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Culture-bound syndromes: the story of dhat syndrome

  • A. Sumathipala (a1), S. H. Siribaddana (a2) and Dinesh Bhugra (a3)
Abstract
Background

Culture-bound syndrome is a term used to describe the uniqueness of some syndromes in specific cultures. Dhat (semen-loss anxiety) has been considered to be an exotic ‘neurosis of the Orient’.

Aims

To ascertain the presence of similar symptoms and syndromes in different cultures and historical settings.

Method

Electronic and manual literature searches were used to gather information on the existence and description of semen-loss anxiety in different cultures and settings.

Results

Most of the empirical studies on dhat syndrome have emerged from Asia, whereas its concepts have been described historically in other cultures, including Britain, the USA and Australia. The different sources indicate the universality of symptoms and global prevalence of this condition, despite its image as a ‘neurosis of the Orient’.

Conclusions

It appears that dhat (semen-loss anxiety) is not as culture-bound as previously thought. We propose that the concept of culture-bound syndromes should be modified in line with DSM–IV recommendations.

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Copyright
Corresponding author
Correspondence: Professor Dinesh Bhugra, Section of Cultural Psychiatry, PO25, Institute of Psychiatry, London SE5 8AF, UK
Footnotes
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Declaration of interest

None. Funding detailed in Acknowledgements.

Footnotes
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Culture-bound syndromes: the story of dhat syndrome

  • A. Sumathipala (a1), S. H. Siribaddana (a2) and Dinesh Bhugra (a3)
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eLetters

Dhat syndrome - culture-related specific syndrome.

RAVI SHANKAR BALU, D.P.M., D.N.B. (Psych)
18 May 2004

I read Bhugra et al’s (2004) the story of dhat syndrome with interest. The author’s contention is dhat syndrome is not culture-bound. My argument is though dhat is globally prevalent; the specificity of the culture (Ayurvedic Concept) and certain of their psychosocial features being pathogenic in the development of dhat syndrome in South Asian context could not be (a) ignored and the essence of cultural perspective of “semen loss anxiety” in different geographic areas has been (b) misunderstood.

According to (a)Ayurvedic (traditional Indian system of medicine) concepts of health and illness, genital secretions are considered a highlypurified form of dhatu, or bodily substance, and loss of this precious substance is thought to result in progressive weakness or even death. In South Asia, the complaint of loss of genital secretions is regarded with concern by both men and women. Cultural and biomedical meanings of the complaint of leukorrhea in South Asian women (Karen, 2001) has shown thatthe complaint of vaginal discharge accompanied by a host of somatic symptoms could not fit a particular biomedical diagnostic category, and best be understood within the ethno medical context of Ayurveda.

As noted by (b) Malhotra and Wig (1975), Asian culture condemns all types of orgasm because they involve semen loss and are therefore “dangerous”. In contrast, the Judeo-Christian cultures of the 18th and 19th centuries in Europe considered most types of sexual activities outside marriage to be “sinful”.

The so-called culture-bound syndromes have been the focus of the debate between adherents of biopsychological universalism (universal humanpsychopathology) and adherents of an ethnological cultural relativism (typical aspects of a particular culture). Culture-bound syndrome is not always “bound” (westermyer & Janca,1997) but heavily “related” to certain cultural traits or cultural factors that can be found in differentgeographic areas, or across ethnicity or cultural unit or systems, which share the common cultural view, attitude or elements attributed to the formation of the specific syndromes. Based on this new understanding, the term should be changed to culture-related specific syndromes to reflect its nature accurately (Tseng & McDermott, 1981).

Declaration of Interest:None

REFERENCES:

Karen.T-K., (2001). Cultural and biomedical meanings of the complaintof leukorrhea in South Asian women. Tropical Medicine & International Health. 6(4),260-266.Malhotra,H.K., & Wig,N.N. (1975). Dhat syndrome: A culture-bound sex neurosis of the Orient. Archives of sexual Behavior, 4(5), 519-528.

Sumathipala,A,.Siribaddana,S.H., Bhugra,D(2004). Culture-bound syndromes: the story of dhat syndrome. The British Journal of Psychiatry 184: 200-209.

Tseng W.S., & McDermott, J. F., Jr. (1981). Culture, mind and therapy: An introduction to cultural psychiatry. New York: Brunner/Mazel.

Westmeyer,J., & Janca,A. (1997). Language, culture and psychopathology: Conceptual and methodological isues. Transcultural Psychiatry, 34(3), 291-311.
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