Pathways to Care for Dhat (Semen Loss Anxiety) Syndrome: A Study from North India

Abstract

:Dhat syndrome is a culture-bound phenomenon, common in south-east Asia. Patients develop somatic, depressive, and anxiety symptoms because of “preoccupation over semen loss.” Multiple erroneous sociocultural beliefs add to the patients’ distress and lead to diverse patterns of help-seeking. We conducted a cross-sectional study to understand pathways to psychiatric care, delay in treatment seeking, and the association of these with sociodemographic and illness-related variables. Fifty-five patients with Dhat syndrome attending the psychiatry outpatient services of a tertiary care hospital were assessed using World Health Organization (WHO) pathway study encounter form modified to suit our study. Majority of patients were unmarried (61.8%), 21–30 years old (72%), and from a rural background (61.8%). Mean duration of illness was 6.48 ± 5.64 years. Mean time to first seeking help was about 1.85 ± 2.14 years. Time between first seeking help to seeing a psychiatrist was about 4.63 ± 5.35 years; patients saw about 3–4 care providers before reaching a psychiatrist. Majority of the patients (49.1%) first contacted unqualified practitioners. Seeking treatment from a psychiatrist was majorly by self-referral (40%). This study highlights that help-seeking is usually delayed in Dhat syndrome, and visits to unqualified practitioners and multiple care providers is the norm, before referral to a psychiatrist.