[Burnout : illness or symptom?]

Is it all about Depression? Determinants of Burnout among Employees Referred for Inpatient Treatment of Job-Related Stress Disorders

Objectives: There is an ongoing debate as to whether job burnout and depression are overlapping concepts or differ from each other, although this has not been scrutinized in inpatients. To further elucidate the robustness of this relationship, we used three different measurements of depression. We further examined the influence of psychological distress, perceived stress and sleep quality in the link between depressive symptoms and burnout. Methods: We investigated 723 consecutive inpatients, aged 23 to 82 years, 51.2 % women, referred to a hospital specialized in the treatment of job stress-related disorders. Patients completed the Maslach Burnout Inventory, the Beck Depression Inventory, the Hospital Anxiety and Depression Scale, the Brief Symptom Inventory, the Perceived Stress Scale, and the Pittsburgh Sleep Quality Index. Results: We found significant correlations between burnout total scores as well as subscales (emotional exhaustion, depersonalization, lack of accomplishment) and depressive symptoms, virtually independent of the applied depression measure. The shared variance ranged between 1.1 % and 19.4 %. Greater levels of burnout were directly associated with cognitiveaffective symptoms and, although to a lesser extent, also with somatic-affective symptoms of depression. In the multivariable analysis, significantly more total burnout symptoms were revealed in more depressed and younger patients, in men than women, and in employees with greater levels of psychological distress and perceived stress, respectively. Conclusions: The findings suggest that although burnout and depression do not represent the same psychopathology, there is considerable overlap between the two constructs; the extent of this overlap may vary depending upon the applied depression measure.

[Burnout-a call for action]

BACKGROUND

Burnout is an emerging topic and has recently been the subject of a position paper of the US American Society of Critical Care Medicine.

OBJECTIVES

To give an overview over prevalence, causes, and relevance of burnout in intensive care unit (ICU) clinicians and point to potential prevention strategies MATERIALS AND METHODS: Narrative review.

RESULTS AND CONCLUSION

Burnout is a job-related state which results from long-lasting, permanent work overload when short spells of recreation, for instance during the weekend, are not effective to reduce exhaustion, vegetative symptoms, loss of efficiency, and depersonalization. Burnout may be due to (1) work-related factors, such as unmanageable workload and lack of appreciation by superiors and (2) personal factors, such as overly high demand and commitment. Surveys from France and Switzerland suggest that approximately one third to one half of ICU clinicians are affected. Large studies among hospital nurses show an increase in burnout. Burnout impairs patient safety and satisfaction, increases clinicians' intent to quit, and staff turnover.

CONCLUSIONS

Burnout is associated with a poor work environment. Burnout prevention or reduction is an important task which demands a multidimensional approach. The goal should be to improve the work environment, achieve good team collaboration, psychological safety, and inclusive leadership.

[Understanding the term burnout in psychiatry and psychotherapy]

BACKGROUND

Currently there is much debate about the concept of burnout and its use as a diagnostic entity. The aim of the present survey was to present the view of mental health professionals towards the concept of burnout.

METHODS

A total of 300 mental health professionals were surveyed using a structured questionnaire.

RESULTS

The majority of participants see burnout as a state of exhaustion which constitutes a risk factor for later developing a mental disorder. Participants reported that from their point of view typical triggers for burnout exist while symptoms overlap to a great extent with depression. Psychotherapy as well as interventions at the workplace are regarded as promising interventions; however, in the clinical routine only a minority of participants actually contacted the patients' workplace. In the participants workplace settings most Burnout-Patients suffered from a diagnosis defined in ICD 10 but judged themselves to be suffering from burnout.

DISCUSSION

Burnout-Patients in mental health settings differ from the picture currently drawn in the media, probably because Burnout-Patients reach the mental health sector only after already having developed a manifest psychiatric disorder.