Occupational burnout

Kaschka, Korczak, and Broich (2011){{cite journal |vauthors=Kaschka WP, Korczak D, Broich K |date=November 2011 |title=Burnout: a fashionable diagnosis |journal=Deutsches Ärzteblatt International |volume=108 |issue=46 |pages=781–787 |doi=10.3238/arztebl.2011.0781 |pmc=3230825 |pmid=22163259}} advanced the view that burnout is described in the Book of Exodus (18:17–18). In the New International Version of the Bible, Moses’ father-in-law said to Moses, “What you are doing is not good. You and these people who come to you will only wear yourselves out. The work is too heavy for you; you cannot handle it alone."[https://www.biblegateway.com/passage/?search=Exodus%2018%3A17-18&version=NIV New International Verson] Gordon Parker suggested that the ancient European concept of acedia refers to burnout and not depression as many others believe.{{cite journal | vauthors = Parker G, Tavella G | title = Burnout: modeling, measuring, and managing | journal = Australasian Psychiatry | volume = 29 | issue = 6 | pages = 625–627 | date = December 2021 | pmid = 34461751 | doi = 10.1177/10398562211037332 | s2cid = 237365209 }}

By 1834, the German concept of {{lang|de|Berufskrankheiten}} (occupational diseases) had become established. The concept reflected adverse work-related effects on mental and physical health.{{Cite web |last=Zeno |title=Lexikoneintrag zu »Berufskrankheiten«. Damen Conversations Lexikon, Band 2. Leipzig ... |url=http://www.zeno.org/DamenConvLex-1834/A/Berufskrankheiten |access-date=2023-10-29 |website=www.zeno.org |language=de}} In 1869, New York neurologist George Beard used the term "neurasthenia" to describe a very broad condition caused by the exhaustion of the nervous system, which he argued was to be found in "civilized, intellectual communities."{{Cite journal |vauthors=Beard G |date=1869-04-29 |title=Neurasthenia, or Nervous Exhaustion |journal=The Boston Medical and Surgical Journal |volume=80 |issue=13 |pages=217–221 |doi=10.1056/NEJM186904290801301 |issn=0096-6762 |url=https://zenodo.org/record/2086793 }} The concept soon became popular, and many in the United States believed themselves to suffer from it. Some came to call it "Americanitis".{{cite news | vauthors = Marcus G |date=1998-01-26 |title=One Step Back; Where Are the Elixirs of Yesteryear When We Hurt? |work=The New York Times |url=https://query.nytimes.com/gst/fullpage.html?res=9A05E1DB133BF935A15752C0A96E958260 |access-date=2008-09-11}} Beard broadened the potential symptoms of neurasthenia such that the disorder could be the source of almost any symptom or behaviour.{{Cite book |vauthors=Beard GM |date=1881 |title=American Nervousness, Its Causes and Consequences: A Supplement to Nervous Exhaustion (neurasthenia) |url=https://books.google.com/books?id=3moPAAAAYAAJ |publisher=Putnam |language=en}} Don R. Lipsitt would later wonder if the term "burnout" was similarly too broadly defined to be useful.{{cite journal |vauthors=Lipsitt DR |title=Is Today's 21st Century Burnout 19th Century's Neurasthenia? |language=en-US |journal=The Journal of Nervous and Mental Disease |volume=207 |issue=9 |pages=773–777 |date=September 2019 |pmid=31464987 |doi=10.1097/NMD.0000000000001014 |s2cid=201667337}} In 2017 the Dutch psychologist Wilmar Schaufeli pointed out similarities between Beard's concept of neurasthenia and that of the contemporary concept of occupational burnout.{{cite book |last=Schaufeli |first=Wilmar B. |chapter=Burnout: A Short Socio-Cultural History |date=2017 |title=Burnout, Fatigue, Exhaustion: An Interdisciplinary Perspective on a Modern Affliction |pages=105–127 |editor-last=Neckel |editor-first=Sighard |place=Cham, Switzerland |publisher=Springer International Publishing |language=en |doi=10.1007/978-3-319-52887-8_5 |hdl=1874/420608 |isbn=978-3-319-52887-8 |editor2-last=Schaffner |editor2-first=Anna Katharina |editor3-last=Wagner |editor3-first=Greta}} The rest cure was a commonly prescribed treatment for neurasthenia in the United States, particularly for women. The American doctor Silas Weir Mitchell often prescribed this treatment. Other treatments included hypnosis, Paul Charles Dubois's cognitive behavioural therapy (this is distinct from and devised much earlier than Aaron Beck's cognitive behavioral therapy), and Otto Binswanger's life normalisation therapy.{{Cite book |last=Kondo |first=K |title=Culturebound Syndromes, Ethnopsychiatry and Alternate Therapies |publisher=University Press of Hawaii |year=1976 |editor-last=Lebra |editor-first=WP |location=Honolulu |pages=250–258 |chapter=The Origin of Morita Therapy}}

In 1888, the English neurologist William Gowers coined the term occupation neurosis to describe cramps experienced by writers and pianists (repetitive strain injury), translating the German concept of Beschäftigungsneurosen (occupational diseases affecting the nerves).{{Cite book |last=Gowers |first=W. R. (William Richard) |url=http://archive.org/details/manualofdiseases02goweuoft |title=A manual of diseases of the nervous system |date=1886–1888 |place=London |publisher=J. & A. Churchill}} The related term occupational neurosis came to include a wide range of work-caused anxieties and other mental problems.Lucire, Y. (1986, Oct. 6). The Medical Journal of Australia, 145, 232-237. By the late 1930s, American health professionals had become widely acquainted with the condition.{{Cite journal |last=Harms |first=Ernest |title=The Social Background of Occupational Neuroses |date=June 1937 |url=https://journals.lww.com/jonmd/Citation/1937/06000/The_Social_Background_of_Occupational_Neuroses.4.aspx |journal=The Journal of Nervous and Mental Disease |language=en |volume=85 |issue=6 |pages=689–695 |doi=10.1097/00005053-193706000-00004 |issn=0022-3018|url-access=subscription }} It became known as {{lang|de|berufsneurose}} in German.{{Cite journal |last=Katz |first=Maya Balakirsky |date=2010 |title=An Occupational Neurosis: A Psychoanalytic Case History Of a Rabbi |journal=AJS Review |volume=34 |issue=1 |pages=1–31 |doi=10.1017/S0364009410000280 |jstor=40982803 |s2cid=162232820 |issn=0364-0094}} From 1915, the Japanese psychiatrist Shoma Morita developed Morita therapy to treat neurasthenia.{{Cite web |title=神経症（不安障害）と森田療法〜公益財団法人メンタルヘルス岡本記念財団 |url=https://www.mental-health.org/morita1.html |access-date=2025-01-11 |website=www.mental-health.org}} He had come to have a different understanding of the condition than Beard,{{Cite journal |last=Suzuki |first=Tomonori |date=1989-06-01 |title=The concept of neurasthenia and its treatment in Japan |url=https://link.springer.com/article/10.1007/BF02220661 |journal=Culture, Medicine and Psychiatry |language=en |volume=13 |issue=2 |pages=187–202 |doi=10.1007/BF02220661 |pmid=2766793 |issn=1573-076X|url-access=subscription }} preferring to call it shinkeishitsui; he published two books about the condition.

In 1957, Swiss psychiatrist Paul Kielholz coined the term {{lang|de|Erschöpfungsdepression}} [exhaustion-depression].{{Cite journal |last=Kielholz |first=Paul |date=1957 |title=Diagnostik und Therapie der depressiven Zustandsbilder |journal=Schweizerische Medizinische Wochenschrift |volume=87}}{{Cite book |last=Tellenbach |first=Hubertus |url=http://archive.org/details/melancholiezurpr00tell |title=Melancholie : zur Problemgeschichte, Typologie, Pathogenese und Klinik |date=1961 |publisher=Berlin : Springer-Verlag |others=Internet Archive}}{{Cite web |date=2019-06-17 |title=Why burnout is such a controversial issue in Switzerland |url=https://www.swissinfo.ch/eng/society/mental-health_why-the-world-is-so-divided-on-burnout/45023452 |access-date=2023-10-30 |website=SWI swissinfo.ch |language=en}} The concept was one of a number of new depression-subtypes that gained traction in France and Germany during the 1960s.{{cite web |last1=Åsberg |first1=Marie |last2=Wahlberg |first2=Kristina |last3=Wiklander |first3=Maria |last4=Nygren |first4=Åke |date=6 September 2011 |title=Psykiskt sjuk av stress ... diagnostik, patofysiologi och rehabilitering |url=https://lakartidningen.se/tema-livsstil-och-psykisk-ohalsa-1/2011/09/psykiskt-sjuk-av-stress-diagnostik-patofysiologi-och-rehabilitering/ |access-date=24 August 2016 |work=Läkartidningen |language=sv |issn=1652-7518}} In 1961, British author Graham Greene published the novel A Burnt-Out Case, the story of an architect who became disenchanted with the fame his achievements garnered for him and volunteered to work at leper colony in the Congo.{{Cite book |url=https://archive.org/details/burntoutcase0000grah |title=A Burnt-Out Case |vauthors=Greene G |publisher=William Heinemann Ltd |year=1961 |isbn=978-0140185393 |pages=cover title |url-access=registration}} In 1965, Kielholz publicised the idea of anti-depressant therapy {{lang|de|Erschöpfungsdepression}} in the German-speaking world through his book Diagnose und Therapie der Depressionen für den Praktiker [Diagnosis and Treatment of Depression for the Practitioner].{{Cite book |last=Kielholz |first=Paul |url=https://link.springer.com/book/10.1007/978-3-642-86197-0 |title=Diagnose und Therapie der Depressionen für den Praktiker |date=1971 |isbn=978-3-540-79771-5 |language=en |doi=10.1007/978-3-642-86197-0}} His work inspired further writing on the topic by Volker Faust.{{Cite web |author=Volker Faust |title=ERSCHÖPFUNGSDEPRESSION |trans-title=Fatigue Depression |url=https://www.psychosoziale-gesundheit.net/psychiatrie/depression3.html |access-date=2023-10-30 |work=Psychosoziale Gesundheit von Angst bis Zwang |language=de |trans-work=Psychosocial health from fear to compulsion}}

In 1968, the second edition of the American Psychiatric Association's (APA) Diagnostic and Statistical Manual (DSM-II; the APA is currently up to DSM-5) replaced "psychophysiologic nervous system reaction" with the condition neurasthenic neurosis (neurasthenia).{{Cite journal |last1=Chatel |first1=John C. |last2=Peele |first2=Roger |date=April 1970 |title=A Centennial Review of Neurasthenia |url=http://psychiatryonline.org/doi/abs/10.1176/ajp.126.10.1404 |journal=American Journal of Psychiatry |language=en |volume=126 |issue=10 |pages=1404–1413 |doi=10.1176/ajp.126.10.1404 |pmid=4907681 |issn=0002-953X|url-access=subscription }} This condition was "characterized by complaints of chronic weakness, easy fatigability, and sometimes exhaustion." Another condition added to this edition was the similar asthenic personality, which was "characterized by easy fatigability, low energy level, lack of enthusiasm, marked incapacity for enjoyment, and oversensitivity to physical and emotional stress."

In 1969, American prison official Harold B Bradley used the term burnout in a criminology paper to describe the fatigued staff at a centre for treating young adult offenders.{{cite journal |vauthors=Bradley HB |date=July 1969 |title=Community-based treatment for young adult offenders. |journal=Crime & Delinquency |volume=15 |issue=3 |pages=359–370 |doi=10.1177/001112876901500307 |s2cid=144032733}} Bradley's article has been cited as the first known academic paper to use the term.{{Cite book |url=https://www.wilmarschaufeli.nl/publications/Schaufeli/082.pdf |title=Handbook of work and health psychology |publisher=Wiley |year=1996 |pages=513–527 |chapter=Professional Burnout}}

In 1974, Herbert Freudenberger, a German-born American clinical psychologist, used the term "burn-out" in his academic paper "Staff Burn-Out."{{cite journal |vauthors=Freudenberger HJ |author-link=Herbert Freudenberger |title=Staff Burn-Out |journal=Journal of Social Issues |date=Winter 1974 |volume=30 |issue=1 |pages=159–165 |doi=10.1111/J.1540-4560.1974.TB00706.X}} The paper was based on his qualitative observations of the volunteer staff (including himself) at a free clinic for drug addicts. He characterized burnout by a set of symptoms that includes exhaustion resulting from work's excessive demands. Other symptoms he identified were headaches, sleeplessness, "quickness to anger," and closed thinking. He observed that the burned-out worker "looks, acts, and seems depressed." After the publication of Freudenberger's paper, interest in the concept grew.

The American social psychologist Christina Maslach described burnout in a 1976 magazine articleMaslach, C. (1976, Sept.). Burned-out. Human Behavior: The Newsmagazine of the Social Science, 5(9), 16–22. as reflecting the impact of interpersonal stress on human service workers (e.g., social workers, psychiatrists, poverty lawyers, etc.). The impact manifested itself in symptoms such as fatigue, quickness to anger, and cynical attitudes toward the people the service workers were supposed to help. Also in 1976, Israeli-American psychologist Ayala Pines and American psychologist Elliot Aronson, using group workshops, began to treat people having symptoms of burnout. Pines collaborated with MaslachMaslach, C., & Pines A. (1977). The burn-out syndrome in the day care setting. Child Youth Care Forum, 6(2), 100–113.Pines, A., & Maslach, C. (1978). Characteristics of staff burnout in mental health settings.Hospital & Community Psychiatry, 29(4), 233–237. {{doi|10.1176/ps.29.4.233}} in writing essentially data-free papersSchonfeld, I. S., & Bianchi, R. (2022). Distress in the workplace: Characterizing the relationship of burnout measures to the Occupational Depression Inventory. International Journal of Stress Management, 29(3), 253–259. {{doi|10.1037/str0000261}} about burnout in individuals who worked in day care centers and mental health facilities.

In 1980, the DSM-III was released. It abolished the concepts of neurasthenia and asthenic personality, both with the explanation "This DSM-II category was rarely used." Neither was directly replaced. Also in 1980, American psychologist Cary Cherniss published the book Staff Burnout: Job Stress in the Human Services.{{Cite book |last=Cherniss |first=Cary |url=https://books.google.com/books?id=XVZqAAAAMAAJ |title=Staff Burnout: Job Stress in the Human Services |date= 1980 |publisher=Sage Publications |isbn=978-0-8039-1338-7 |language=en}}

In 1981, Maslach and fellow American psychologist Susan E. Jackson published an instrument for assessing occupational burnout, the Maslach Burnout Inventory (MBI). It was the first such instrument of its kind, and soon became the most widely used measure of occupational burnout.{{cite journal |vauthors=Schonfeld IS, Verkuilen J, Bianchi R |title=Inquiry into the correlation between burnout and depression |journal=Journal of Occupational Health Psychology |volume=24 |issue=6 |pages=603–616 |date=December 2019 |pmid=30945922 |doi=10.1037/ocp0000151 |s2cid=92997542 |url=https://academicworks.cuny.edu/cgi/viewcontent.cgi?article=1717&context=gc_pubs|url-access=subscription }} The two researchers described occupational burnout in terms of emotional exhaustion, depersonalization (feeling low-empathy towards other people in an occupational setting), and reduced feelings of work-related accomplishment.{{cite web |title=MBI: The Maslach Burnout Inventory: Manual |url=https://www.researchgate.net/publication/277816643 |publisher=Consulting Psychologists Press |location=Palo Alto |vauthors=Maslach C, Jackson SE, Leiter MP |year=1996}}{{cite journal |vauthors=Ruotsalainen JH, Verbeek JH, Mariné A, Serra C |date=April 2015 |title=Preventing occupational stress in healthcare workers |journal=The Cochrane Database of Systematic Reviews |volume=2015 |issue=4 |page=CD002892 |doi=10.1002/14651858.CD002892.pub5 |pmc=6718215 |pmid=25847433}} In 1988, Pines and Aronson wrote the popular book Career Burnout: Causes and Cures, an updated version of a book they had published in April 1981 with American psychologist Ditsa Kafry. They found that "marriage burnout" was just as prevalent as "job burnout."

The WHO's ICD-10 (1994) removed the diagnosis of asthenic personality; the WHO, however, continued to include neurasthenia (F48.0).{{Cite web |title=ICD-10 Version:2008 |url=https://icd.who.int/browse10/2008/en#/Z73.0 |access-date=2023-11-03 |website=icd.who.int}} In 1998, Swedish psychiatrists Marie Åsberg and Åke Nygren{{Cite web |title=Lars Åke Nygren {{!}} Staff Portal |url=https://staff.ki.se/people/lars-ake-nygren |access-date=2023-06-26 |website=staff.ki.se |language=en}} investigated a surge of depression-related health insurance claims in their country. They found that the symptoms of many cases did not match the typical presentation of depression. Complaints like fatigue and decreased cognitive ability dominated, and many believed their working conditions to be the cause.{{cite journal |date=2021 |last=Jernberg |first=Maria |issn=0280-9702 |journal=Psykologtidningen |number=2 |pages=14–22 |title=Gåtan Utmattningssyndrom |url=https://psykologtidningen.se/wp-content/uploads/2021/03/Psykologtidningen_nr2_2021_LOW.pdf |language=sv}}{{rp|p=16}}

In 2003, the American psychiatrists Philip M. Liu and David A. Van Liew advanced the view that the concept of burnout is largely bereft of meaning and has often come to refer to "stress-induced unhappiness" with one's job. They, however, also wrote that burnout can mean "everything from fatigue to a major depression and now seems to have become an alternative word for depression but with less serious significance" (p. 434).

In 2005, the Swedish Board of Health and Welfare adopted a category described as "exhaustion disorder."{{cite journal | vauthors = Besèr A, Sorjonen K, Wahlberg K, Peterson U, Nygren A, Asberg M | title = Construction and evaluation of a self rating scale for stress-induced exhaustion disorder, the Karolinska Exhaustion Disorder Scale | journal = Scandinavian Journal of Psychology | volume = 55 | issue = 1 | pages = 72–82 | date = February 2014 | pmid = 24236500 | pmc = 4235404 | doi = 10.1111/sjop.12088 }} Treatment programs followed. In December 2007, the Swiss Expert Network on Burnout (SEB) was established.{{Cite web |title=Über uns |url=https://www.burnoutexperts.ch/deu/%C3%BCber-uns/ |access-date=2023-10-30 |website=SEB Schweizer Expertennnetzwerk für Burnout |language=de-DE}} It has since held a number of symposia, and published recommendations for treating burnout.{{Cite web |title=Wissenswertes Definition Burnout |url=https://www.burnoutexperts.ch/deu/wissenswertes/ |access-date=2023-10-30 |website=SEB Schweizer Expertennnetzwerk für Burnout |language=de-DE}} The diagnosis used in Sweden, however, is about to be abandoned.Bianchi, R., & Schonfeld, I. S. (2025). Burnout forever. Work & Stress. https://doi.org/10.1080/02678373.2025.2497247

In 2015, French psychologist Renzo Bianchi and his colleagues published a literature review on the burnout–depression overlap (based on 92 studies) and concluded that the studies fail to demonstrate the nosological distinctiveness of the burnout phenomenon.{{cite journal |vauthors=Bianchi R, Schonfeld IS, Laurent E |date=March 2015 |title=Burnout-depression overlap: a review |url=https://academicworks.cuny.edu/cgi/viewcontent.cgi?article=1318&context=cc_pubs |journal=Clinical Psychology Review |volume=36 |issue= |pages=28–41 |doi=10.1016/j.cpr.2015.01.004 |pmid=25638755|url-access=subscription }} Bianchi et al.'s (2021) later research suggests that burnout is a depressive condition.

File:Deaths from Karoshi.png and International Labour Organization in 2016.]] Also in 2015, the WHO adopted a new conceptualization of "occupational burnout." The conceptualization was consistent with Maslach's.Bianchi, R., & Schonfeld, I. S. (2023). Examining the evidence base for burnout. Bulletin of the World Health Organization, 101, 743–745. {{doi|10.2471/BLT.23.289996}} However, occupational burnout was "not itself classified by the WHO as a medical or psychiatric condition or mental disorder."{{Cite web |date=28 May 2019 |title=Burn-out an 'occupational phenomenon': International Classification of Diseases |url=https://www.who.int/mental_health/evidence/burn-out/en/ |access-date=2019-06-01 |website=WHO}} As of 2017, nine European countries (Denmark, Estonia, France, Hungary, Latvia, Netherlands, Portugal, and Slovakia) legally recognized the burnout syndrome as an occupational disorder, for example, by awarding workers' compensation payments to affected people. The WHO's ICD-11 began official use in 2022. Within this categorisation, the concept of neurasthenia became part of the new condition known as "bodily distress disorder" (6C20).{{Cite journal |last1=Reed |first1=Geoffrey M. |last2=First |first2=Michael B. |last3=Kogan |first3=Cary S. |last4=Hyman |first4=Steven E. |last5=Gureje |first5=Oye |last6=Gaebel |first6=Wolfgang |last7=Maj |first7=Mario |last8=Stein |first8=Dan J. |last9=Maercker |first9=Andreas |last10=Tyrer |first10=Peter |last11=Claudino |first11=Angelica |last12=Garralda |first12=Elena |last13=Salvador-Carulla |first13=Luis |last14=Ray |first14=Rajat |last15=Saunders |first15=John B. |date=February 2019 |title=Innovations and changes in the ICD-11 classification of mental, behavioural and neurodevelopmental disorders |journal=World Psychiatry |language=en |volume=18 |issue=1 |pages=3–19 |doi=10.1002/wps.20611 |issn=1723-8617 |pmc=6313247 |pmid=30600616}}{{Cite web |title=ICD-11 for Mortality and Morbidity Statistics |url=https://icd.who.int/browse11/l-m/en#/http://id.who.int/icd/entity/767044268 |access-date=2023-11-03 |website=icd.who.int}} The WHO also modified their definition of burnout that year.{{Cite web |title=2022 ICD-10-CM Diagnosis Code Z73.0: Burn-out |url=https://www.icd10data.com/ICD10CM/Codes/Z00-Z99/Z69-Z76/Z73-/Z73.0 |access-date=2022-07-15 |website=www.icd10data.com}}

In 2020, the Occupational Depression Inventory was published and considered to be a potential replacement for burnout scales such as the MBI.

The two main classification systems for psychiatic disorders are the APA's Diagnostic and Statistical Manual of Mental Disorders (DSM, used in North America and elsewhere) and the WHO's International Classification of Diseases (ICD, used in Europe and elsewhere). Burnout is not recognized as a distinct mental disorder in the DSM-5 (published in 2013).{{cite journal | vauthors = Vahia VN | title = Diagnostic and statistical manual of mental disorders 5: A quick glance | journal = Indian Journal of Psychiatry | volume = 55 | issue = 3 | pages = 220–223 | date = July 2013 | pmid = 24082241 | pmc = 3777342 | doi = 10.4103/0019-5545.117131 | doi-access = free }} Its definitions for Adjustment Disorders,{{cite journal | vauthors = Boudoukha AH, Hautekeete M, Abdellaoui S, Abdelaoui S, Groux W, Garay D | title = [Burnout and victimisation: impact of inmates' aggression towards prison guards] | journal = L'Encéphale | volume = 37 | issue = 4 | pages = 284–292 | date = September 2011 | pmid = 21981889 | doi = 10.1016/j.encep.2010.08.006 | quote = "Burnout doesn't appear per se in any international classification of mental disorders: clinicians often use the diagnosis of adjustment disorder" }}{{cite journal | vauthors = Höschl C |title=2394 – Burnout is a myth |journal=European Psychiatry |date=January 2013 |volume=28 |issue=Supplement 1 |page=1 |doi=10.1016/S0924-9338(13)77215-8 |s2cid=144410795 }}{{cite book | vauthors = Liu PM, Van Liew DA | date = 2003 | chapter = Depression and burnout. | veditors = Kahn JP, Langlieb AM | title = Mental health and productivity in the workplace: A handbook for organizations and clinician | pages = 433–457 | location = San Francisco | publisher = Jossey-Bass }} and Unspecified Trauma- and Stressor-Related Disorder{{Cite book | author = American Psychiatric Association |url=http://worldcat.org/oclc/926613691 |title=Diagnostic and statistical manual of mental disorders : DSM-5 |date=2013 |publisher=American Psychiatric Publishing |isbn=978-0-89042-555-8 |page=290 |oclc=926613691}} have been said that in some cases reflect the condition. The 2022 update of the DSM, the DSM-5-TR, did not include burnout.{{Cite web |title=Psychiatry.org - Updates to DSM-5 Criteria & Text |url=https://psychiatry.org:443/psychiatrists/practice/dsm/updates-to-dsm/updates-to-dsm-5-criteria-text |access-date=2022-07-14 |website=psychiatry.org |language=en}}

The ICD-10 (1994–2021) classification "burn-out" as a type of non-medical life-management difficulty under code Z73.0.ICD-10: International Classification of Diseases, Z73. Geneva: World Health Organization, 2015. It was considered to be one of the "factors influencing health status and contact with health services" and "should not be used" for "primary mortality coding."{{Cite book | chapter = XXI: Factors influencing health status and contact with health services | chapter-url=https://icd.who.int/browse10/2019/en#/XXI |title = International Statistical Classification of Diseases and Related Health Problems 10th Revision (ICD-10) | date = 2019 | publisher = World Health Organization }} It was also considered one of the "problems related to life-management difficulty."{{Cite book | chapter = Z73 Problems related to life-management difficulty | chapter-url=https://icd.who.int/browse10/2019/en#/Z73 |title = International Statistical Classification of Diseases and Related Health Problems 10th Revision (ICD-10) | date = 2019 | publisher = World Health Organization }} The condition is further defined as being a "state of vital exhaustion," which historically had been called neurasthenia.{{Cite book | chapter = Z73 Burn-out | chapter-url=https://icd.who.int/browse10/2019/en#/Z73.0 |title = International Statistical Classification of Diseases and Related Health Problems 10th Revision (ICD-10) | date = 2019 | publisher = World Health Organization }} The ICD-10 also contained a medical condition category of "F43.8 Other reactions to severe stress."{{Cite book | chapter = F43.8 Other reactions to severe stress | chapter-url=https://icd.who.int/browse10/2019/en#/F43.8 |title = International Statistical Classification of Diseases and Related Health Problems 10th Revision (ICD-10) | date = 2019 | publisher = World Health Organization }}

In 2003, Liu and van Liew wrote that "the term burnout is used so frequently that it has lost much of its original meaning. As originally used, burnout meant a mild degree of stress-induced unhappiness. The solutions ranged from a vacation to a sabbatical. Ultimately, it was used to describe everything from fatigue to a major depression and now seems to have become an alternative word for depression, but with a less serious significance" (p. 434). The authors equated burnout with adjustment disorder with depressed mood.

In a 2003 paper that described Dutch practice guidelines, van der Klink and van Dijk observed that the Royal Dutch Medical Association defined burnout as a subtype of adjustment disorder{{cite journal |vauthors=van der Klink JJ, van Dijk FJ |date=December 2003 |title=Dutch practice guidelines for managing adjustment disorders in occupational and primary health care |journal=Scandinavian Journal of Work, Environment & Health |volume=29 |issue=6 |pages=478–487 |doi=10.5271/sjweh.756 |jstor=40967326 |pmid=14712856 |doi-access=free}} as part of the ICD-10 system. In the Netherlands, overspannenheid (overstrain) is a condition that leads to burn-out.{{Cite journal |last1=Maslach |first1=Christina |last2=Leiter |first2=Michael P. |date=June 2016 |title=Understanding the burnout experience: recent research and its implications for psychiatry |journal=World Psychiatry |language=en |volume=15 |issue=2 |pages=103–111 |doi=10.1002/wps.20311 |pmc=4911781 |pmid=27265691}} In that country, burnout is included in handbooks and medical staff are trained in its diagnosis and treatment.{{cite journal |vauthors=Schaufeli WB |date=June 2009 |title=Burnout: 35 years of research and practice |journal=Career Development International |volume=14 |issue=3 |pages=204–220 |doi=10.1108/13620430910966406 |s2cid=47047482}} A reform of Dutch health insurance programs resulted in adjustment disorder treatment being removed from the compulsory basic package in 2012. Practitioners were told that more serious cases of the condition may qualify for classification as depression or anxiety disorder.{{Cite web | author = Ministerie van Volksgezondheid Welzijn en Sport |date=2011-10-28 |title=Besluit van 30 september 2011, houdende wijziging van het Besluit zorgverzekering in verband met wijziging van de te verzekeren prestaties Zorgverzekeringswet per 2012 en de eigen bijdragen daarvoor en wijziging van dat besluit en het Besluit zorgaanspraken AWBZ in verband met stringent pakketbeheer en wijziging van het Besluit tegemoetkoming chronisch zieken en gehandicapten |url=https://zoek.officielebekendmakingen.nl/stb-2011-467.html |access-date=2022-07-14 |website=zoek.officielebekendmakingen.nl |language=nl}}

A 2013 French study bearing on diagnosis compared the depressive symptom profiles of 46 depressed outpatients, an equal number of individuals, in this case teachers, with clinical burnout, and more than 400 burnout-free teachers. The depressive symptom profiles of the depressed patients and the burnt-out teachers were highly similar but both groups had similarly and significantly higher levels of depressive symptoms than that of the teachers without clinical burnout.

With several European countries having legally recognized burnout in some way, such as by providing workers' compensation payments.{{cite journal |display-authors=6 |vauthors=Lastovkova A, Carder M, Rasmussen HM, Sjoberg L, Groene GJ, Sauni R, Vevoda J, Vevodova S, Lasfargues G, Svartengren M, Varga M, Colosio C, Pelclova D |date=April 2018 |title=Burnout syndrome as an occupational disease in the European Union: an exploratory study |journal=Industrial Health |volume=56 |issue=2 |pages=160–165 |doi=10.2486/indhealth.2017-0132 |pmc=5889935 |pmid=29109358 |quote=In 9 countries (Denmark, Estonia, France, Hungary, Latvia, Netherlands, Portugal, and Slovakia) burnout syndrome may be acknowledged as an occupational disease. [emphasis added]}} Legal recognition for financial purposes, however, is not the same as medical recognition as a discrete disease. If, after treatment, a person with burnout continues to have persistent physical symptoms triggered by the condition, in Iceland the individual may be considered to have "somatic symptom disorder" (DSM-5) or "bodily distress disorder" (ICD-11).{{cite journal | vauthors = Broddadóttir E, Flóvenz SÓ, Gylfason HF, Þormar Þ, Einarsson H, Salkovskis P, Sigurðsson JF | title = 'I'm So Tired': Fatigue as a Persistent Physical Symptom among Working People Experiencing Exhaustion Disorder | journal = International Journal of Environmental Research and Public Health | volume = 18 | issue = 16 | page= 8657 | date = August 2021 | pmid = 34444405 | pmc = 8392333 | doi = 10.3390/ijerph18168657 | doi-access = free }}

Rotentstein et al. (2018){{cite journal | vauthors = Rotenstein LS, Torre M, Ramos MA, Rosales RC, Guille C, Sen S, Mata DA | title = Prevalence of Burnout Among Physicians: A Systematic Review | journal = JAMA | volume = 320 | issue = 11 | pages = 1131–1150 | date = September 2018 | pmid = 30326495 | pmc = 6233645 | doi = 10.1001/jama.2018.12777 }} in a review of research on physician burnout identified 142 different definitions of burnout, underlining the great heterogeneity in diagnostic criteria for the condition. Marked differences among researchers' conceptualizations of what constitutes burnout have underlined the absence of a consensus definition.

A new version of the ICD, ICD-11, was released in June 2018, for first use in January 2022.{{Cite web | url=https://www.who.int/news-room/detail/18-06-2018-who-releases-new-international-classification-of-diseases-(icd-11) | title=WHO releases new International Classification of Diseases (ICD 11)}} The new version has an entry coded and titled "QD85 Burn-out." The ICD-11 describes the condition as follows:

{{blockquote|Burn-out is a syndrome conceptualized as resulting from chronic workplace stress that has not been successfully managed. It is characterized by three dimensions: 1) feelings of energy depletion or exhaustion; 2) increased mental distance from one's job, or feelings of negativism or cynicism related to one's job; and 3) reduced professional efficacy. Burn-out refers specifically to phenomena in the occupational context and should not be applied to describe experiences in other areas of life.{{Cite web |title=QD85 Burn-out |url=https://icd.who.int/browse11/l-m/en#/http%3A%2F%2Fid.who.int%2Ficd%2Fentity%2F129180281 |website=icd.who.int |url-status= |archive-url= |archive-date= }}}}

This condition is classified under "Problems associated with employment or unemployment" in the section on "Factors influencing health status or contact with health services." The section is devoted to reasons other than recognized diseases or health conditions for which people contact health services.{{Cite web |url=https://icd.who.int/browse11/l-m/en#/http://id.who.int/icd/entity/1249056269 |title=24. Factors influencing health status or contact with health services |website=icd.who.int|access-date=2019-05-28 |quote=Categories in this chapter are provided for occasions when circumstances other than a disease, injury or external cause classifiable elsewhere are recorded as "diagnoses" or "problems." This can arise... When some circumstance or problem is present which influences the person's health status but is not in itself a current illness or injury. Such circumstance or problem may be elicited during population surveys, when the person may or may not be currently sick, or be recorded as additional information to be borne in mind when the person is receiving care for some illness or injury.}} In a statement made in May 2019, the WHO said "Burn-out is included in the 11th Revision of the International Classification of Diseases (ICD-11) as an occupational phenomenon. It is not classified as a medical condition."{{Cite web | url=https://www.who.int/mental_health/evidence/burn-out/en/ |title = Burn-out an 'occupational phenomenon': International Classification of Diseases |website=WHO}} The ICD-11 also has the medical condition "6B4Y Other specified disorders specifically associated with stress,"{{Cite web | url=https://icd.who.int/browse11/l-m/en#/http%3a%2f%2fid.who.int%2ficd%2fentity%2f991786158%2fmms%2fother |title = ICD-11 – Mortality and Morbidity Statistics}} which is the equivalent of the ICD-10's F43.8.

Further detail about the varied ways clinicians and others used the then-current ICD and DSM classifications with burnout was published by Dutch psychologist Arno Van Dam in 2021.{{Cite journal | vauthors = van Dam A |date=2021-09-03 |title=A clinical perspective on burnout: diagnosis, classification, and treatment of clinical burnout |journal=European Journal of Work and Organizational Psychology |volume=30 |issue=5 |pages=732–741 |doi=10.1080/1359432X.2021.1948400 |s2cid=237829018 |issn=1359-432X|doi-access=free }} The US government's National Institutes of Health includes the condition as "psychological burnout" in its index of the National Library of Medicine,{{Cite web |title=MeSH Browser |url=https://meshb.nlm.nih.gov/record/ui?ui=D000077062 |access-date=2022-07-14 |website=meshb.nlm.nih.gov}} and provides a number of synonyms. It defines the condition as "An excessive reaction to stress caused by one's environment that may be characterized by feelings of emotional and physical exhaustion, coupled with a sense of frustration and failure." SNOMED CT includes the term "burnout" as a synonym for its defined condition of "Physical AND emotional exhaustion state," which is a subtype of anxiety disorder.{{Cite web |title=58535001 – Physical AND emotional exhaustion state – SNOMED CT |url=https://www.findacode.com/snomed/58535001--physical-and-emotional-exhaustion-state.html |access-date=2022-07-14 |website=www.findacode.com |language=en |archive-date=2023-04-16 |archive-url=https://web.archive.org/web/20230416004253/https://www.findacode.com/snomed/58535001--physical-and-emotional-exhaustion-state.html |url-status=dead }} The Diseases Database defines the condition as "professional burnout."{{Cite web | vauthors = Duncan M |date=2022-05-04 |title=Professional burnout information Diseases Database |url=http://www.diseasesdatabase.com/ddb33346.htm |access-date=2022-07-14 |website=www.diseasesdatabase.com |language=en}}

A number of instruments have been developed to assess work-related burnout. These instruments include the Maslach Burnout Inventory, the Oldenburg Burnout Inventory, the Copenhagen Burnout Inventory, the Shirom-Melamed Burnout Measure, the Karolinska Exhaustion Disorder Scale, and the Sydney Burnout Measure among other scales. The National Academy of Medicine has created an inventory of burnout scales.National Academy of Medicine. Valid and Reliable Survey Instruments to Measure Burnout, Well-Being, and Other Work-Related Dimensions. Available at: https://nam.edu/product/valid-and-reliable-survey-instruments-to-measure-burnout-well-being-and-other-work-related-dimensions/

In 1981, Maslach and Jackson published the first widely used instrument for assessing burnout, the Maslach Burnout Inventory (MBI).{{cite journal| vauthors = Maslach C, Jackson SE |s2cid=53003646|year=1981|title=The measurement of experienced burnout|journal=Journal of Occupational Behaviour|volume=2|issue=2|pages=99–113|doi=10.1002/job.4030020205|doi-access=free}} It remains by far the most commonly used instrument to assess the condition. Consistent with Maslach's conceptualization, the MBI operationalizes burnout as a three-dimensional syndrome consisting of emotional exhaustion, depersonalization (an unfeeling and impersonal response toward recipients of one's service, care, treatment, or instruction),{{Efn|The term "depersonalization" as used by Maslach and Jackson should not be confused with the same term used in psychiatry and clinical psychology as a hallmark of dissociative disorder.|name=|group=}} and reduced personal accomplishment. The MBI originally focused on human service professionals (e.g., teachers, social workers). Since that time, the MBI has been used for a wider variety of workers (e.g., healthcare workers). The instrument or its variants are now employed with job incumbents working in many other occupations.

The MBI is proprietary. Its cost may be a disincentive that discourages graduate students and young assistant professors from using it. There are other conceptualizations of burnout that differ from the conceptualization suggested by Maslach and adopted by the WHO.

In 1999, Demerouti and Bakker,{{cite journal | vauthors = Demerouti E, Bakker AB, Vardakou I, Kantas A | year = 2003 | title = The convergent validity of two burnout instruments: A multitrait-multimethod analysis | journal = European Journal of Psychological Assessment | volume = 19 | pages = 12–23 | doi = 10.1027//1015-5759.19.1.12 }} with their Oldenburg Burnout Inventory (OLBI), conceptualized burnout in terms of exhaustion and disengagement, linking their conceptualization to the job demands–resources model.

In 2005, Kristensen et al.{{cite journal |vauthors=Kristensen TS, Borritz M, Villadsen E, Christensen KB |year=2005 |title=The Copenhagen Burnout Inventory: A new tool for the assessment of burnout |journal=Work & Stress |volume=19 |issue=3 |pages=192–207 |doi=10.1080/02678370500297720 |s2cid=146576094}} released the public domain Copenhagen Burnout Inventory (CBI). They argued that the definition of burnout should be limited to fatigue and exhaustion.

In 2006, Shirom and Melamed with their Shirom-Melamed Burnout Measure (SMBM) conceptualized burnout in terms of physical exhaustion, cognitive weariness, and emotional exhaustion.{{cite journal |vauthors=Shirom A, Melamed S |year=2006 |title=A comparison of the construct validity of two burnout measures in two groups of professionals |journal=International Journal of Stress Management |volume=13 |issue=2 |pages=176–200 |doi=10.1037/1072-5245.13.2.176}},{{cite journal |vauthors=Toker S, Melamed S, Berliner S, Zeltser D, Shapira I |date=October 2012 |title=Burnout and risk of coronary heart disease: a prospective study of 8838 employees |journal=Psychosomatic Medicine |volume=74 |issue=8 |pages=840–847 |doi=10.1097/PSY.0b013e31826c3174 |pmid=23006431 |s2cid=25632534}} An examination of the SMBM's emotional exhaustion subscale, however, indicates that the subscale more clearly embodies Maslach's{{cite journal |vauthors=Maslach C, Schaufeli WB, Leiter MP |year=2001 | veditors = Schacter DL, Zahn-Waxler C, Fiske ST |title=Job burnout |journal=Annual Review of Psychology |volume=52 |pages=397–422 |doi=10.1146/annurev.psych.52.1.397 |pmid=11148311 |s2cid=42874270 }} concept of depersonalization than her concept of emotional exhaustion. This measure has seen some use in Sweden.

In 2014, Besèr et al. publised the Karolinska Exhaustion Disorder Scale (KEDS),{{Cite web |title=K E D S – Karolinska Exhaustion Disorder Scale |url=https://www.kedsstresstest.com/ |access-date=2022-07-15 |website=www.kedsstresstest.com}} which is used mainly in Sweden. It was designed to measure the symptoms defined by the ICD-10-SE's category for exhaustion disorder. The authors believed that those with the disorder were often initially depressed, but that this soon passed. The core symptoms of the disorder were deemed to be "exhaustion, cognitive problems, sleep disturbance". The authors also believed that the condition was clearly differentiated from both depression and anxiety.

In 2021, Gordon Parker et al. published the Sydney Burnout Measure (SBM), an instrument that "captures domains of exhaustion, cognitive impairment, loss of empathy, withdrawal and insularity, and impaired work performance, as well as several anxiety, depression and irritability symptoms."{{cite journal | vauthors = Parker G, Tavella G | title = Burnout: a case for its formal inclusion in classification systems | journal = World Psychiatry | volume = 21 | issue = 3 | pages = 467–468 | date = October 2022 | pmid = 36073702 | pmc = 9453885 | doi = 10.1002/wps.21025 }}

There are other conceptualizations of burnout embodied in other instruments, including the Hamburg Burnout Inventory,{{cite journal | vauthors = Wurm W, Vogel K, Holl A, Ebner C, Bayer D, Mörkl S, Szilagyi IS, Hotter E, Kapfhammer HP, Hofmann P | display-authors = 6 | title = Depression-Burnout Overlap in Physicians | journal = PLOS ONE | volume = 11 | issue = 3 | pages = e0149913 | year = 2016 | pmid = 26930395 | pmc = 4773131 | doi = 10.1371/journal.pone.0149913 | bibcode = 2016PLoSO..1149913W | doi-access = free }} the Burnout Assessment Tool,Schaufeli, W., Desart, S., & De Witte, H. (2020). The Burnout Assessment Tool (BAT) – development, validity and reliability. International Journal of Environmental Research and Public Health, 17(24), 9495. https://doi.org/10.3390/ijerph17249495 the Burnout Measure,Pines, A., & Aronson, E. (1988). Career burnout: Causes and cures. The Free Press.{{cite journal |vauthors=Malach-Pines A |year=2005 |title=The Burnout Measure, Short Version |journal=International Journal of Stress Management |volume=12 |issue=1 |pages=78–88 |doi=10.1037/1072-5245.12.1.78}} and the Meier Burnout Assessment.Meier, S. T. (1984). The construct validity of burnout. Journal of Occupational Psychology, 53(3), 211–219. https://doi.org/10.1111/j.2044-8325.1984.tb00163.x

Two other instruments were developed with a partial relationship to burnout. One is the Utrecht Work Engagement Scale (UWES). In 1999, Wilmar Schaufeli and Arnold Bakker published the UWES, an instrument that uses a conceptualisation similar to that of the MBI. However the UWES measures vigour, dedication and absorption; positive counterparts to the values measured by the MBI.{{cite book | vauthors = Schaufeli WB, Bakker A | title = UWES-Utrecht work engagement scale. Preliminary manual. | date = 2003 | pages = 3–60 | publisher = Occupational Health Psychology Unit Utrecht University | url = https://www.wilmarschaufeli.nl/publications/Schaufeli/Test%20Manuals/Test_manual_UWES_English.pdf }} The other instrument is the Well-Being Index. In 2010, researchers at the Mayo Clinic used portions of the MBI, along with other comprehensive assessments, to develop the Well-Being Index, a nine-item self-assessment tool designed to measure burnout and other dimensions of distress in healthcare workers specifically.{{cite journal | vauthors = Dyrbye LN, Szydlo DW, Downing SM, Sloan JA, Shanafelt TD | title = Development and preliminary psychometric properties of a well-being index for medical students | journal = BMC Medical Education | volume = 10 | issue = 1 | pages = 8 | date = January 2010 | pmid = 20105312 | pmc = 2823603 | doi = 10.1186/1472-6920-10-8 | doi-access = free }} The measure has mainly been used in the United States.

The core of all of the abovementioned conceptualizations, including that of Freudenberger, is exhaustion.{{cite journal |vauthors=Schonfeld IS, Verkuilen J, Bianchi R |date=August 2019 |title=An exploratory structural equation modeling bi-factor analytic approach to uncovering what burnout, depression, and anxiety scales measure |url=https://academicworks.cuny.edu/gc_pubs/608 |journal=Psychological Assessment |volume=31 |issue=8 |pages=1073–1079 |doi=10.1037/pas0000721 |pmid=30958024 |s2cid=102348532|url-access=subscription }}

In 2020, the Occupational Depression Inventory (ODI){{cite journal | vauthors = Bianchi R, Schonfeld IS | title = The Occupational Depression Inventory: A new tool for clinicians and epidemiologists | journal = Journal of Psychosomatic Research | volume = 138 | page = 110249 | date = November 2020 | pmid = 32977198 | doi = 10.1016/j.jpsychores.2020.110249 | s2cid = 221937871 | doi-access = free }} was published. The measure covers the nine main symptoms of depression,American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). quantifies the severity of work-attributed symptoms, and generates provisional diagnoses of job-ascribed depression.{{cite journal | vauthors = Schonfeld IS, Bianchi R | title = Distress in the workplace: Characterizing the relationship of burnout measures to the Occupational Depression Inventory | journal = International Journal of Stress Management |date = 2022 | volume = 29 | issue = 3 | pages = 253–259 | doi = 10.1037/str0000261 | url = https://academicworks.cuny.edu/cgi/viewcontent.cgi?article=2062&context=cc_pubs | url-access = subscription }}{{cite journal | vauthors = Schonfeld IS, Bianchi R | title = From burnout to occupational depression: Recent developments in research on job-related distress and occupational health | journal = Frontiers in Public Health | volume = 9 | date = 2021 | page = 796401 | pmid = 34957039 | doi = 10.3389/fpubh.2021.796401 | pmc = 8702721 | doi-access = free }} The instrument exhibits robust psychometric properties. The ODI is the only instrument that assesses work-related suicidal thoughts, a particularly important symptom calling for immediate attention. Available evidence indicates that burnout scales have very high correlations with the ODI, correlations that cannot be explained by item content overlap, suggesting that the ODI is a suitable replacement for burnout scales like the MBI.

Maslach advanced the idea that burnout should not be viewed as a depressive condition. Recent evidence, based on factor-analytic and meta-analytic findings, calls into question this supposition.{{Cite journal |display-authors=6 |vauthors=Bianchi R, Verkuilen J, Schonfeld IS, Hakanen JJ, Jansson-Fröjmark M, Manzano-García G, Laurent E, Meier LL |date=March 2021 |title=Is burnout a depressive condition? A 14-sample meta-analytic and bifactor analytic study |url=https://academicworks.cuny.edu/gc_pubs/707 |journal=Clinical Psychological Science |language=en |volume=24 |issue=6 |pages=603–616 |doi=10.1177/2167702620979597 |s2cid=233636338|url-access=subscription }}{{cite journal |vauthors=Bianchi R, Schonfeld IS, Verkuilen J |date=April 2020 |title=A five-sample confirmatory factor analytic study of burnout-depression overlap |url=https://academicworks.cuny.edu/cgi/viewcontent.cgi?article=1715&context=gc_pubs |journal=Journal of Clinical Psychology |volume=76 |issue=4 |pages=801–821 |doi=10.1002/jclp.22927 |pmid=31926025 |s2cid=210150400|url-access=subscription }} Burnout is also now often seen as involving the full array of depressive symptoms (e.g., low mood, cognitive alterations, sleep disturbance).{{cite journal |vauthors=Bianchi R, Schonfeld IS, Laurent E |date=March 2015 |title=Burnout-depression overlap: a review |url=https://academicworks.cuny.edu/cc_pubs/297 |journal=Clinical Psychology Review |volume=36 |pages=28–41 |doi=10.1016/j.cpr.2015.01.004 |pmid=25638755|url-access=subscription }}{{cite journal |vauthors=Bianchi R, Schonfeld IS, Vandel P, Laurent E |date=March 2017 |title=On the depressive nature of the 'burnout syndrome': A clarification |url=https://academicworks.cuny.edu/gc_pubs/455 |journal=European Psychiatry |volume=41 |pages=109–110 |doi=10.1016/j.eurpsy.2016.10.008 |pmid=28135592 |s2cid=9411035|url-access=subscription }}

As listed below, there are thought to be other types of burnout. Except for teacher burnout, the other types of burnout are not reflective of occupational burnout.

{{Main|Caregiver stress}}Burnout is thought to affect caregivers. In the ICD-11, in the description for code QF27 "Difficulty or need for assistance at home and no other household member able to render care" the term "caregiver burnout" is given as a synonym.

Malach-Pines (who also published as Ayala Pines){{cite journal |vauthors=Pines AM |year=1987 |title=Marriage burnout |journal=Psychotherapy in Private Practice |volume=5 |pages=31–44}} advanced the view that burnout can also occur in connection to the spousal role.{{cite book |title=Couple burnout |vauthors=Pines AM |date=1996 |publisher=Routledge |location=New York/London}}{{cite journal |vauthors=Pines AM, Neal MB, Hammer LB, Icekson T |year=2011 |title=Job burnout and couple burnout in dual-earner couples in the sandwiched generation |journal=Social Psychology Quarterly |volume=74 |issue=4 |pages=361–386 |doi=10.1177/0190272511422452 |s2cid=55657249}}

{{Main|Teacher burnout}}

Burnout in teachers represents a type occupational burnout.{{cite book |url=https://archive.org/details/crisisineducatio0000farb |title=Crisis in education: stress and burnout in the American teacher |vauthors=Farber BA |date=1991 |publisher=Jossey-Bass |isbn=9781555422714 |location=San Francisco |url-access=registration}}

{{Main|Overtraining}}

Athlete burnout, which burdens athletes' mental health and well-being, can, in extreme cases, lead to athletes terminating their participation in a physical activity they once enjoyed.{{Cite journal |last1=Rotella |first1=Robert |last2=Hanson |first2=Tom |last3=Coop |first3=Richard |date=May 1991 |title=Burnout in Youth Sports |url=https://www.jstor.org/stable/1001882 |journal=The Elementary School Journal |volume=91 |issue=5 |pages=421–428 |doi=10.1086/461664 |jstor=1001882 |url-access=subscription }}

{{Main|Autistic burnout}}

Autistic people are known to experience a state of mental, emotional, or physical exhaustion referred to as autistic burnout because of the general stress involved in masking of autistic traits and behavior and the strains associated with living in an unaccommodating environment.{{Cite journal |last=Deweerdt |first=Sarah |date=2020-03-30 |title=Autistic burnout, explained |url=https://www.spectrumnews.org/news/autistic-burnout-explained/ |access-date=2023-05-09 |journal=Spectrum |publisher=Simons Foundation |language=en-US |doi=10.53053/bpzp2355|s2cid=251634477 |doi-access=free }}{{Cite journal |last1=Arnold |first1=Samuel RC |last2=Higgins |first2=Julianne M |last3=Weise |first3=Janelle |last4=Desai |first4=Aishani |last5=Pellicano |first5=Elizabeth |last6=Trollor |first6=Julian N |date=2023 |title=Confirming the nature of autistic burnout |url=https://journals.sagepub.com/doi/10.1177/13623613221147410 |journal=Autism |volume=27 |issue=7 |pages=1906–1918 |language=en |doi=10.1177/13623613221147410|pmid=36637293 |s2cid=255773489 |hdl=1959.4/unsworks_83739 |hdl-access=free }}{{Cite journal |last1=Arnold |first1=Samuel RC |last2=Higgins |first2=Julianne M |last3=Weise |first3=Janelle |last4=Desai |first4=Aishani |last5=Pellicano |first5=Elizabeth |last6=Trollor |first6=Julian N |date=2023 |title=Towards the measurement of autistic burnout |url=https://journals.sagepub.com/doi/10.1177/13623613221147401 |journal=Autism |volume=27 |issue=7 |pages=1933–1948 |language=en |doi=10.1177/13623613221147401|pmid=36637292 |s2cid=255774785 |hdl=1959.4/unsworks_83734 |hdl-access=free }} Autistic burnout is considered to be distinct from occupational burnout in both etiology and presentation.{{Cite journal |last1=Raymaker |first1=Dora M. |last2=Teo |first2=Alan R. |last3=Steckler |first3=Nicole A. |last4=Lentz |first4=Brandy |last5=Scharer |first5=Mirah |last6=Delos Santos |first6=Austin |last7=Kapp |first7=Steven K. |last8=Hunter |first8=Morrigan |last9=Joyce |first9=Andee |last10=Nicolaidis |first10=Christina |date=2020 |title='Having All of Your Internal Resources Exhausted Beyond Measure and Being Left with No Clean-Up Crew': Defining Autistic Burnout |journal=Autism in Adulthood |volume=2 |issue=2 |pages=132–143 |doi=10.1089/aut.2019.0079 |pmc=7313636 |pmid=32851204}}

Liu and van Liew advanced the view that the concept of burnout has been overused and "lost much of its original meaning." They wrote that originally the term referred to a mild degree of unhappiness caused by job stress. The remedies include a vacation. They suggested that the contemporary use of the term burnout can refer to conditions that range from fatigue to major depression. They wrote that the term has served as a euphemism for depression.

A body of evidence indicates that burnout is etiologically, clinically, and nosologically similar to depression.{{cite book | vauthors = Bianchi E, Schonfeld IS, Laurent E | date = 2018 | chapter = Burnout syndrome and depression. | veditors = Kim YK | title = Understanding depression: Volume 2. Clinical manifestations, diagnosis and treatment | pages = 187–202 | location = Singapore | publisher = Springer | doi = 10.1007/978-981-10-6577-4_14 | isbn = 978-981-10-6576-7 | chapter-url = https://academicworks.cuny.edu/cgi/viewcontent.cgi?article=1556&context=gc_pubs }}{{cite journal | vauthors = Ahola K, Hakanen J, Perhoniemi R, Mutanen P | year = 2014 | title = Relationship between burnout and depressive symptoms: A study using the person-centred approach | journal = Burnout Research | volume = 1 | issue = 1| pages = 29–37 | doi=10.1016/j.burn.2014.03.003| doi-access = free }}{{cite journal | vauthors = Hintsa T, Elovainio M, Jokela M, Ahola K, Virtanen M, Pirkola S | title = Is there an independent association between burnout and increased allostatic load? Testing the contribution of psychological distress and depression | journal = Journal of Health Psychology | volume = 21 | issue = 8 | pages = 1576–1586 | date = August 2016 | pmid = 25476575 | doi = 10.1177/1359105314559619 | hdl-access = free | s2cid = 206711913 | hdl = 10138/224473 }}{{cite journal | vauthors = Schonfeld IS, Bianchi R | title = Burnout and Depression: Two Entities or One? | journal = Journal of Clinical Psychology | volume = 72 | issue = 1 | pages = 22–37 | date = January 2016 | pmid = 26451877 | doi = 10.1002/jclp.22229 | url = https://academicworks.cuny.edu/cgi/viewcontent.cgi?article=1276&context=gc_pubs | url-access = subscription }} In a study that directly compared depressive symptoms in burned out workers and clinically depressed patients, no diagnostically significant differences were found between the two groups; burned out workers reported as many depressive symptoms as clinically depressed patients.{{cite journal | vauthors = Bianchi R, Boffy C, Hingray C, Truchot D, Laurent E | title = Comparative symptomatology of burnout and depression | journal = Journal of Health Psychology | volume = 18 | issue = 6 | pages = 782–787 | date = June 2013 | pmid = 23520355 | doi = 10.1177/1359105313481079 | s2cid = 37998080 }} Moreover, a study by Bianchi et al. (2014) showed that about 90% of workers with very high scores on the MBI meet diagnostic criteria for depression.{{cite journal | vauthors = Bianchi R, Schonfeld IS, Laurent E | title = Is burnout separable from depression in cluster analysis? A longitudinal study | journal = Social Psychiatry and Psychiatric Epidemiology | volume = 50 | issue = 6 | pages = 1005–1011 | date = June 2015 | pmid = 25527209 | doi = 10.1007/s00127-014-0996-8 | s2cid = 10307296 | url = https://academicworks.cuny.edu/cc_pubs/323 | url-access = subscription }} The view that burnout is a form of depression has found support. Some authors have recommended that the nosological concept of burnout be revised or even abandoned entirely given that it is not a distinct disorder and that there is little agreement on burnout's diagnostic criteria.{{cite journal | vauthors = Schwenk TL, Gold KJ | title = Physician Burnout-A Serious Symptom, But of What? | journal = JAMA | volume = 320 | issue = 11 | pages = 1109–1110 | date = September 2018 | pmid = 30422283 | doi = 10.1001/jama.2018.11703 | s2cid = 53293067 }} A newer generation of studies indicates that burnout, particularly its exhaustion dimension, problematically overlaps with depression; these studies have relied on more sophisticated statistical techniques, for example, exploratory structural equation modeling (ESEM) bifactor analysis, than earlier studies of the topic.{{cite journal | vauthors = Verkuilen J, Bianchi R, Schonfeld IS, Laurent E | title = Burnout-Depression Overlap: Exploratory Structural Equation Modeling Bifactor Analysis and Network Analysis | journal = Assessment | volume = 28 | issue = 6 | pages = 1583–1600 | date = September 2021 | pmid = 32153199 | doi = 10.1177/1073191120911095 | s2cid = 212651644 }} The advantage of ESEM bifactor analysis, which combines the best features of exploratory and confirmatory factor analysis, is that it provides a granular look at item-construct relationships, without falling into traps earlier burnout researchers fell into.{{cite journal | vauthors = Rodriguez A, Reise SP, Haviland MG | title = Evaluating bifactor models: Calculating and interpreting statistical indices | journal = Psychological Methods | volume = 21 | issue = 2 | pages = 137–150 | date = June 2016 | pmid = 26523435 | doi = 10.1037/met0000045 }}

Kakiashvili et al.{{cite journal | vauthors = Kakiashvili T, Leszek J, Rutkowski K | title = The medical perspective on burnout | journal = International Journal of Occupational Medicine and Environmental Health | volume = 26 | issue = 3 | pages = 401–412 | date = June 2013 | pmid = 24018996 | doi = 10.2478/s13382-013-0093-3 | doi-access = free }} argued that although burnout and depression have overlapping symptoms, endocrine evidence suggests that the disorders' biological bases are different. They argued that antidepressants should not be used by people with burnout because the medications can make the underlying hypothalamic–pituitary–adrenal axis dysfunction worse. Others have found Kakiashvili et al.'s argument specious.{{cite journal | vauthors = Bianchi R, Schonfeld IS, Laurent E | year = 2014 | title = Is burnout a depressive disorder? A re-examination with special focus on atypical depression | url = https://academicworks.cuny.edu/cgi/viewcontent.cgi?article=1316&context=cc_pubs| journal = International Journal of Stress Management | volume = 21 | issue = 4 | pages = 307–324 | doi=10.1037/a0037906| url-access = subscription }}

Evidence suggests that the etiology of burnout is multifactorial, with personality factors playing an important, long-overlooked role.Schaufeli, W. B., & Enzmann, D. (1998). The burnout companion to study and practice: A critical analysis. Taylor & Francis.{{cite journal | vauthors = Alarcon G, Eschleman KJ, Bowling NA |year = 2009|title = Relationships between personality variables and burnout: A meta-analysis|journal = Work & Stress|volume = 23|issue = 3|pages = 244–263|doi = 10.1080/02678370903282600|s2cid = 144848431}}{{cite journal | vauthors = Swider BW, Zimmerman RD |year = 2010|title = Born to burnout: A meta-analytic path model of personality, job burnout, and work outcomes|journal = Journal of Vocational Behavior|volume = 76|issue = 3|pages = 487–506|doi = 10.1016/j.jvb.2010.01.003}} The researchers identified the prominent personality factor neuroticism in the development of burnout. Cognitive dispositional factors implicated in depression have also been found to be implicated in burnout.{{cite journal| vauthors = Bianchi R, Schonfeld IS |year=2016|title=Burnout is associated with a depressive cognitive style|url=https://academicworks.cuny.edu/cc_pubs/318|journal=Personality and Individual Differences|volume=100|pages=1–5|doi=10.1016/j.paid.2016.01.008|url-access=subscription}}

Burnout is thought to occur when there is a mismatch between the job and the worker. A common type of mismatch is work overload. For example, work overload can occur when a worker survives a round of layoffs, but after the layoffs the worker is doing too much with too few resources. In the context of downsizing, an organization does not ordinarily narrow its goals, although fewer employees are available to meet those goals.{{cite book| vauthors = Maslach C, Leiter MP |title=The Truth About Burnout: How Organizations Cause Personal Stress and What to Do About It|publisher=Jossey-Bass|year=1997|location=New York}} The research on downsizing indicates that it has more destructive effects on the health of the workers who survive the layoffs than just its effect on burnout; these health effects include increased levels of sickness and greater risk of mortality.{{cite journal | vauthors = Vahtera J, Kivimäki M, Pentti J, Linna A, Virtanen M, Virtanen P, Ferrie JE | title = Organisational downsizing, sickness absence, and mortality: 10-town prospective cohort study | journal = BMJ | volume = 328 | issue = 7439 | pages = 555 | date = March 2004 | pmid = 14980982 | pmc = 381046 | doi = 10.1136/bmj.37972.496262.0d }}

The job demands–resources model has implications for burnout, as measured by the Oldenburg Burnout Inventory (OLBI). Physical and psychological job demands were concurrently associated with the exhaustion, as measured by the OLBI.{{cite journal | vauthors = Demerouti E, Bakker AB, Nachreiner F, Schaufeli WB | title = The job demands-resources model of burnout | journal = The Journal of Applied Psychology | volume = 86 | issue = 3 | pages = 499–512 | date = June 2001 | pmid = 11419809 | doi = 10.1037/0021-9010.86.3.499 }} Lack of job resources was associated with the disengagement component of the OLBI. Maslach and her colleagues (2001) identified six risk factors for burnout: mismatch in workload, mismatch in control, lack of appropriate awards, loss of a sense of positive connection with others in the workplace, perceived lack of fairness, and conflict between values.

Although job stress has long been viewed as the main determinant of burnout, recent meta-analytic findings indicate that job stress is at best a weak predictor of burnout.{{cite journal | vauthors = Guthier C, Dormann C, Voelkle MC | title = Reciprocal effects between job stressors and burnout: A continuous time meta-analysis of longitudinal studies | journal = Psychological Bulletin | volume = 146 | issue = 12 | pages = 1146–1173 | date = December 2020 | pmid = 33119345 | doi = 10.1037/bul0000304 | s2cid = 226204886 }} These findings question one of the most central assumptions of burnout research. It has long been known that the personality dimension neuroticism is a strong predictor of burnout.

In a systematic literature review in 2014, the Swedish Agency for Health Technology Assessment and Assessment of Social Services (SBU) found that a number of work environment factors could affect the risk of developing exhaustion disorder or depressive symptoms:

• People who experience a work situation with little opportunity to influence, in combination with too high demands, develop more depressive symptoms.
• People who experience a lack of compassionate support in the work environment develop more symptoms of depression and exhaustion disorder than others. Those who experience bullying or conflict in their work develop more depressive symptoms than others, but it is not possible to determine whether there is a corresponding connection for symptoms of exhaustion disorder.
• People whose work situation is such that the reward they receive is perceived to be small in relation to the effort they put into their job are at greater risk for developing symptoms of depression and exhaustion. Workers who experience job insecurity are at greater risk of developing depressive symptoms.
• People whose job provides opportunities for autonomy and who are treated fairly at work are a lower risk of developing symptoms of depression and exhaustion.{{Cite web | work = Statens beredning för medicinsk och social utvärdering (SBU) | trans-work = Swedish Agency for Health Technology Assessment and Assessment of Social Services |date=2014-02-19 |title=Arbetsmiljöns betydelse för symtom på depression och utmattningssyndrom | trans-title = The importance of the work environment for symptoms of depression and fatigue syndrome |url=https://www.sbu.se/sv/publikationer/SBU-utvarderar/arbetsmiljons-betydelse-for-symtom-pa-depression-och-utmattningssyndrom/ |access-date=2022-07-15 |language=sv}}

In line with the work of Maslach and Jackson The World Health Organisation has defined burnout as consisting of:

1. feelings of energy depletion or exhaustion
2. increased mental distance from one's job, or feelings of negativism or cynicism related to one's job
3. reduced professional efficacy.{{Cite web |title=ICD-11 for Mortality and Morbidity Statistics |url=https://icd.who.int/browse11/l-m/en#/http://id.who.int/icd/entity/129180281 |access-date=2023-04-24 |website=icd.who.int}}

File:Smi3224-fig-0002-m.webp

Lindsäter et al. (2023) found a wide range of symptoms in individuals who were formally diagnosed with exhaustion disorder. The most commonly reported symptoms among people suffering with the disorder were tiredness, lack of energy, difficulty recovering from exertion, poor general cognitive functioning, memory problems, and difficulty coping with perceived stressors and demands. Some research indicates that burnout is associated with reduced job performance,{{cite journal | vauthors = Daniels AH, DePasse JM, Kamal RN | title = Orthopaedic Surgeon Burnout: Diagnosis, Treatment, and Prevention | journal = The Journal of the American Academy of Orthopaedic Surgeons | volume = 24 | issue = 4 | pages = 213–219 | date = April 2016 | pmid = 26885712 | doi = 10.5435/JAAOS-D-15-00148 | s2cid = 3175428 }} coronary heart disease, and mental health problems.{{cite journal | vauthors = Gray P, Senabe S, Naicker N, Kgalamono S, Yassi A, Spiegel JM | title = Workplace-Based Organizational Interventions Promoting Mental Health and Happiness among Healthcare Workers: A Realist Review | journal = International Journal of Environmental Research and Public Health | volume = 16 | issue = 22 | pages = 4396 | date = November 2019 | pmid = 31717906 | pmc = 6888154 | doi = 10.3390/ijerph16224396 | doi-access = free }} Emotional symptoms associated with occupational burnout include a lack of interest in work, reduced performance, feelings of helplessness, and trouble sleeping.{{cite book| vauthors = Aamodt M |title=Industrial/organizational psychology : an applied approach|date=2016|publisher=Cengage Learning|isbn=978-1-305-11842-3|edition=8th|location=Boston, MA|page=563}}

The Swedish health department has defined the effects of exhaustion disorder as being:

1. Concentration difficulties or impaired memory
2. Markedly reduced capacity to tolerate demands or to work under time pressure
3. Emotional instability or irritability
4. Sleep disturbance
5. Marked fatigability or physical weakness
6. Physical symptoms such as aches and pains, palpitations, gastrointestinal problems, vertigo or increased sensitivity to sound.{{cite journal | vauthors = Bartfai A, Åsberg M, Beser A, Sorjonen K, Wilczek A, Warkentin S | title = Impaired cognitive functioning in stress-induced exhaustion disorder: a new tablet-based assessment | journal = BMC Psychiatry | volume = 21 | issue = 1 | pages = 459 | date = September 2021 | pmid = 34537040 | pmc = 8449908 | doi = 10.1186/s12888-021-03454-1 | doi-access = free }}

Research on dentists and physicians suggests that burnout is a depressive syndrome. Thus reduced job performance and cardiovascular risk could be related to burnout because of burnout's tie to depression. Behavioral signs of occupational burnout are demonstrated through cynicism within workplace relationships with coworkers, clients, and the organization itself. Forced overtime, heavy workloads, and frenetic work paces give rise to debilitating repetitive stress injuries, on-the-job accidents, over-exposure to toxic substances, and other dangerous work conditions.{{cite web |last=Lung |first=Shirley |title=Overwork and overtime |url=https://mckinneylaw.iu.edu/ilr/pdf/vol39p51.pdf |access-date=2015-05-26 |website=mckinneylaw.iu.edu |ref=lung}} Williams and Strasser suggested that healthcare workers have focused much attention on the workplace risk factors for heart disease and other illnesses, but have underemphasized work-related depression risk.{{Cite book |last=Graaf |first=John de |url=https://books.google.com/books?id=dKziyTBAvzIC&q=%22compulsory+overwork%22&pg=PA129 |title=Take Back Your Time: Fighting Overwork and Time Poverty in America |year=2003 |publisher=Berrett-Koehler Publishers |isbn=9781609943974 |language=en |access-date=2015-05-09}}

Other effects of burnout can manifest as lower energy and productivity levels, with workers observed to be consistently late for work and feeling a sense of dread upon arriving.{{citation needed|date=February 2025}} They can suffer concentration problems, forgetfulness, increased frustration, and/or feelings of being overwhelmed.{{citation needed|date=February 2025}} They may complain and feel negative, or feel apathetic and believe they have little impact on their coworkers and environment. Occupational burnout is also associated with absenteeism, other time missed from work, and thoughts of quitting.{{cite journal | vauthors = Elliott TR, Shewchuk R, Hagglund K, Rybarczyk B, Harkins S | year = 1996 | title = Occupational burnout, tolerance for stress, and coping among nurses in rehabilitation units | journal = Rehabilitation Psychology | volume = 41 | issue = 4| pages = 267–284 | doi=10.1037/0090-5550.41.4.267}}

As in depression, chronic burnout is also associated with cognitive impairments in memory and attention.{{cite journal | vauthors = Sandström A, Rhodin IN, Lundberg M, Olsson T, Nyberg L | title = Impaired cognitive performance in patients with chronic burnout syndrome | journal = Biological Psychology | volume = 69 | issue = 3 | pages = 271–279 | date = July 2005 | pmid = 15925030 | doi = 10.1016/j.biopsycho.2004.08.003 | s2cid = 565283 }} Research suggests that burnout can manifest differently between genders, with higher levels of depersonalisation among men and increased emotional exhaustion among women.{{cite journal |vauthors=Houkes I, Winants Y, Twellaar M, Verdonk P |title=Development of burnout over time and the causal order of the three dimensions of burnout among male and female GPs. A three-wave panel study |journal=BMC Public Health |volume=11 |pages=240 |date=April 2011 |pmid=21501467 |pmc=3101180 |doi=10.1186/1471-2458-11-240 |doi-access=free}}{{Cite web|url=https://e-surgery.com/burnout-the-mens-health-crisis-we-arent-talking-about/ |title=Burnout: The Men's Health Crisis We Aren't Talking About| vauthors=Caufield M |website=e-Surgery|date=8 November 2019 |language=en|access-date=2019-12-31}} Other research suggests that people revealing a history of occupational burnout face future hiring discrimination.{{cite journal |vauthors=Sterkens P, Baert S, Rooman C, Derous E |title=As If It Weren't Hard Enough Already: Breaking down Hiring Discrimination Following Burnout |journal=Economics & Human Biology |date=December 2021 |volume=43 |pages=101050 |url=https://www.iza.org/publications/dp/13514/as-if-it-werent-hard-enough-already-breaking-down-hiring-discrimination-following-burnout |access-date=14 May 2021 |series=IZA Discussion Papers |doi=10.1016/j.ehb.2021.101050 |pmid=34375926 |s2cid=221135643 |id=IZA DP No. 13514|doi-access=free |hdl=1854/LU-8717382 |hdl-access=free }}

There are thought to be three general types of workplace prevention-related interventions.Schonfeld, I. S., & Chang, C.-H. (2017). Occupational health psychology: Work, stress, and health. Springer Publishing Company. https://doi.org/10.1891/9780826199683. Primary prevention-type interventions are aimed preventing health-damaging workplace stressors from developing in the first place or, if they are present, removing them from the workplace. Secondary prevention has an early-detection purpose and is aimed at helping workers who manifest the beginnings of a health problem before that problem becomes full blown. Tertiary prevention-type interventions are designed to help workers who have already experienced significant health problems.

{{See also|Occupational stress|Caregiver stress|Stress management}}

Maslach suggested that preventing burnout requires a combination of organizational change and worker education. She and Leiter argued that burnout can occur in connection to six areas of work life: workload, control, reward, community, fairness, and values. For example, with regard to workload, an organization should ensure that a worker has adequate resources to meet job demands. With regard to values, clearly stated ethical organizational values are important for employee well-being and commitment. Supportive leadership and relationships with colleagues are also helpful. Hätinen et al.{{Cite journal |vauthors=Hätinen M, Kinnunen U, Pekkonen M, Kalimo R |year=2007 |title=Comparing two burnout interventions: Perceived job control mediates decreases in burnout |journal=International Journal of Stress Management |volume=14 |issue=3 |pages=227–248 |doi=10.1037/1072-5245.14.3.227 |s2cid=54520149}} suggested that "improving job-person fit by focusing attention on the relationship between the person and the job situation, rather than either of these in isolation, seems to be the most promising way of dealing with burnout." One approach for addressing these discrepancies focuses specifically on the fairness area. In one study employees met weekly to discuss and attempt to resolve perceived inequities in their job.{{cite journal | vauthors = Van Dierendonck D, Schaufeli WB, Buunk BP |s2cid = 53132933|year = 1998|title = The evaluation of an individual burnout intervention program: the role of in- equity and social support|journal = J. Appl. Psychol.|volume = 83|issue = 3|pages = 392–407|doi = 10.1037/0021-9010.83.3.392}} The intervention was associated with decreases in exhaustion over time but not cynicism or inefficacy, suggesting that a broader approach is required.

Corporate Social Responsibility (CSR) initiatives are considered a resource which counteracts the stress effects of job demands, lowering employee burnout by boosting happiness, resilience and capitalizing altruism.Ma, W.; Li, R.Y.M.; Manta, O.; Alzuman, A. "Balancing Wellbeing and Responsibility: CSR’s Role in Mitigating Burnout in Hospitality under UN-SDGs". Sustainability 2024, 16, 3374 Establishing a sense of psychological safety (the belief that it is safe to speak up) in an organisation helps prevent burnout.{{Cite journal |last1=Kerrissey |first1=Michaela J. |last2=Hayirli |first2=Tuna C. |last3=Bhanja |first3=Aditi |last4=Stark |first4=Nicholas |last5=Hardy |first5=James |last6=Peabody |first6=Christopher R. |date=October–December 2022 |title=How psychological safety and feeling heard relate to burnout and adaptation amid uncertainty |journal=Health Care Management Review |language=en-US |volume=47 |issue=4 |pages=308–316 |doi=10.1097/HMR.0000000000000338 |pmid=35135989 |pmc=9422764 |issn=0361-6274}}{{Cite book |last=Davis |first=Paula |url=https://www.pennpress.org/9781613631126/beating-burnout-at-work/ |title=Beating Burnout at Work |date=March 2021 |publisher=Wharton School Press}}{{Cite web |title=Gen Z wants psychological safety at work – and here's why it's good for companies and employees |url=https://fortune.com/well/2023/11/21/psychological-safety-gen-z-work-employee-burnout/ |access-date=2024-03-10 |website=Fortune Well |language=en}}{{Cite web |title=How Psychological Safety Minimizes Psychosocial Hazards {{!}} Psychology Today |url=https://www.psychologytoday.com/blog/from-functioning-to-flourishing/202306/how-psychological-safety-minimizes-psychosocial-hazards |access-date=2024-03-10 |website=www.psychologytoday.com |language=}} Similarly, feeling heard may also help. Increasing workers' control over their work tasks is another intervention that can reduce exhaustion and cynicism.

Despite the above recommendations, high-quality research on burnout prevention with random allocation of experimental units (either individual workers or organizational units) to intervention and control conditions has been relatively rare.Richardson, K. M., & Rothstein, H. R. (2008). Effects of occupational stress management intervention programs: A meta-analysis. Journal of Occupational Health Psychology, 13(1), 69–93. https://doi.org/10.1037/1076-8998.13.1.69Estevez Cores, S., Sayed, A. A., Tracy, D. K., & Kempton, M. J. (2021). Individual-focused occupational health interventions: A meta-analysis of randomized controlled trials. Journal of Occupational Health Psychology, 26(3), 189–203. https://doi.org/10.1037/ocp0000249 For example, Richardson and Rothstein's (2008) meta-analysis of primary workplace interventions included only two high-quality studies that addressed burnout. In their meta-analysis, Estevez Corres et al. (2021) identified only eight high-quality primary prevention studies devoted to reducing emotional exhaustion in "high-stress jobs"; fewer high-quality primary prevention studies were devoted to depersonalization and reduced accomplishment.

{{See also|Management of depression|Treatments for PTSD|Anxiety Disorder#Treatment}}

van der Klink and van Dijk (2003) suggested stress inoculation training, cognitive restructuring, and graded activity to help workers with burnout symptoms, although insufficient high-quality research has been carried out on their efficacy. Hätinen et al. (2007) listed a number of common secondary and tertiary interventions, including treatment of any outstanding medical conditions, stress management, time management, depression treatment, psychotherapies, ergonomic improvement as well as occupational therapy, physical exercise and relaxation. Mindfulness therapy has been used to help with occupational burnout in medical practitioners.{{cite journal |vauthors=Scheepers RA, Emke H, Epstein RM, Lombarts KM |date=February 2020 |title=The impact of mindfulness-based interventions on doctors' well-being and performance: A systematic review |journal=Medical Education |volume=54 |issue=2 |pages=138–149 |doi=10.1111/medu.14020 |pmc=7003865 |pmid=31868262}} Additional prevention methods include: starting the day with a relaxing ritual; yoga; adopting healthy eating, exercising, and sleeping habits; setting boundaries; taking breaks from technology; nourishing one's creative side, and learning how to manage stress.{{cite web |date=27 February 2017 |title=Politically Active? 4 Tips for Incorporating Self-Care |url=http://health.usnews.com/health-care/for-better/articles/2017-02-27/politically-active-4-tips-for-incorporating-self-care |access-date=5 March 2017 |work=US News}}{{cite web |year=2014 |title=Stress Symptoms, Signs, & Causes: The Effects of Stress Overload and What You Can Do About It |url=http://www.helpguide.org/mental/stress_signs.htm |url-status=dead |archive-url=https://web.archive.org/web/20140927114835/http://www.helpguide.org/mental/stress_signs.htm |archive-date=27 September 2014 |access-date=31 March 2014 |vauthors=Smith M, Segal R, Segal J}}{{cite journal |vauthors=Grensman A, Acharya BD, Wändell P, Nilsson GH, Falkenberg T, Sundin Ö, Werner S |date=March 2018 |title=Effect of traditional yoga, mindfulness-based cognitive therapy, and cognitive behavioral therapy, on health related quality of life: a randomized controlled trial on patients on sick leave because of burnout |journal=BMC Complementary and Alternative Medicine |volume=18 |issue=1 |pages=80 |doi=10.1186/s12906-018-2141-9 |pmc=5839058 |pmid=29510704 |doi-access=free}}

Farber (2000),{{cite journal |vauthors=Farber BA |date=May 2000 |title=Treatment strategies for different types of teacher burnout |journal=Journal of Clinical Psychology |volume=56 |issue=5 |pages=675–689 |doi=10.1002/(SICI)1097-4679(200005)56:5<675::AID-JCLP8>3.0.CO;2-D |pmid=10852153 |doi-access=free}} writing about educators, suggested that strategies such as setting achievable goals, focusing on the value of the work, and finding better ways of doing the job can help teachers experiencing occupational stress. Some secondary interventions can improve conditions at work by addressing work-life balance. The ways in which people spend their non-work time can help to prevent burnout and improve health and well-being.{{cite journal |vauthors=Woolston C |date=8 July 2022 |title=How to deal with work stress – and actually recover from burnout |url=https://knowablemagazine.org/article/society/2022/deal-work-stress-recover-burnout |journal=Knowable Magazine |doi=10.1146/knowable-070722-1 |access-date=4 August 2022 |doi-access=free}} Training employees in ways to manage stress in the workplace has been thought to reduce burnout.{{cite book |url=https://books.google.com/books?id=uRU3tG29VfUC&q=job%20burnout%20prevention&pg=PA92 |title=A correlational study of job burnout and organizational commitment among correctional officers |vauthors=McLaurine WD |publisher=Capella University. School of Psychology |isbn=9780549438144 |page=92}} One study suggests that social-cognitive processes such as commitment to work, self-efficacy, learned resourcefulness, and hope may insulate individuals from experiencing occupational burnout.

Kakiashvili et al. wrote that "medical treatment of burnout is mostly symptomatic: it involves measures to prevent and treat the symptoms." The authors reported that the use of pharmacotherapy to treat stress-related burnout is effective, but does nothing to change the sources of stress. They reported that the exhaustion and poor sleep that are part of burnout are best treated with cognitive behavioral therapy (CBT). Salomonsson et al. (2020){{cite journal | vauthors = Salomonsson S, Santoft F, Lindsäter E, Ejeby K, Ingvar M, Ljótsson B, Öst LG, Lekander M, Hedman-Lagerlöf E | display-authors = 6 | title = Effects of cognitive behavioural therapy and return-to-work intervention for patients on sick leave due to stress-related disorders: Results from a randomized trial | journal = Scandinavian Journal of Psychology | volume = 61 | issue = 2 | pages = 281–289 | date = April 2020 | pmid = 31691305 | doi = 10.1111/sjop.12590 | s2cid = 207893892 }} found that for workers with exhaustion disorder, CBT was better than a Return to Work Intervention (RTW-I) for reducing stress. The researchers also found that people who were primarily experiencing symptoms of depression, anxiety, or insomnia, CBT reduced total time away from work. van Dam et al. (2012){{Cite journal | vauthors = van Dam A, Keijsers GP, Eling PA, Becker ES |date=2012-10-01 |title=Impaired cognitive performance and responsiveness to reward in burnout patients: Two years later |journal=Work & Stress |volume=26 |issue=4 |pages=333–346 |doi=10.1080/02678373.2012.737550 |s2cid=145349068 |issn=0267-8373|hdl=2066/102609 |hdl-access=free }} had also earlier found that CBT was an effective treatment. Parker et al. (2021){{Cite book | vauthors = Parker G, Tavella G, Eyers K |url=https://books.google.com/books?id=f1MmEAAAQBAJ |title=Burnout: A guide to identifying burnout and pathways to recovery |year=2021 |publisher=Allen & Unwin |isbn=978-1-76106-214-8 |language=en}} found that the most useful treatment strategies appear to be talking to someone and seeking support, walking or other exercise, mindfulness and meditation, improving sleep, and leaving work completely or taking time off work.

The Swedish national health information service (known as "1177")){{Cite web |title=Utmattningssyndrom |url=http://www.1177.se/sjukdomar--besvar/hjarna-och-nerver/utmattningssyndrom/ |access-date=2023-04-24 |website=1177 |language=sv}} reported that treatment and rehabilitation for exhaustion disorder have several components, including:

• Information and education about how stress affects the body.
• Counseling and education on lifestyle and on methods to reduce daily stress. It can be done individually or in a group.
• Treatment with CBT.
• Conversation with a counsellor, psychologist or occupational therapist.
• Physiotherapy to work with the body in different ways.
• Medicines for sleep difficulties or depression."

The Royal Dutch College of General Practiconers{{Cite web |title=Overspanning en burn-out {{!}} NHG-Richtlijnen |url=https://richtlijnen.nhg.org/standaarden/overspanning-en-burn-out |access-date=2023-06-29 |website=richtlijnen.nhg.org |language=nl}} recommended a three-stage treatment process, made up of a crisis phase, a problem and solution stage, and an application stage. The Gothenburg regional government's Institute for Stress Medicine{{Cite web |date=2017-01-24 |title=Behandling och rehabilitering vid UMS |url=https://www.vgregion.se/ov/ism/stress--rad-och-behandling/for_vardgivare/behandlingrehabilitering/ |access-date=2023-04-24 |website=Institutet för stressmedicin |language=sv}} reported that "[r]ecovery [from exhaustion disorder] is found in what is undemanding and joyful, and what that is varies greatly between individuals. Sleep and physical exercise are the basis of recovery and should be prioritized initially." According to a survey of their patients in 2018, the two most important drivers of recovery were "the sick leave itself" and "advice on physical activity."{{Cite web |title=Utmattning – det går att komma tillbaka |url=https://www.suntarbetsliv.se/forskning/anpassning-och-rehabilitering/utmattning-det-gar-att-komma-tillbaka/ |access-date=2023-04-24 |website=Suntarbetsliv |language=sv}}

Despite the above recommendations, high-quality research (e.g., random allocation to experimental and control groups) has been relatively rare in secondary and tertiary prevention-related interventions aimed at reducing symptoms of occupational burnout.Tamminga, S. J., Emal, L. M., Boschman, J. S., Levasseur, A., Thota, A., Ruotsalainen, J. H., Schelvis, R. M. C., van Nieuwenhuijsen, K., & der Molen, H. F. (2023). Individual-level interventions for reducing occupational stress in healthcare workers. Cochrane Database of Systematic Reviews (5), CD002892. https://doi.org/10.1002/14651858.CD002892.pub6 One study suggests that cognitive behavioral therapy (CBT), which was developed to treat depression, can help some workers with symptoms of occupational burnout although high-quality research on the application of CBT to treating burnout has been sparse.Schramm, E., Mack, S., Thiel, N., Jenkner, C., Elsaesser, M., & Fangmeier, T. (2020). Interpersonal psychotherapy vs. treatment as usual for major depression related to work stress: A pilot randomized controlled study. Frontiers in Psychiatry, 11(193). https://doi.org/10.3389/fpsyt.2020.00193. A shortcoming of CBT and other tertiary interventions is that they help to restructure the thinking of the worker/patient but do not change the adverse working conditions that give rise to the symptoms.

In a qualitative study, Meluch (2023),{{Cite journal |last=Meluch |first=Andrea L. |date=2023-12-31 |title=Core and catalyst criteria for disclosing one's burnout in the workplace |url=https://www.tandfonline.com/doi/full/10.1080/17459435.2022.2074528 |journal=Qualitative Research Reports in Communication |language=en |volume=24 |issue=1 |pages=61–67 |doi=10.1080/17459435.2022.2074528 |s2cid=248688875 |issn=1745-9435|url-access=subscription }} found that disclosing feelings of job burnout tends to make employees feel vulnerable. She also found that the perceived judgment of coworkers towards burnout is worrisome. Kim and Lee{{Cite journal |last1=Kim |first1=Katie Haejung |last2=Lee |first2=Yeunjae |date=2021-10-20 |title=Employees' Communicative Behaviors in Response to Emotional Exhaustion: The Moderating Role of Transparent Communication |url=https://www.tandfonline.com/doi/full/10.1080/1553118X.2021.1967959 |journal=International Journal of Strategic Communication |language=en |volume=15 |issue=5 |pages=410–424 |doi=10.1080/1553118X.2021.1967959 |s2cid=244747155 |issn=1553-118X|url-access=subscription }} recommended that organizations provide timely accurate information on activities and policies in order to minimize emotional exhaustion.

{{Portal|Psychology}}

{{div col|colwidth=15em}}

• Annual leave
• Autistic burnout
• Clouding of consciousness
• Critique of work
• Depression
• Effects of overtime
• Four-day workweek
• Job strain
• Karoshi
• Labor rights
• Lived experience
• Occupational Depression Inventory
• Occupational stress
• Overwork
• Paid time off
• Presenteeism
• Right to rest and leisure
• Six-hour day
• Stress (biological)
• Stress management
• Suicide crisis
• Tang ping
• Teacher burnout
• Workaholic
• Workload
• Writer's block

{{div col end}}

{{Notelist}}

{{Reflist}}

{{refbegin|30em}}

• {{Cite report | vauthors = Ahola K | publisher = University of Helsinki |date=2007-12-08 |title=Occupational burnout and health |url=https://helda.helsinki.fi/handle/10138/19788 |language=en}}
• {{cite book | vauthors = Caputo JS | date = 1991 | title = Stress and Burnout in Library Service | location = Phoenix, AZ | publisher = Oryx Press }}
• {{cite journal | vauthors = Cordes C, Dougherty T | year = 1996 | title = A review and integration of research on job burnout | journal = Academy of Management Review | volume = 18 | issue = 4| pages = 621–656 | doi = 10.5465/AMR.1993.9402210153 }}
• {{cite journal | vauthors = Freudenberger HJ F| year = 1974 | title = Staff burnout | journal = Journal of Social Issues | volume = 30 | pages = 159–165 | doi = 10.1111/j.1540-4560.1974.tb00706.x }}
• {{cite book | vauthors = Freudenberger HJ | date = 1980 | title = Burn-Out: The High Cost of High Achievement. | publisher = Anchor Press }}
• {{cite book | vauthors = Freudenberger HJ, North G | date = 1985 | title = Women's Burnout: How to Spot It, How to Reverse It, and How to Prevent It | publisher = Doubleday }}
• {{cite journal | vauthors = Maslach C, Leiter MP | title = Early predictors of job burnout and engagement | journal = The Journal of Applied Psychology | volume = 93 | issue = 3 | pages = 498–512 | date = May 2008 | pmid = 18457483 | doi = 10.1037/0021-9010.93.3.498 | citeseerx = 10.1.1.607.4751 }}
• {{cite journal | title = Boundary work as a buffer against burnout: Evidence from healthcare workers during the COVID-19 pandemic | vauthors = Rapp D, Hughey M, Kreiner G | year = 2021 | journal = Journal of Applied Psychology | volume = 106 | issue = 8 | pages = 1169–1187| doi = 10.1037/apl0000951 | pmid = 34424001 | s2cid = 237268483 }}
• {{cite book | vauthors = Ray B | date = 2002 | title = An assessment of burnout in academic librarians in America using the Maslach Burnout Inventory | location = New Brunswick, NJ | publisher = Rutgers University Press }}
• {{cite journal | vauthors = Shaw CS | year = 1992 | title = A Scientific Solution To Librarian Burnout. | journal = New Library World | volume = 93 | issue = 5 | doi = 10.1108/eum0000000002428 }}
• {{cite book | vauthors = Shirom A, Melamed S | chapter = 39: Does burnout affect physical health? A review of the evidence. | veditors = Antoniou AS, Cooper CL | title = Research companion to organizational health psychology | date = 2005 | pages = 599–622 | location = Cheltenham, UK | publisher = Edward Elgar }}
• {{cite journal | vauthors = Wang Y, Ramos A, Wu H, Liu L, Yang X, Wang J, Wang L | title = Relationship between occupational stress and burnout among Chinese teachers: a cross-sectional survey in Liaoning, China | journal = International Archives of Occupational and Environmental Health | volume = 88 | issue = 5 | pages = 589–597 | date = July 2015 | pmid = 25256806 | doi = 10.1007/s00420-014-0987-9 | bibcode = 2015IAOEH..88..589W | s2cid = 29960829 }}
• {{cite book | vauthors = Warr P | date = 1999 | title = Psychology at Work | edition = 4th | location = London | publisher = Penguin }}

{{Refend}}

• {{Scholia-inline|Q327988|topic}}

Category:Human resource management

Category:Occupational stress

Category:Organizational theory

Category:Motivation

Category:Organizational behavior