Keywords (Extracted from title, table of contents and
abstract of thesis)
Dhat, Syndrome, Psychological, Implications, Anxiety, Depression,
Somatic, Complaints, Urine, Emissions |
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Abstract
Dhat Syndrome is
commonly reported in the Indian sub continent. Previous researches
conduced in India and Sri Lanka has employed clinical observations
and informal assessment procedures and no formal assessment tool has
yet been developed to examine manifestation of Dhat Syndrome. Main
objectives of the present research were to develop Dhat Syndrome
Symptom Checklist (DSSC) and to examine manifestation and
implications of Dhat Syndrome. A series of studies were carried out
to develop DSSC and examine manifestation and implications of Dhat
Syndrome.
Dhat Syndrome Symptom Checklist (DSSC) was developed through
in-depth interviews of health professionals, patients with Dhat
Syndrome as well as in consultation with existing literature.
Psychometric properties of DSSC were estimated using Inter rater
Congruence, Factor Analysis and Reliability Analysis. A final DSSC
comprised of 62 symptoms with three subscales i.e. Physical,
Psychological and Sexual symptoms (Studies 2 -6).
Main study aimed to examine manifestation and implications of Dhat
Syndrome. It was hypothesized that patients with Dhat Syndrome would
manifest variety of Physical Psychological and Sexual symptoms.
Patients with Dhat Syndrome (N = 318) were recruited from private
practice of health professionals. Semi Structured Interview
Schedule, DSSC and General Health Questionnaire (GHQ-28) were used
for assessment and individual assessment of patients was carried
out.Data was analyzed using descriptive and inferential statistics.
Descriptive statistics indicated that majority of the patients were
consulting Hakims and Homeopaths and typical profile of Dhat
Syndrome patient in Pakistan is a young,single, less educated man
with poor socioeconomic status. Dhat Syndrome had adverse
implications for patients’ health, particularly physical and sexual
health, and marital life. Premature ejaculation and nocturnal
emissions were main reasons for referral, whereas masturbation and
exposure to pornographic material was reported as major causes of
Dhat Syndrome.
Inferential statistics revealed that sexual weakness, education,
discharge before urine, perceived implications of Dhat Syndrome on
physical and sexual health, severity of the problem, lack of
information and diet were significant predictors of “Physical
Symptoms”. Sexual weakness, perceived implications of Dhat Syndrome
on patient’s life, lack of information and “emission” emerged as
significant predictors of “Psychological Symptoms”. Sexual weakness,
perceived implications of Dhat Syndrome on health, “emission” and
age were significant predictors of “Sexual Symptoms”.
Most patients fell above caseness scores on somatic complaints and
anxiety. Somatic complaints were experienced the most and depression
the least. There was positive relationship between somatic
complaints, anxiety, social dysfunctioning, depression and DSSC
symptoms. DSSC physical and sexual symptoms, perceived implications
of semen loss for patients’ life emerged as significant predictors
of somatic complaints in patients. Anxiety in patients was predicted
by DSSC physical and psychological symptoms, perceived implications
of Dhat Syndrome for patients’ life and “discharge before urine”.
DSSC sexual, psychological and physical symptoms, perceived
psychological effects of Dhat Syndrome, lack of information about
sex and “nocturnal emission” predicted depression in patients. DSSC
psychological and physical symptoms emerged as significant
predictors of social dysfunctioning in patients.
Sex is a tabooed area in Pakistan and this is the first systematic
study on Dhat Syndrome in Pakistan. DSSC would be a useful tool for
diagnosticians, clinicians and researchers. Findings of the study
have very important implications for the patients, health
professionals and researchers and warrant the need for counselling
services as well as sex education. Moreover, further investigations
on sexual health in general and Dhat Syndrome in particular are also
recommended.
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