Association of duration of untreated Dhat Syndrome on coping mechanism, quality of life and disability in Dhat Syndrome: A cross-sectional study

Background: Dhat syndrome (DS) is a culture-bound psychiatric condition prevalent in South Asia, characterized by anxiety, distress, and somatic complaints due to the perceived loss of semen. Despite the high prevalence of DS, it is often under-reported due to stigma and cultural beliefs. Untreated DS negatively impacts coping mechanisms, quality of life (QoL), and functional disability. Aim: This study aims to evaluate the association of duration of untreated DS on coping mechanisms, QoL, and disability. Methodology: A secondary data analysis of a cross-sectional study conducted at a tertiary care center in North India between October 2016 and September 2017. Convenience sampling was used to enroll 117 patients diagnosed with DS, based on ICD-10 criteria. Data were collected through a semi-structured proforma, and coping mechanisms, QoL, and disability were assessed using the Brief COPE, World Health Organization Quality of Life (WHO QoL-BREF), and World Health Organization Disability Assessment Schedule (WHODAS 2.0) scales. Structural equation modeling (SEM) was employed to examine the direct and indirect effects of untreated DS on coping and psychosocial outcomes. Results: The mean duration of untreated DS was 5.18 ± 3.8 years. Longer durations of untreated DS were associated with reliance on avoidant (P = 0.05) and emotion-focused (P = 0.02) coping strategies, while shorter durations showed higher use of problem-focused coping (P = 0.001). Participants with longer untreated DS had poorer psychological (P = 0.03) and social relationship QoL (P = 0.03), along with greater impairment in participation in activities (P = 0.021). SEM analysis revealed that untreated DS directly affected emotion-focused coping (β = 2.79, P = 0.01) and avoidant coping (β = 0.62, P = 0.05), negatively influenced problem-focused coping (β = −1.68, P = 0.001), social relationship QoL, and disability in participation. It also indirectly influenced psychological QoL, social relationship QoL, environmental QoL, and disability in mobility, cognition, and participation. Conclusion: Prolonged untreated DS has been associated with maladaptive coping strategies, impaired QoL, and increased disability. Early diagnosis and intervention are crucial for mitigating the adverse psychosocial consequences of DS.