EPA-0272 - An oriental culture bound syndrome ('dhat' syndrome) in an adolescent 2nd generation immigrant male in australia

Abstract

Introduction Culture-bound syndromes are defined as 'episodic and dramatic reactions specific to a particular community'. 'Dhat' syndrome or 'loss of semen' leading to weakness, is a culture bound sex neurosis in the Indian subcontinent not common in rest of the world. Aims and Objective To highlight how Culture Bound Syndromes can transcend geographical boundaries. Method A detailed history of the presenting complaints, past and family history and use of ICD 10 (WHO) for diagnosis/excluding other major mental illness. ResulT 15 year old unmarried, Afghani male whose family migrated to Australia before his birth (never went back to Afghanistan), presented with anxiety, difficulty in falling asleep, poor appetite, and weakness for 6 months. His symptoms started after being introduced to pornographic films by friends. He began masturbating 3-4 times everyday which soon became a concern to him, believing it to be 'excessive and harmful' (masturbatory guilt). For the next 3 months, he tried to abstain from masturbation, leading to problems like passage of 'whitish' discharge in urine (?precome) and nocturnal emissions, leading to more anxiety and low mood. He did not fulfil ICD 10 criteria for depression. Fluoxetine 20 mgs daily was started with sexual counselling,(psycho education about masturbation). He showed improvement within 6 weeks and at follow-up 6 months showed complete resolution. Conclusion 'Dhat Syndrome' a Culture Bound Syndrome, not normally reported in Modern Western world may still present in 2nd generation immigrants, with no overt contact with their original culture, possibly due to deep rooted trans-generational cultural ties.