[Psychiatry as a profession]

Factors Associated With a Higher Score of Burnout in a Population of 860 French Psychiatrists

Burnout rates are estimated to be twice as high among healthcare professionals as in the general working population, and studies indicate rising incidence. The present study aimed to identify the contextual factors associated with self-reported burnout rates among French psychiatrists. A total of 860 French or French-speaking psychiatrists completed an online questionnaire when they registered for a major psychiatric conference. The Copenhagen Burnout Inventory, a validated scale that independently appraises personal, work- and patient-related dimensions, was used to assess the degree of perceived burnout. Respondents were divided into lower risk and higher risk groups. The latter contained the 25% of individuals who scored the highest on each of the three dimensions of the CBI scale. Univariate analysis showed that private practice was associated with lower levels of risk on the personal and work-related dimensions. Working for the public sector and long hours were both associated with a higher score on the work-related dimension. Interestingly, none of the variables we investigated, except from poor atmosphere at work, correlated with the patient-related dimension. Among public-sector psychiatrists, female gender, longer hours, and more consultations per week were associated with a higher score on the work-related dimension. Working four or more night shifts per month was significantly associated with a higher score of burnout risk on all three dimensions. Private- and public-sector practitioners who mainly treated patients with schizophrenia had a higher score of burnout risk. Multivariate analysis showed that a poor atmosphere at work, longer hours, and working four or more night shifts were significantly associated with higher score of burnout risk. A nonreassuring working environment and more stressors while treating patients each had a possibly negative impact. Although this study only examined the factors that distinguish between clinicians with the lowest versus highest CBI burnout risk scores, it opens up important avenues for research and development of programs to reduce burnout risk within the French healthcare system.

Update on Addressing Mental Health and Burnout in Physicians: What Is the Role for Psychiatry?

PURPOSE OF REVIEW

To highlight an emerging understanding of burnout and physician mental health. This review will provide a discussion of conceptual and diagnostic issues of the burnout syndrome with its relevance to psychiatry, and how psychiatry may interface with other medical disciplines to provide support in creating burnout prevention and treatment programs.

RECENT FINDINGS

Descriptive data of burnout correlations and risk factors are available while an understanding of burnout best practices is lacking but growing. Two recent meta-analyses provide efficacy data along with key subgroup analyses that point to greater efficacy among systemic/organizational over individual level interventions. Among individual interventions, groups work better than individual therapy and the incorporation of Mindfulness-Based Stress Reduction and/or Cognitive Behavioral Therapy modalities provide greater efficacy over other therapies. Ultimately, addressing burnout will be an iterative process specific to institutional cultures and therefore should be thought of as quality improvement initiatives involving leadership to adopt the quadruple aim of physician wellness and to seek institution-specific collaboration and feedback. Psychiatry is uniquely positioned to help change institutional cultures regarding the burnout syndrome, which has been labeled a national crisis. Combinatorial strategies that combine efficacious individual-level interventions with systemic-level interventions that enhance workflow will likely provide the most sustainable model for preventing and treating burnout. Psychiatry should be involved, especially at the level of the liaison psychiatrist to assist with how these types of interventions may be best implemented in specific institutions.

Burnout and psychiatrists: what do we know and where to from here?

Medicine in most parts of the world is becoming a stressful profession. Psychiatrists represent a high-risk group among doctors for experiencing burnout, alcohol and drug use, posing suicide risk and other forms of work-related stress. There are reports that entrants in the profession of psychiatrists are decreasing globally. Conceptual issues related to burnout are explored and factors contributing to burnout in psychiatrists are reviewed. Methodologically sound studies are needed to help us understand positive aspects of psychiatry as a profession and the environment psychiatrists work in. Effective treatment programmes for burnout are also needed not only to reduce suffering but also to retain psychiatrists in the profession.

Burnout in psychiatrists: an etiological model

OBJECTIVE

This article reviews burnout in psychiatrists. A model of burnout is presented which considers three factors: those which may predispose, precipitate, and perpetuate burnout. Lastly, recommendations are made for future research.

METHODS

We conducted a selective literature review to expand on two recent systematic reviews to examine the etiology, prevalence, and consequences of burnout in psychiatrists. We distinguish the effects of burnout, depression, and work-related stress.

RESULTS

An etiological model for the development of burnout in psychiatrists is described here in terms of an interaction between the predisposing, precipitating, and perpetuating factors.

CONCLUSIONS

Research is needed on the long-term effects of work-place stress on psychiatrists, to identify possible protective factors, and to utilize this information to inform the design of interventions that protect or mitigate the effects of work-place stress on psychiatrists.

["Great jobs"-also in psychiatry?]

Against the background of a beginning shortage of psychiatrists, results from interviews with 112 employees of an automotive company with the topic "Great Job" are presented to discuss their relevance to psychiatry. The interviews were analysed by means of a qualitative content analysis. Most employees assigned importance to great pay, constructive collaboration with colleagues, and work appealing to personal interests. Further statements particularly relevant to psychiatry were: successful career, flexible working hours, manageable job, work-life balance, well-founded training, no bureaucracy within the company, and personal status in society. The well-known economic restrictions in health care and the still negative attitude towards psychiatry currently reduce the attraction of psychiatry as a profession. From the viewpoint of personnel management, the attractors of a great job revealed in this study are proposed as important clues for the recruitment of medical students for psychiatry and the development of psychiatric staff.