sure, and other covariates. However, some ataques represent normative expressions of
acute distress (e.g., at a funeral) without clinical sequelae. The term ataque de nervios  may
also refer to an idiom of distress that includ es any “fit”-like paroxysm  of emotionality (e.g.,
hysterical laughing) and may be used to indica te an episode of loss of control in response
to an intense stressor.
Related conditions in other cultural contexts:  Indisposition in Haiti, blacking out in
the Southern United States, and falling out in the West Indies.
Related conditions in DSM-5:  Panic attack, panic disorder, other specified or unspec-
ified dissociative disorder, co nversion (functional neurologic symptom) disorder, inter-
mittent explosive disorder, other specified or unspecified anxiety disorder, other specified
or unspecified trauma and stressor-related disorder.
Dhat syndrome
Dhat syndrome  is a term that was coined in South Asia  little more than half a century ago to
account for common clinical presentations of young male patients who attributed their
various symptoms to semen loss. Despite the name, it is not a discrete syndrome but rather
a cultural explanation of distress for patients  who refer to diverse symptoms, such as anx-
iety, fatigue, weakness, weight loss, impotence, other multiple somatic complaints, and
depressive mood. The cardinal feature is an xiety and distress about the loss of dhat in the
absence of any identifiable physiological dysfunction. Dhat  was identified by patients as
a white discharge that was noted on defecation  or urination. Ideas about this substance
are related to the concept of dhatu  (semen) described in the Hindu system of medicine,
Ayurveda, as one of seven essential bodily fluids whose balance is necessary to maintain