Preprint / Version 1

Phenomenology, disability and sexual functioning in female Dhat syndrome: a study of tertiary care gynaecology outpatients

Authors

  • Shubha Joshi Department of Geriatric Mental Health, King George's Medical University, Lucknow, Uttar Pradesh, India
  • Adarsh Tripathi Department of Psychiatry, King George's Medical University, Lucknow, Uttar Pradesh, India
  • Smriti Agarwal Department of Gynaecology and Obstetrics, King George's Medical University, Lucknow, Uttar Pradesh, India
  • Nisha Singh Department of Gynaecology and Obstetrics, King George's Medical University, Lucknow, Uttar Pradesh, India
  • Bandna Gupta Department of Psychiatry, King George's Medical University, Lucknow, Uttar Pradesh, India
  • Anil Nischal Department of Psychiatry, King George's Medical University, Lucknow, Uttar Pradesh, India
  • Sujita Kar Department of Psychiatry, King George's Medical University, Lucknow, Uttar Pradesh, India

Keywords:

attitude to health, behavioral medicine, epidemiologic factors, epidemiologic studies, health behavior

Abstract

Dhat syndrome, a clinical condition related to semen loss in urine often found among males in India, has rarely been described as a separate clinical condition in females. Women with the syndrome complain of passing vaginal discharge and can be excessively concerned and preoccupied with it, often attributing various physical symptoms to the loss of vaginal fluids. Aims This study aimed to assess the sociodemographic and clinical profiles of female patients with Dhat syndrome and their perceived stress, disability and sexual functioning. Methods Sociodemographic details of 70 females with non-pathological vaginal discharge were evaluated with a semistructured sociodemographic assessment. The phenomenology of the vaginal discharge was assessed with the Scale for Assessment of Female Dhat Syndrome Questionnaire. Anxiety and depressive symptoms were measured with the Hospital Anxiety and Depression Scale. Perceived stress in the past month and disability caused by the illness were assessed with the Perceived Stress Scale and the World Health Organization Disability Assessment Scale. In addition, the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Level 2 Somatic Symptoms Scale was administered to rate the severity of somatic symptoms, and sexual functioning was evaluated using the Female Sexual Function Index (FSFI) scale for women who had had sexual intercourse in the past month. Results The mean age of onset vaginal discharge was 23.0 (6.6) years. Biological factors, such as urinary tract infection, were the commonly attributed cause of the loss of vaginal fluids. Psychiatric comorbidity and perceived moderate stress in the past month were found in 38.6% and 68.6% of female patients with Dhat syndrome, respectively. Disability scores tended to be low. Among the females having had sexual intercourse in the past month, 48.3% had FSFI scores indicative of a female sexual disorder. Conclusions The clinical presentation of women with non-pathological vaginal discharge is similar to that of males with Dhat syndrome. It requires comprehensive assessment and management that targets the biological, social and psychological factors and cultural issues. Keywords: attitude to health, behavioral medicine, epidemiologic factors, epidemiologic studies, health behavior