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A. Sumathipala, S. H. Siribaddana, and Dinesh Bhugra
Culture-bound syndromes: the story of dhat syndrome
The British Journal of Psychiatry 2004; 184: 200-209 [Abstract] [Full text] [PDF]
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[Read eLetter] Dhat syndrome - culture-related specific syndrome.
RAVI SHANKAR BALU   (18 May 2004)

Dhat syndrome - culture-related specific syndrome. 18 May 2004
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RAVI SHANKAR BALU,
D.P.M., D.N.B. (Psych)
Kestrel(MSU),Forensic Services,Morisset Hospital,NSW-2264,Australia,Fax No: (02) 4973 0334,

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Re: Dhat syndrome - culture-related specific syndrome.

drravishankar{at}hotmail.com RAVI SHANKAR BALU

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 highly purified 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 that the 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 human psychopathology) 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 different geographic 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 complaint of 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.