Dhat Syndrome: Physical and Psychological Implications

Abstract

Dhat Syndrome is commonly reported in the Indian sub continent. Previous researches conduced in India and Sri Lanka has employed clinical observations and informal assessment procedures and no formal assessment tool has yet been developed to examine manifestation of Dhat Syndrome. Main objectives of the present research were to develop Dhat Syndrome Symptom Checklist (DSSC) and to examine manifestation and implications of Dhat Syndrome. A series of studies were carried out to develop DSSC and examine manifestation and implications of Dhat Syndrome. Dhat Syndrome Symptom Checklist (DSSC) was developed through in-depth interviews of health professionals, patients with Dhat Syndrome as well as in consultation with existing literature. Psychometric properties of DSSC were estimated using Inter rater Congruence, Factor Analysis and Reliability Analysis. A final DSSC comprised of 62 symptoms with three subscales i.e. Physical, Psychological and Sexual symptoms (Studies 2 -6). Main study aimed to examine manifestation and implications of Dhat Syndrome. It was hypothesized that patients with Dhat Syndrome would manifest variety of Physical Psychological and Sexual symptoms. Patients with Dhat Syndrome (N = 318) were recruited from private practice of health professionals. Semi Structured Interview Schedule, DSSC and General Health Questionnaire (GHQ-28) were used for assessment and individual assessment of patients was carried out. Data was analyzed using descriptive and inferential statistics. Descriptive statistics indicated that majority of the patients were consulting Hakims and Homeopaths and typical profile of Dhat Syndrome patient in Pakistan is a young, single, less educated man with poor socioeconomic status. Dhat Syndrome had xviadverse implications for patients’ health, particularly physical and sexual health, and marital life. Premature ejaculation and nocturnal emissions were main reasons for referral, whereas masturbation and exposure to pornographic material was reported as major causes of Dhat Syndrome. Inferential statistics revealed that sexual weakness, education, discharge before urine, perceived implications of Dhat Syndrome on physical and sexual health, severity of the problem, lack of information and diet were significant predictors of “Physical Symptoms”. Sexual weakness, perceived implications of Dhat Syndrome on patient’s life, lack of information and “emission” emerged as significant predictors of “Psychological Symptoms”. Sexual weakness, perceived implications of Dhat Syndrome on health, “emission” and age were significant predictors of “Sexual Symptoms”. Most patients fell above caseness scores on somatic complaints and anxiety. Somatic complaints were experienced the most and depression the least. There was positive relationship between somatic complaints, anxiety, social dysfunctioning, depression and DSSC symptoms. DSSC physical and sexual symptoms, perceived implications of semen loss for patients’ life emerged as significant predictors of somatic complaints in patients. Anxiety in patients was predicted by DSSC physical and psychological symptoms, perceived implications of Dhat Syndrome for patients’ life and “discharge before urine”. DSSC sexual, psychological and physical symptoms, perceived psychological effects of Dhat Syndrome, lack of information about sex and “nocturnal emission” predicted depression in patients. DSSC psychological and physical symptoms emerged as significant predictors of social dysfunctioning in patients.Sex is a tabooed area in Pakistan and this is the first systematic study on Dhat Syndrome in Pakistan. DSSC would be a useful tool for diagnosticians, clinicians and researchers. Findings of the study have very important implications for the patients, health professionals and researchers and warrant the need for counselling services as well as sex education. Moreover, further investigations on sexual health in general and Dhat Syndrome in particular are also recommended. KEY WORDS: Dhat Syndrome, Dhat Syndrome Symptom Checklist, Manifestation, Implications, Hakims, Homeopaths, General Health Questionnaire, Somatic Complaints, Anxiety, Depression, Social Dysfunctioning, Emissions, Discharge before Urine, Nocturnal Emissions.