced that he was losing ‘important minerals’ due to masturbation and wanted to desist the harmful act forever. He was diagnosed with Dhat Syndrome(F 48.8) with moderate depression(F 32.1) and was started on Tab Escitalopram 10mg/day increased to 20mg/day over 2 weeks plus T.Clonazepam 0.5mg/day along with weekly supportive psychotherapy sessions. He showed improvement over next 3 months (Beck Depression inventory score 28 to 15 and Hamilton anxiety rating scale score 16 to 10) CONCLUSION: Dhat syndrome is a curable disorder more common than appears worldwide(described under different terminologies) and requires multidimensional treatment approach.