Dhat syndrome: A case report on a culture-bound challenge
Introduction Dhat Syndrome is a culture-bound entity frequent in the Indian subcontinent. It is characterized by somatic symptoms, together with depressive and anxiety features, specifically focused on the belief of losing semen through urine1. Objectives To describe an atypical Dhat Syndrome ca...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
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Cambridge University Press
2021-04-01
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| Series: | European Psychiatry |
| Subjects: | |
| Online Access: | https://www.cambridge.org/core/product/identifier/S0924933821019416/type/journal_article |
| _version_ | 1827754148875993088 |
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| author | L. Ilzarbe D. Ilzarbe N. Arbelo C. Llach G. Anmella E. Vieta A. Murru |
| author_facet | L. Ilzarbe D. Ilzarbe N. Arbelo C. Llach G. Anmella E. Vieta A. Murru |
| author_sort | L. Ilzarbe |
| collection | DOAJ |
| description |
Introduction
Dhat Syndrome is a culture-bound entity frequent in the Indian subcontinent. It is characterized by somatic symptoms, together with depressive and anxiety features, specifically focused on the belief of losing semen through urine1.
Objectives
To describe an atypical Dhat Syndrome case in European cultural context,and to determine the appropriate diagnostic frame and subsequent therapeutic approach.
Methods
We present the case of a 37-year-old Indian man attended in our psychiatric outpatient unit mainly due to somatic complaints (gastrointestinal, sexual dysfunction, weakness, and dizziness). He interpreted his problem as possibly due to diabetes and hypothyroidism, and specifically from sugar loss in urine. Organic diseases were excluded.
Results
Although considered as culture-bound, Dhat syndrome has been classified as a subtype of depression, anxiety disorder, somatoform disorder2,3,4, and even a prodromal phase of schizophrenia5. Antidepressants and benzodiazepines are the most recommended pharmacological treatments1. Antipsychotic agents have been used when clear psychotic symptoms were present (auditory hallucinations,delusions)5. Nonetheless, paliperidone 6mg/d was initiated at baseline, with good response and partial remission of the symptoms at two weeks, despite the absence of clear psychotic features. Culturally-informed cognitive-behavioural therapy, as well as sexual education could be beneficial were planned and initiated1.
Conclusions
Data on Dhat Syndrome is scarce, yet agreement exist in considering the cultural context of the patient to avoid diagnostic delays. The adequate treatment remains uncertain. Antipsychotics may be a potential treatment. Further research is necessary to clarify the nature of this syndrome but European clinicians must be aware of culturally-mediated psychiatric manifestations which are increasingly prevalent due to globalization.
Disclosure
No significant relationships.
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| first_indexed | 2024-03-11T07:45:11Z |
| format | Article |
| id | doaj.art-512bc77d0e984d629c1f21dbfd558890 |
| institution | Directory Open Access Journal |
| issn | 0924-9338 1778-3585 |
| language | English |
| last_indexed | 2024-03-11T07:45:11Z |
| publishDate | 2021-04-01 |
| publisher | Cambridge University Press |
| record_format | Article |
| series | European Psychiatry |
| spelling | doaj.art-512bc77d0e984d629c1f21dbfd5588902023-11-17T05:07:42ZengCambridge University PressEuropean Psychiatry0924-93381778-35852021-04-0164S733S73310.1192/j.eurpsy.2021.1941Dhat syndrome: A case report on a culture-bound challengeL. Ilzarbe0D. Ilzarbe1N. Arbelo2C. Llach3G. Anmella4E. Vieta5A. Murru6Department Of Psychiatry And Psychology, Institute Of Neuroscience, Hospital Clinic de Barcelona, Barcelona, SpainDepartment Of Child And Adolescent Psychiatry And Psychology, Idibaps, University Of Barcelona, Hospital Clínic de Barcelona, Barcelona, Spain Department Of Child And Adolescent Psychiatry, King’s College London, London, United KingdomDepartment Of Psychiatry And Psychology, Institute Of Neuroscience, Hospital Clinic de Barcelona, Barcelona, SpainDepartment Of Psychiatry And Psychology, Institute Of Neuroscience, Hospital Clinic de Barcelona, Barcelona, SpainBipolar And Depressive Disorders Unit, Idibaps Cibersam, Hospital Clinic, University Of Barcelona, Hospital Clínic de Barcelona, Barcelona, SpainBipolar And Depressive Disorders Unit, Idibaps Cibersam, Hospital Clinic, University Of Barcelona, Hospital Clínic de Barcelona, Barcelona, SpainBipolar And Depressive Disorders Unit, Idibaps Cibersam, Hospital Clinic, University Of Barcelona, Hospital Clínic de Barcelona, Barcelona, Spain Introduction Dhat Syndrome is a culture-bound entity frequent in the Indian subcontinent. It is characterized by somatic symptoms, together with depressive and anxiety features, specifically focused on the belief of losing semen through urine1. Objectives To describe an atypical Dhat Syndrome case in European cultural context,and to determine the appropriate diagnostic frame and subsequent therapeutic approach. Methods We present the case of a 37-year-old Indian man attended in our psychiatric outpatient unit mainly due to somatic complaints (gastrointestinal, sexual dysfunction, weakness, and dizziness). He interpreted his problem as possibly due to diabetes and hypothyroidism, and specifically from sugar loss in urine. Organic diseases were excluded. Results Although considered as culture-bound, Dhat syndrome has been classified as a subtype of depression, anxiety disorder, somatoform disorder2,3,4, and even a prodromal phase of schizophrenia5. Antidepressants and benzodiazepines are the most recommended pharmacological treatments1. Antipsychotic agents have been used when clear psychotic symptoms were present (auditory hallucinations,delusions)5. Nonetheless, paliperidone 6mg/d was initiated at baseline, with good response and partial remission of the symptoms at two weeks, despite the absence of clear psychotic features. Culturally-informed cognitive-behavioural therapy, as well as sexual education could be beneficial were planned and initiated1. Conclusions Data on Dhat Syndrome is scarce, yet agreement exist in considering the cultural context of the patient to avoid diagnostic delays. The adequate treatment remains uncertain. Antipsychotics may be a potential treatment. Further research is necessary to clarify the nature of this syndrome but European clinicians must be aware of culturally-mediated psychiatric manifestations which are increasingly prevalent due to globalization. Disclosure No significant relationships. https://www.cambridge.org/core/product/identifier/S0924933821019416/type/journal_articleCulturedhat syndrometranscultural psychiatryMigration |
| spellingShingle | L. Ilzarbe D. Ilzarbe N. Arbelo C. Llach G. Anmella E. Vieta A. Murru Dhat syndrome: A case report on a culture-bound challenge European Psychiatry Culture dhat syndrome transcultural psychiatry Migration |
| title | Dhat syndrome: A case report on a culture-bound challenge |
| title_full | Dhat syndrome: A case report on a culture-bound challenge |
| title_fullStr | Dhat syndrome: A case report on a culture-bound challenge |
| title_full_unstemmed | Dhat syndrome: A case report on a culture-bound challenge |
| title_short | Dhat syndrome: A case report on a culture-bound challenge |
| title_sort | dhat syndrome a case report on a culture bound challenge |
| topic | Culture dhat syndrome transcultural psychiatry Migration |
| url | https://www.cambridge.org/core/product/identifier/S0924933821019416/type/journal_article |
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