At the same time, several conclusions of the book can be disputed. For instance, clinicians' preference to give, and patients' preference to get, a diagnosis of neurasthenia instead of depression is considered an example of the social stigma of depression existing in many cultures. However, numerous depressions take masked forms, with a prevalence of vegetative and somatic symptoms. The frequency of these symptoms is variable and depends on age, gender, level of education, and an individual's idea about his or her health. The tragic vignette of a Japanese pilot who was suffering from schizophrenia but received instead a diagnosis of psychosomatic disorder illustrates the predominance of nonpsychotic, pseudoneurotic, or somatoform symptoms in the beginning stages of schizophrenia, which often result in an erroneous diagnosis. One real example of stigmatization is the use of the diagnosis of schizophrenia for political purposes in the former U.S.S.R.