(025) Evaluation of the Efficacy of the Novel Treatment Strategy to Treat Dhat Syndrome: A Pilot Study
Authors: Bhat G , Shastry A 
Published: May 2023

Abstract

Introduction
Dhat Syndrome, a syndrome which has obtained the status of culture-bound sexual neurosis, is difficult to treat due to the unwavering belief of the patient that his symptoms are attributable to semen loss. At present, the treatment is aimed at relieving anxiety and depression associated with this condition and not at addressal of the root cause. The best way to address this is by direct demonstration to the patient that the prevention of ejaculation has no health benefits.

Objective
To prospectively evaluate the efficacy of a novel treatment strategy to alter the mental construct of the dhat syndrome patients by demonstrating zero health benefits of total prevention of semen loss during treatment with silodosin over occasional semen loss during treatment with placebo in a randomized double blind placebo controlled two arm switch over study design.

Methods
After obtaining ethical committee approval and written informed consent from the participants, the adult males attending to the out-patient department with complaints suggestive of dhat syndrome were recruited as study participants. Those with pre-existing psychiatric disorders, sexual disorders, endocrine disorders and disorders referable to the genitourinary system were excluded. All the study participants were administered Dhat Syndrome Evaluation Questionnaire (DSEQ), Physical Activity Scale for Persons with Physical Disabilities (PASPPD) modified for the study and Hamilton Anxiety Rating Scale (HARS) at the beginning of the study. PASPPD was again administered to the participants at monthly intervals till the end of the study. Following recruitment, the participants were randomly assigned to two groups. Group 1 received daily dose of oral placebo and weekly counseling for 2 months whereas Group 2 received oral silodosin 8 mg daily and weekly counseling for 2 months. Then, the treatment with silodosin and placebo were switched between the groups for two more months. In the end, the responses to PASPPD at monthly intervals were compared and the details were shared with the participants during a special individual counseling session, after which, the participants were again administered DSEQ and HARS and the responses were compared with the responses recorded at the beginning. The difference was considered statistically significant if p value was ≤0.05

Results
A total of 32 males grouped as 1(N=18, mean age 28.9±4.8 years) and 2 (N=14, mean age 27.4±4.3 years) were part of this study. All the participants reported total anejaculation during the treatment with silodosin. 59.4% patients reported occasional semen loss during treatment with placebo. The PASPPD scores showed no statistically significant difference irrespective of the type of treatment in 90.6% of the participants. At the end of the study, there was statistically significant improvement in HARS in 71.9% of the patients and 62.5% of the patients had the insight that semen loss was not harmful.

Conclusions
The alteration of the mental construct of the dhat syndrome patients using novel treatment strategy was successful in majority of our study participants. A larger multicentre trial with a bigger sample size could bring in a paradigm shift in the management of dhat syndrome, which is very difficult to treat.

Disclosure
No