Culture Bound Syndrome | Koro, Dhat, and Shen-K’uei

Culture-Bound Syndrome — or Culture-Specific Syndrome — is a pattern of mental illness and abnormal behavior that is unique to a specific ethnic or cultural population and does not conform to standard classifications of psychiatric disorders.

In the case of culture bound syndromes with a sexual background i.e. sexual disorder or sexual dysfunction, there are usually no specific treatments available. At best, the affected person may go to a (traditional) medical clinic or folk healer that specializes in sexual problems.

If after examination of the patient no physical problems are found (which is usually the case in these specific pathologies), a variety of therapies, such as psychotherapy, sex coaching and counseling, or herbal medicine and massage may be used to help deal with anxiety or relieve stress.

To give some examples of sexual culture bound syndromes, we describe three syndromes occurring primarily in males in Asia.

Table of contents:

Koro Syndrome

The Koro Syndrome is a culture-bound syndrome that may occur in males in China and Southeast Asia. Although rare, it can also affect women.

It’s an acute anxiety reaction in which the male suddenly fears that his penis is shrinking and will disappear into his abdomen, eventually bringing death. In females, Koro may also appear, but then the fear is focused on the vulva and nipples.

Individuals may also experience shame if they associate the fear with immoral sexual behavior. Koro is also called Jinjinia Bemar, Rok-joo, Shook Yong, Shuk Yang, Suk-Yeong, or Suo Yang.

Shen-K’uei Syndrome

Shen-K’uei Syndrome is a culture-specific pathology happening in males in Chinese or Taiwanese cultures. It’s characterized by symptoms of anxiety, panic, and somatization, such as sexual dysfunction, insomnia, and dizziness.

Symptoms cannot be linked to a physical cause, but are commonly attributed to the idea of an excessive loss of semen because of unrestrained sexual activity.

In Sri Lanka, we find a similar syndrome called Sukra Prameha. In India it’s called Jiryan. There are also close similarities with the Dhat Syndrome.

Dhat Syndrome

Dhat Syndrome is a culture specific syndrome specific to India. Dhat involves severe anxiety and hypochondriacal worries about the discharge or loss of semen, said to be visible by a whitish discoloration of the urine, and feelings of weakness and exhaustion.

Apart from India this syndrome is also found in Pakistan, Bangladesh, Nepal, and Sri Lanka.

Further complaints associated with Dhat are Premature Ejaculation (PE) and impotence. Men believe that they are passing semen in their urine. Nevertheless, there isn’t any known biological cause.

Causes attributed to this syndrome are excessive sex or masturbation, and it’s believed the cause of the syndrome has its roots in feelings of immoral behavior, shame, and guilt.

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