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General practice Terapia 2021, 11 ( 406 ) :  54  -  60

Depression masked by somatic symptoms: Outline of the problem and clinical vignette

Summary: “Masked depression” is a clinical manifestation of depressive episodes in which typical symptoms like lowered mood, anhedonia and tiredness/lack of energy are only discreetly expressed or completely absent. Symptoms that are the cause of medical consultation requested by the patient are predominantly somatic or evoke associations with the non-depressive symptomatology of other mental disorders. These symptoms include insomnia, pain syndromes, a variety of somatic complaints, anxiety, obsessiveness, hypochondriasis etc. Although “masked depression” is widespread, it is often underdiagnosed and therefore incorrectly treated. Patients with “masked depression,” especially with somatic symptoms, mostly visit general practitioners or specialists in all areas of medicine except psychiatry. The paper describes depressive episodes with atypical clinical manifestations along with a list of the most common forms of “masked depression.” The clinical vignette illustrates an example of this kind of depressive episode in the context of proper diagnosis and treatment.
Keywords: “masked depression”, equivalent to depression, depression masks, diagnostics

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