Masked depression--an ambiguous entity.

The term 'masked depression' is not accepted in current psychiatric classification for three basic reasons: (1) It is not a unique type of a disease or a syndrome, but a state or a stage which is a part of the depressive syndromes. (2) No special list of symptoms which has enough specificity, reliability and validity can be drawn in order to describe this state. (3) The term 'masked' is vague, and is in contradiction to the basic necessity to describe what is observed in contrast to what is unobservable and masked. However, precise and scientific criteria may be unsuitable for diagnostic purposes in these cases which are quite common; thus an entity which has a deep meaning and begs recognition among general physicians may be ignored. In addition, diagnosis of such depression is very important to allow for suitable and adequate treatment procedures. Diagnostic problems, clarification of the term 'masked' and the procedures of diagnosis are discussed in the article.