Dhat syndrome: evidence for a depressive spectrum subtype

Dhat syndrome is a condition described in the Indian subcontinent, in which patients present with concerns about loss of semen. Though this condition has been conceptualized as a culture-bound syndrome, some authors have also considered it a manifestation of depression. This calls for a closer examination of the possible genetic link between Dhat syndrome and depression.

We examined the relationship between Dhat syndrome and the depressive spectrum, as conceptualized by Winokur, using a retrospective design. The case records of 46 patients with Dhat syndrome were reviewed, and patients were divided into two groups - family history positive (FH+) and family history negative (FH-) - based on the presence of depressive spectrum conditions in first degree relatives. These two groups were compared in terms of demographic variables, symptom profile and comorbidity.

The FH+ group had significantly higher rates of depressive disorders and substance use disorders (alcohol and nicotine dependence). They were also more likely to report concerns about penile size.

These results suggest that a subgroup of patients with the Dhat syndrome can be viewed as suffering from a depressive spectrum disorder. Dhat syndrome may be better understood as a heterogeneous group than as a single diagnostic entity. Identifying such sub-groups can help in choosing optimal treatments for patients with Dhat syndrome, such as selecting antidepressants for the group described in this study.