Sir,Dhat syndrome, originally described as a culture bound syndrome of the Indian subcontinent[1] is a controversial diagnosis in many ways. Increasingly, its nosological status has been questioned with some describing it as a culturally determined form of depression[2] or an idiom of distress.[3] The Diagnostic and Statistical Manual of Mental Disorders (DSM)-5 has already withdrawn the separate status given to dhat syndrome in its earlier editions terming it as ‘not a true syndrome’.[3] But is there really evidence to suggest that dhat syndrome is a culturally determined form of depression? A PubMed search reveals 40 papers published on dhat syndrome. By going through back references, contacting prominent authors and tracing articles not available on the internet, we were able to obtain an additional 25 articles making a total of 65. Of these, only two papers have argued exclusively that dhat syndrome is a culturally determined form of depression.[24] Two more papers, while arguing that it is not a true syndrome, have not committed that it is a depressive illness.[56] Some other papers have only made brief references that it is not a true syndrome without discussing it in detail.[7] We will be critically examining the arguments provided for calling dhat syndrome a culturally determined form of depression.In an original study, Mumford[2] observed that men reporting dhat symptom had higher Hospital Anxiety and Depression Scale (HADS) depression score, but not anxiety scores. Also, dhat symptom was endorsed by four out of six men who were diagnosed with depression or dysthymia. Based on these findings, Mumford concluded that dhat syndrome was a culturally appropriate form of depression. However, this study had certain major limitations. A fundamental error was to enquire regarding dhat ‘symptom’ and not ‘syndrome’. Also, the dhat symptom was elicited by a leading question. Mere reporting of passage of dhat (without associated preoccupation or distress), in a patient presenting to the clinic for some other health condition, who does not necessarily believe that his current problems are due to loss of dhat, does not constitute dhat syndrome. Moreover, Mumford made no attempt to clarify whether the depressive symptoms reported could be attributed to a comorbid depressive illness and instead concluded that the syndrome itself is depressive in nature.Dhikav et al.,[4] proposed that since somatic symptoms are a common presentation of depression in India and since depressive symptoms are commonly reported in dhat syndrome, it represents a culturally appropriate form of depression. While this possibility cannot be entirely ruled out, at the same time, this argument is not compelling either. Just because somatic symptoms are common in depression in India, one cannot conclude that all presentations with prominent somatic symptoms are depressive in nature. Similarly, high prevalence of depressive symptoms is present along with many other disorders as well, for example, obsessive compulsive disorder. Therefore, this argument also does not in any way suggest that dhat syndrome is a depressive disorder. Moreover, not all studies have demonstrated high prevalence of depression in dhat syndrome.[8] We would like to explain this phenomenon using an alternative hypothesis. Just as the marked distress in obsessive compulsive disorder is a possible factor resulting in high rates of depression, so also the distress related to loss of dhat may be responsible for high rates of depression in dhat syndrome. We have demonstrated in an original study earlier that in subsets of patients with dhat syndrome with only mild distress, the prevalence of depression is much lower.[8] However, the true picture can only be confirmed by longitudinal observation of the phenomenology.Thereafter, several authors have made passing remarks[7] that dhat syndrome is probably a depressive disorder without providing any evidence or even discussing it in detail on theoretical grounds. Thus, we see that there does not actually exist strong evidence to support the contention that dhat syndrome is a depressive disorder although we do admit that such a possibility cannot be entirely ruled out for want of evidence. But what seems to have occurred is that influential publication in high impact factor journal by western psychiatrists[2] with inadequate understanding of cultural issues in the subcontinent has fuelled a belief favoring dhat syndrome as a depressive disorder by being repeatedly cited in multiple papers although the actual evidence is weak.Thus, the purpose of the current paper is to draw the attention of psychiatrists in the subcontinent to revisit the nosological status of dhat syndrome with an unbiased mind. The issue of depression being comorbidity rather than the nature of dhat syndrome itself needs to be actively considered. Longitudinal studies demonstrating the evolution of various groups of symptoms may help in clarifying the nature of the disorder. By merely doing away with dhat syndrome by labeling it as a depressive disorder will only curb further work in this already neglected area of research. This is especially important keeping in mind the extent of the problem in the subcontinent and the distress and dysfunction it results in.[8]