834 Glossary of Cultural Concepts of Distress
Although dhat syndrome  was formulated as a cultural guide to local clinical practice, related
ideas about the harmful effects of  semen loss have been shown to be widespread in the general
population, suggesting a cultural disposition for explaining health problems and symptoms
with reference to dhat syndrome.  Research in health care settings has yielded diverse estimates
of the syndrome’s prevalence (e .g., 64% of men attending psychiatric clinics in India for sexual
complaints; 30% of men attending general medical clinics in Pakistan). Although dhat syndrome
is most commonly identified with young men from lower socioeconomic backgrounds, mid-
dle-aged men may also be affe cted. Comparable concerns about white vaginal discharge (leu-
korrhea) have been associated with a variant of the concept for women.
Related conditions in other cultural contexts:  koro in Southeast Asia, particularly Sin-
gapore and shen-k’uei  (“kidney deficiency”) in China.
Related conditions in DSM-5:  Major depressive disorder, persistent depressive disor-
der (dysthymia), generalized anxiety disorder, somatic symptom disorder, illness anxiety
disorder, erectile disorder, early (premature) ejaculation, other specified or unspecified
sexual dysfunction, academic problem.
Khyâl cap
“Khyâl  attacks” ( khyâl cap ), or “wind attacks,” is a synd rome found among Cambodians in
the United States and Cambodia. Common symptoms include those of panic attacks, such
as dizziness, palpitations, shortness of breath, and cold extremities, as well as other symp-
toms of anxiety and auto nomic arousal (e.g., tinnitus and neck soreness). Khyâl  attacks in-