Dhat Syndrome Presenting as Secondary Depression in a Patient With Mild Intellectual Disability

Dhat syndrome is a condition in which the patient is morbidly preoccupied with excess loss of semen either from urination, nocturnal emissions, or masturbation. The anxiety surrounding this is based on the cultural and societal belief that excessive semen loss will result in illness. Here, we report a case of a 34-year-old male with intellectual disability who presented with depressive symptoms and on detailed exploration was found to have Dhat syndrome. The challenging part in this case was eliciting psychopathology and giving psychotherapy as the patient had mild intellectual disability. We treated this patient successfully with a combination of Manualised Individual Cognitive Behavioural Therapy (M-iCBT) and pharmacotherapy. This case report highlights the importance of exploring sexual history and screening for culture-bound syndromes in patients with mild intellectual disability.