Bianchi, Renzo

2015-6, Bianchi, Renzo, Schonfeld, Irvin Sam, Laurent, Eric

The "burnout syndrome" has been defined as a combination of emotional exhaustion, depersonalization, and reduced personal accomplishment caused by chronic occupational stress. Although there has been increasing medical interest in burnout over the last decades, it is argued in this paper that the syndrome cannot be elevated to the status of diagnostic category, based on (1) an analysis of the genesis of the burnout construct, (2) a review of the latest literature on burnout-depression overlap, (3) a questioning of the three-dimensional structure of the burnout syndrome, and (4) a critical examination of the notion that burnout is singularized by its job-related character. It turns out that the burnout construct is built on a fragile foundation, both from a clinical and a theoretical standpoint. The current state of science suggests that burnout is a form of depression rather than a differentiated type of pathology. The inclusion of burnout in future disorder classifications is therefore unwarranted. The focus of public health policies dedicated to the management of "burnout" should not be narrowed to the three definitional components of the syndrome but consider its depressive core.

2014-11, Bianchi, Renzo, Schonfeld, Irvin Sam, Laurent, Eric

Whether burnout and depression cover the same psychopathology remains to be elucidated. To date, subtypes of depression have been overlooked in research on the burnout–depression overlap. Our aim was to estimate the prevalence of depressive disorders in workers with burnout while examining the overlap of burnout with the atypical subtype of depression. The present study included 5,575 schoolteachers (mean age = 41 years; 78% female). Burnout was assessed with the Maslach Burnout Inventory. Depression was measured with the 9-item depression scale of the Patient Health Questionnaire (PHQ-9). Atypical features of depression were examined using a dedicated module, referenced to the Diagnostic and Statistical Manual of Mental Disorders (4th ed.; American Psychiatric Association, 1994). We found that 90% of the teachers identified as burned out met diagnostic criteria for depression. Among them, 92% scored 15 or higher on the PHQ-9, a threshold at which active treatment with pharmacotherapy and/or psychotherapy is recommended. The features of atypical depression were observed in 63% of the burned-out participants with major depression. Emotional exhaustion, the hallmark of burnout, was more strongly associated with depression than with depersonalization and reduced personal accomplishment, the 2 other putative dimensions of burnout. The present study suggests that the burnout–depression overlap has been largely underestimated. Atypical depression may account for a substantial part of this overlap. Overall, our findings point to depressive symptoms and depressive disorders as central concerns in the management of burnout. The clinical research on treatments for depression offers solutions that may help workers identified as burned out.

2015-3, Bianchi, Renzo, Laurent, Eric

Whether burnout is a form of depression is unclear. The aim of this study was to examine the relevance of the burnout–depression distinction by comparing attentional processing of emotional information in burnout and depression. Eye-tracking technology was employed for assessing overt attentional deployment. The gaze of 54 human services employees was monitored as they freely viewed a series of emotional images, labeled as dysphoric, positive, anxiogenic, and neutral. Similar to depression, burnout was associated with increased attention for dysphoric stimuli and decreased attention for positive stimuli. Hierarchical multiple regression analyses revealed that burnout no longer predicted these attentional alterations when depression was controlled for and vice versa, suggesting interchangeability of the two entities in this matter. To our knowledge, this study is the first to (a) investigate emotional attention in burnout and (b) address the issue of the burnout–depression overlap at both cognitive and behavioral levels using eye movement measurement. Overall, our findings point to structural similarities between burnout and depression, thus deepening concerns regarding the singularity of the burnout phenomenon.

2013-6, Bianchi, Renzo, Boffy, Claire, Hingray, Coraline, Truchot, Didier, Laurent, Eric

The link between burnout and depression remains unclear. In this study, we compared depressive symptoms in 46 burned-out workers, 46 outpatients experiencing a major depressive episode, and 453 burnout-free workers to test the distinctiveness of burnout as a clinical entity. Participants with burnout and major depressive episode reported similar, severe levels of overall depressive symptoms. The between-syndrome overlap was further verified for eight of the nine major depressive episode diagnostic criteria of the Diagnostic and Statistical Manual of Mental Disorders (4th ed., text rev.). Our findings do not support the view hypothesizing that burnout and depression are separate entities and question the nosological added value of the burnout construct.

2015-1, Bianchi, Renzo, Schonfeld, Irvin Sam, Laurent, Eric

Whether burnout is a form of depression or a distinct phenomenon is an object of controversy. The aim of the present article was to provide an up-to-date review of the literature dedicated to the question of burnout–depression overlap. A systematic literature search was carried out in PubMed, PsycINFO, and IngentaConnect. A total of 92 studies were identified as informing the issue of burnout–depression overlap. The current state of the art suggests that the distinction between burnout and depression is conceptually fragile. It is notably unclear how the state of burnout (i.e., the end stage of the burnout process) is conceived to differ from clinical depression. Empirically, evidence for the distinctiveness of the burnout phenomenon has been inconsistent, with the most recent studies casting doubt on that distinctiveness. The absence of consensual diagnostic criteria for burnout and burnout research's insufficient consideration of the heterogeneity of depressive disorders constitute major obstacles to the resolution of the raised issue. In conclusion, the epistemic status of the seminal, field-dominating definition of burnout is questioned. It is suggested that systematic clinical observation should be given a central place in future research on burnout–depression overlap.

, Bianchi, Renzo, Mayor, Eric, Schonfeld, Irvin S, Laurent, Eric

We examined the overlap of burnout with depression in a sample of 184 New Zealand schoolteachers. Burnout and depressive symptoms were strongly correlated with each other (r = .73; disattenuated correlation: .82) and moderately correlated with dysfunctional attitudes, ruminative responses, and pessimistic attributions. All the participants with high frequencies of burnout symptoms were identified as clinically depressed. Suicidal ideation was reported by 36% of those participants. Three groups of teachers emerged from a two-step cluster analysis: “low burnout-depression,” “medium burnout-depression,” and “high burnout-depression.” The correlation between the affective-cognitive and somatic symptoms of depression was similar in strength to the burnout-depression correlation. Consistent with recent results obtained in Europe and the U.S., our findings suggest that burnout is a depressive syndrome.