Depression presenting with genital symptoms – a series of unusual case histories

Abstract

Interpretation and conceptualisation of depressive symptoms is influenced by cultural factors across the globe. Somatisation is common in eastern cultures. Many people in the Indian subcontinent are unduly concerned about genital symptoms and secretions, which are more evident when they are depressed. We present a case series of depressed patients to emphasise this important area. Our first patient was extremely distressed about her unusual vaginal sensations, which appeared when she was depressed, whereas our third patient, with recurrent depressive disorder, was tormented with the belief of having contracted a sexually transmitted disease, since he experienced unusual urethral sensations whenever he was depressed. The second patient in the case series, again with recurrent depressive disorder, had symptoms resembling Koro; however his symptoms disappeared with remission and recurred with relapses. Awareness of unusual presentations of depression would help to minimise any confusion regarding diagnosis and management.

Keywords

• depression, genital symptoms, culture, sri lanka