Assessment of pathway to care and phenomenology among patients with dhat syndrome: a cross-sectional study

Abstract

Background: Dhat syndrome is a culture-bound psychosomatic disorder prevalent among young South Asian men. It is characterized by anxiety and somatic symptoms attributed to semen loss, rooted in traditional beliefs. This study explored the clinical features, pathways to care, personality traits, and quality of life in affected individuals. Materials and Methods: A cross-sectional study was conducted at a tertiary care hospital in Karnataka, India, involving 47 male patients diagnosed with Dhat syndrome per ICD-10 criteria. Data were collected using a semi structured proforma, WHO Pathways Interview Schedule, IPDE screening module and the WHOQOL-BREF questionnaires. Statistical analysis included descriptive statistics and correlation tests. Results: Participants were predominantly young (mean age 24.91 ± 5.11 years), unmarried, and from rural, low income backgrounds. A significant proportion (87.2%) predominantly exhibited Cluster C personality traits. The average duration from symptom onset to psychiatric care was 3.95 years, with 1.6 ± 0.1 non-psychiatric consultations before reaching Psychiatric services. The financial burden increased with the delay in getting professional help and was significantly associated with a poorer quality of life. WHOQOL-BREF scores indicated lower physical (46.57) and psychological (45.26) health domain scores compared to Social relations (53.17) and environmental domain (54.20). A longer duration of Dhat syndrome is significantly associated with poorer Quality of Life, particularly in the physical (r = -0.434, p = 0.002) and psychological (r = -0.400, p = 0.005) domains, indicating that these areas are the most adversely affected. Conclusion: Our study highlights that Dhat syndrome is associated with significant delays in psychiatric care, substantial financial burden, poor quality of life, and a high prevalence of Cluster C personality traits. The findings emphasize the need for early recognition, culturally sensitive psychoeducation, and better integration of mental health services to improve patient outcomes and reduce the overall burden of illness.