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| Boilerpipe Text | Occupational burnout
Other names
Burn-out, exhaustion disorder, neurasthenia
A person who is experiencing
psychological stress
Specialty
Psychology
Â
Symptoms
Emotional exhaustion
,
depersonalization
, reduced personal accomplishment,
[
1
]
[
2
]
fatigue
[
3
]
Differential diagnosis
Major depressive disorder
The ICD-11 of the
World Health Organization
(WHO) describes
occupational burnout
as a work-related phenomenon resulting from chronic workplace stress that has not been successfully managed. According to the WHO, symptoms include "feelings of energy depletion or exhaustion; increased mental distance from one's job, or feelings of negativism or cynicism related to one's job; and reduced professional efficacy."
[
4
]
Occupational burnout is classified as an occupational phenomenon but is not recognized by the WHO as a
medical
or
psychiatric
condition.
[
5
]
Social psychologist Christina Maslach and colleagues made clear that burnout does not constitute "a single, one-dimensional phenomenon."
[
6
]
However, national health bodies in some European countries do recognize it as such,
[
7
]
and it is also independently recognized by some health practitioners.
[
8
]
Nevertheless, a body of evidence suggests that what is termed burnout is a depressive condition, that is to say, indistinct from, and overlaps with, depression.
[
9
]
Kaschka, Korczak, and Broich (2011)
[
10
]
advanced the view that burnout is described in the
Book of Exodus
(18:17â18).
[
10
]
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."
[
11
]
Gordon Parker
suggested that the ancient European concept of
acedia
refers to burnout and not depression as many others believe.
[
12
]
[
13
]
By 1834, the German concept of
Berufskrankheiten
(
occupational diseases
) had become established. The concept reflected adverse work-related effects on mental and physical health.
[
14
]
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."
[
15
]
The concept soon became popular, and many in the United States believed themselves to suffer from it. Some came to call it "Americanitis".
[
16
]
Beard broadened the potential symptoms of neurasthenia such that the disorder could be the source of almost any symptom or behaviour.
[
17
]
Don R. Lipsitt would later wonder if the term "burnout" was similarly too broadly defined to be useful.
[
18
]
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.
[
19
]
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.
[
20
]
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
BeschÀftigungsneurosen
(occupational diseases affecting the nerves).
[
21
]
The related term
occupational neurosis
came to include a wide range of work-caused anxieties and other mental problems.
[
22
]
By the late 1930s, American health professionals had become widely acquainted with the condition.
[
23
]
It became known as
berufsneurose
in German.
[
24
]
From 1915, the Japanese psychiatrist
Shoma Morita
developed
Morita therapy
to treat neurasthenia.
[
25
]
He had come to have a different understanding of the condition than Beard,
[
26
]
preferring to call it
shinkeishitsui
; he published two books about the condition.
In 1957, Swiss psychiatrist
Paul Kielholz
coined the term
Erschöpfungsdepression
[exhaustion-depression].
[
27
]
[
28
]
[
29
]
The concept was one of a number of new depression-subtypes that gained traction in France and Germany during the 1960s.
[
30
]
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.
[
31
]
In 1965, Kielholz publicised therapy for
Erschöpfungsdepression
in the German-speaking world through his book
Diagnose und Therapie der Depressionen fĂŒr den Praktiker
[
Diagnosis and Treatment of Depression for the Practitioner
].
[
32
]
His work inspired further writing on the topic by German psychiatrist Volker Faust.
[
33
]
In 1968, the second edition of the
American Psychiatric Association
's (APA)
Diagnostic and Statistical Manual
(
DSM-II
) replaced "
psychophysiologic nervous system reaction
" with the condition
neurasthenic neurosis (neurasthenia)
.
[
34
]
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.
[
35
]
Bradley's article has been cited as the first known academic paper to use the term.
[
36
]
In 1974,
Herbert Freudenberger
, a German-born American clinical psychologist, used the term "burn-out" in his academic paper "Staff Burn-Out."
[
37
]
The paper was based on his qualitative observations of the volunteer staff (including himself) at a free clinic for drug addicts.
[
37
]
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 psychologist
Christina Maslach
described burnout in a 1976 magazine article
[
38
]
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.
[
39
]
Pines collaborated with Maslach
[
40
]
[
41
]
in writing essentially data-free papers
[
42
]
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.
[
43
]
In 1981, Maslach and fellow American psychologist
Susan E. Jackson
published an instrument for assessing occupational burnout, the
Maslach Burnout Inventory
(MBI).
[
2
]
It was the first such instrument of its kind, and soon became the most widely used measure of occupational burnout.
[
44
]
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.
[
1
]
[
45
]
In 1988, Pines and Aronson wrote the popular book
Career Burnout: Causes and Cures,
[
39
]
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).
[
46
]
In 1998, Swedish psychiatrists
Marie Ă
sberg
and Ă
ke Nygren
[
47
]
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.
[
48
]
:â16â
In 2003, the American psychiatrists Philip M. Liu and David A. Van Liew
[
49
]
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 also noted 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
created the national ICD condition of "
exhaustion disorder
" (F43.8A) as a specific "Other reactions to severe stress" (F43.8).
[
50
]
Treatment programs followed. In December 2007, the Swiss Expert Network on Burnout (SEB) was established.
[
51
]
It has since held a number of symposia, and published recommendations for treating burnout.
[
52
]
In 2015, French psychologist Renzo Bianchi and his colleagues published a
literature review
on the burnoutâdepression overlap (based on 92 studies) and concluded that the studies fail to demonstrate the
nosological
distinctiveness of the burnout phenomenon.
[
53
]
A number of papers followed that showed the overlap of burnout with depression, suggesting that burnout is a depressive condition.
[
54
]
[
55
]
[
56
]
Deaths due to long working hours per 100,000 people (15+), joint study conducted by
World Health Organization
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.
[
57
]
However, occupational burnout was "not itself classified by the WHO as a medical or psychiatric condition or mental disorder."
[
58
]
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.
[
7
]
In 2020, the Occupational Depression Inventory was published
[
59
]
and was considered to be a potential replacement for burnout scales such as the MBI.
[
60
]
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).
[
61
]
[
62
]
The WHO also modified their definition of burnout that year.
[
63
]
This new edition additionally saw the WHO abolish nation-defined conditions, leading to Sweden's planned end to its specific recognition of exhaustion disorder in 2028.
[
64
]
[
65
]
The two main classification systems for psychiatric 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).
[
66
]
Its definitions for
Adjustment Disorders
,
[
67
]
[
68
]
[
49
]
and
Unspecified Trauma- and Stressor-Related Disorder
[
69
]
have been said that in some cases reflect the condition. The 2022 update of the
DSM
, the
DSM-5-TR
, did not include burnout.
[
70
]
The
ICD-10
(1994â2021) classification "burn-out" as a type of non-medical life-management difficulty under code Z73.0.
[
71
]
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."
[
72
]
It was also considered one of the "problems related to life-management difficulty."
[
73
]
The condition is further defined as being a "state of vital exhaustion," which historically had been called
neurasthenia
.
[
74
]
The
ICD-10
also contained a medical condition category of "F43.8 Other reactions to severe stress."
[
75
]
In 2003, Liu and van Liew
[
49
]
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.
By 2003, the
Royal Dutch Medical Association
had defined
burnout
as a subtype of
adjustment disorder
[
76
]
as part of the
ICD-10
system. In the Netherlands,
overspannenheid
(overstrain) is a condition that leads to
burnout
.
[
77
]
In that country, burnout is included in handbooks and medical staff are trained in its diagnosis and treatment.
[
78
]
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
.
[
79
]
A 2013 French study
[
80
]
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.
Several European countries having legally recognized burnout in some way, such as by providing workers' compensation payments.
[
7
]
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
).
[
81
]
Rotentstein et al. (2018)
[
82
]
in a review of 182 studies of physician burnout identified 142 different definitions of burnout, underlining the great heterogeneity in diagnostic criteria for the condition. When they limited themselves to studies that used the canonical Maslach Burnout Inventory, the study team found 47 distinct definitions of burnout. Marked differences among researchers' conceptualizations of what constitutes burnout have underlined the absence of a
consensus definition
.
[
83
]
A new version of the
ICD
,
ICD-11
, was released in June 2018, for first use in January 2022.
[
84
]
The new version has an entry coded and titled "QD85 Burn-out." The
ICD-11
describes the condition as follows:
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.
[
85
]
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.
[
58
]
[
86
]
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."
[
87
]
The
ICD-11
also has the medical condition "6B4Y Other specified disorders specifically associated with stress,"
[
88
]
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.
[
8
]
The US government's
National Institutes of Health
includes the condition as "psychological burnout" in its index of the
National Library of Medicine
,
[
89
]
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."
[
89
]
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
.
[
90
]
The
Diseases Database
defines the condition as "professional burnout."
[
91
]
Instruments used to assess burnout symptoms
[
edit
]
A number of instruments have been developed to assess work-related burnout. The National Academy of Medicine has created an inventory of burnout scales.
[
92
]
The core of all of the abovementioned conceptualizations, including that of
Freudenberger
, is exhaustion.
[
93
]
[
94
]
Maslach Burnout Inventory
[
edit
]
In 1981, Maslach and Jackson published the first widely used instrument for assessing burnout, the
Maslach Burnout Inventory
(MBI).
[
2
]
It remains by far the most commonly used instrument to assess the condition.
[
44
]
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),
[
a
]
and reduced personal accomplishment.
[
1
]
[
2
]
The MBI originally focused on human service professionals (e.g., teachers, social workers).
[
2
]
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.
[
1
]
The MBI is proprietary. Its cost may be a disincentive that discourages graduate students and young assistant professors from using it.
[
83
]
There are other conceptualizations of burnout that differ from the conceptualization suggested by Maslach and adopted by the WHO.
[
5
]
Oldenburg Burnout Inventory
[
edit
]
In 1999, Demerouti and Bakker,
[
95
]
with their Oldenburg Burnout Inventory (OLBI), conceptualized burnout in terms of exhaustion and disengagement, linking their conceptualization to the
job demandsâresources model
.
Copenhagen Burnout Inventory
[
edit
]
In 2005, Kristensen et al.
[
3
]
released the public domain Copenhagen Burnout Inventory (CBI). They argued that the definition of burnout should be limited to the fatigue/exhaustion continuum.
[
3
]
Shirom-Melamed Burnout Measure
[
edit
]
In 2006, Shirom and Melamed with their Shirom-Melamed Burnout Measure (SMBM) conceptualized burnout in terms of physical exhaustion, cognitive weariness, and emotional exhaustion.
[
96
]
[
97
]
The SMBM's emotional exhaustion subscale more clearly embodies Maslach's
[
93
]
concept of depersonalization than her concept of emotional exhaustion.
[
44
]
This measure has seen some use in Sweden.
Karolinska Exhaustion Disorder Scale
[
edit
]
In 2014, BesĂšr et al. published the Karolinska Exhaustion Disorder Scale (KEDS),
[
50
]
[
98
]
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.
Sydney Burnout Measure
[
edit
]
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."
[
99
]
Lesser known burnout scales
[
edit
]
There are other conceptualizations of burnout embodied in other instruments, including the Hamburg Burnout Inventory,
[
100
]
the Burnout Assessment Tool,
[
101
]
the Burnout Measure,
[
39
]
[
102
]
and the Meier Burnout Assessment.
[
103
]
Other instruments that measure burnout
[
edit
]
In 1999, Wilmar Schaufeli and Arnold Bakker
[
104
]
published the Utrecht Work Engagement Scale (UWES), an instrument that uses a conceptualisation similar to that of the MBI. However the UWES measures vigour, dedication and absorption, positive counterparts (or polar opposites) of the high-burnout endpoints of the MBI's subscales.
[
104
]
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.
[
105
]
The measure has mainly been used in the United States.
The
Occupational Depression Inventory
(ODI)
[
59
]
[
9
]
was published in 2020. The measure covers the nine main symptoms of depression
[
106
]
that individuals ascribe to their jobs and quantifies the severity of those work-attributed symptoms.
[
59
]
The ODI also generates provisional diagnoses of job-ascribed depression.
[
60
]
[
83
]
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,
[
60
]
suggesting that the ODI is a suitable replacement for burnout scales like the MBI.
[
83
]
[
9
]
Different types of burnout
[
edit
]
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.
Caregiver burnout in the context of unpaid caregiving
[
edit
]
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.
[
88
]
Malach-Pines (who also published as Ayala Pines)
[
107
]
advanced the view that burnout can also occur in connection to the spousal role.
[
108
]
[
109
]
Burnout in teachers represents a type occupational burnout.
[
110
]
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.
[
111
]
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
.
[
112
]
[
113
]
[
114
]
Autistic burnout is considered to be distinct from occupational burnout in both
etiology
and
presentation
.
[
113
]
[
115
]
Relationship with other conditions
[
edit
]
Liu and van Liew
[
49
]
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
.
[
116
]
[
117
]
[
118
]
[
119
]
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.
[
80
]
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.
[
120
]
The view that burnout is a form of depression has found support.
[
94
]
[
117
]
[
120
]
[
118
]
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.
[
82
]
[
121
]
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.
[
122
]
[
94
]
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.
[
123
]
Maslach
[
93
]
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.
[
56
]
[
124
]
[
44
]
Burnout is also now often seen as involving the full array of
depressive
symptoms (e.g., low
mood
,
cognitive
alterations,
sleep disturbance
).
[
125
]
[
9
]
Kakiashvili et al.
[
126
]
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
hypothalamicâpituitaryâadrenal axis
dysfunction worse. Others have found Kakiashvili et al.'s argument specious.
[
127
]
Test
Major depressive disorder
(typically
melancholic depression
)
Atypical depression
PTSD
Burnout
Cortisol awakening response
â
[
126
]
â
[
128
]
â
[
126
]
â
[
126
]
[
129
]
Adrenocorticotropic hormone
(ACTH)
â
[
126
]
-
[
130
]
or â
[
129
]
- or â
[
126
]
- or â
[
126
]
or â
[
129
]
Dehydroepiandrosterone sulphate
(DHEA-S)
â
[
126
]
â or â
[
126
]
â
[
126
]
Low dose
dexamethasone suppression test
effect on cortisol
no suppression
[
126
]
hypersuppression
[
126
]
[
126
]
[
131
]
[
132
]
[
133
]
Despite its name, depression with atypical features, which is seen in the above table, is not a rare form of depression.
[
134
]
The cortisol profile in atypical depression, in contrast to that of melancholic depression, is similar to the cortisol profile found in burnout.
[
127
]
Commentators advanced the view that burnout differs from depression because the cortisol profile of burnout differs from that of melancholic depression; however, as the above table indicates, burnout's cortisol profile is similar to that of atypical depression.
[
127
]
Evidence suggests that the etiology of burnout is multifactorial, with personality factors playing an important, long-overlooked role.
[
135
]
[
136
]
[
137
]
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.
[
138
]
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.
[
139
]
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.
[
140
]
The
job demandsâresources 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.
[
141
]
Lack of job resources was associated with the disengagement component of the OLBI. Maslach and her colleagues (2001)
[
93
]
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.
[
142
]
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.
[
135
]
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.
[
143
]
In line with the work of
Maslach
and
Jackson
[
1
]
[
45
]
The World Health Organisation has defined burnout as consisting of:
feelings of energy depletion or exhaustion
increased mental distance from one's job, or feelings of negativism or cynicism related to one's job
reduced professional efficacy.
[
144
]
Symptoms sufferers, past sufferers and health professionals associate with exhaustion disorder.
[
145
]
LindsÀter et al. (2023)
[
145
]
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
,
[
146
]
coronary
heart disease
,
[
97
]
and
mental health
problems.
[
147
]
Emotional symptoms associated with occupational burnout include a lack of interest in work, reduced performance, feelings of helplessness, and trouble sleeping.
[
148
]
The Swedish health department has defined the effects of exhaustion disorder as being:
Concentration difficulties or impaired memory
Markedly reduced capacity to tolerate demands or to work under time pressure
Emotional instability or irritability
Sleep disturbance
Marked fatigability or physical weakness
Physical symptoms such as aches and pains, palpitations, gastrointestinal problems, vertigo or increased sensitivity to sound.
[
149
]
Research on dentists
[
117
]
and physicians
[
100
]
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.
[
150
]
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.
[
151
]
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.
[
152
]
They can suffer concentration problems, forgetfulness, increased frustration, and/or feelings of being overwhelmed.
[
153
]
They may complain and feel negative, or feel apathetic and believe they have little impact on their coworkers and environment.
[
148
]
Occupational burnout is also associated with absenteeism, other time missed from work, and thoughts of quitting.
[
154
]
As in depression, chronic burnout is also associated with cognitive impairments in
memory
and
attention
.
[
155
]
Research suggests that burnout can manifest differently between genders, with higher levels of depersonalisation among men and increased emotional exhaustion among women.
[
156
]
[
157
]
Other research suggests that people revealing a history of occupational burnout face future hiring discrimination.
[
158
]
Treatment and prevention
[
edit
]
There are thought to be three general types of workplace prevention-related interventions.
[
159
]
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.
Maslach suggested that preventing burnout requires a combination of organizational change and worker education.
[
139
]
She and her co-authors argued that burnout can occur in connection to six areas of work life: workload, control, reward, community, fairness, and values.
[
93
]
For example, with regard to workload, an organization should ensure that a worker has adequate resources to meet job demands.
[
93
]
With regard to values, clearly stated ethical organizational values are important for employee well-being and commitment.
[
93
]
Supportive leadership and relationships with colleagues are also helpful.
[
93
]
HĂ€tinen et al.
[
160
]
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.
[
161
]
The intervention was associated with decreases in exhaustion over time but not cynicism or inefficacy, suggesting that a broader approach is required.
[
93
]
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.
[
162
]
Establishing a sense of
psychological safety
(the belief that it is safe to speak up) in an organisation helps prevent burnout.
[
163
]
[
164
]
[
165
]
[
166
]
Similarly, feeling heard may also help.
[
163
]
Increasing workers'
control over their work tasks
is another intervention that can reduce exhaustion and
cynicism
.
[
160
]
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.
[
167
]
[
168
]
For example, Richardson and Rothstein's (2008)
[
167
]
meta-analysis of primary workplace interventions included only two high-quality studies that addressed burnout. In their meta-analysis, Estevez Corres et al. (2021)
[
168
]
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.
In a qualitative study, Meluch (2023),
[
169
]
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
[
170
]
recommended that organizations provide timely accurate information on activities and policies in order to minimize emotional exhaustion.
Secondary and tertiary prevention
[
edit
]
Van der Klink and van Dijk (2003)
[
76
]
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. HĂ€tinen et al. (2007)
[
160
]
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.
[
171
]
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.
[
172
]
[
173
]
[
174
]
Farber (2000),
[
175
]
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.
[
176
]
Training employees in ways to manage stress in the workplace has been thought to reduce burnout.
[
177
]
One study
[
154
]
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.
[
126
]
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)
[
178
]
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)
[
179
]
had also earlier found that CBT was an effective treatment.
Parker
et al. (2021)
[
12
]
[
13
]
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")
[
180
]
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 recommend a three-stage treatment process, made up of a crisis phase, a problem and solution stage, and an application stage.
[
181
]
The
Gothenburg
regional government's Institute for Stress Medicine
[
182
]
reports 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."
[
183
]
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.
[
168
]
[
184
]
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.
[
185
]
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.
[
184
]
Allostatic load
Annual leave
Autistic burnout
Boreout
Clouding of consciousness
Code Lavender
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
Quiet cracking
Workaholic
Workload
Writer's block
^
The term "depersonalization" as used by Maslach and Jackson should not be confused with the
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## Contents
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- [1 History](https://en.wikipedia.org/wiki/Occupational_burnout#History)
- [2 Diagnosis](https://en.wikipedia.org/wiki/Occupational_burnout#Diagnosis)
- [3 Instruments used to assess burnout symptoms](https://en.wikipedia.org/wiki/Occupational_burnout#Instruments_used_to_assess_burnout_symptoms)
Toggle Instruments used to assess burnout symptoms subsection
- [3\.1 Maslach Burnout Inventory](https://en.wikipedia.org/wiki/Occupational_burnout#Maslach_Burnout_Inventory)
- [3\.2 Oldenburg Burnout Inventory](https://en.wikipedia.org/wiki/Occupational_burnout#Oldenburg_Burnout_Inventory)
- [3\.3 Copenhagen Burnout Inventory](https://en.wikipedia.org/wiki/Occupational_burnout#Copenhagen_Burnout_Inventory)
- [3\.4 Shirom-Melamed Burnout Measure](https://en.wikipedia.org/wiki/Occupational_burnout#Shirom-Melamed_Burnout_Measure)
- [3\.5 Karolinska Exhaustion Disorder Scale](https://en.wikipedia.org/wiki/Occupational_burnout#Karolinska_Exhaustion_Disorder_Scale)
- [3\.6 Sydney Burnout Measure](https://en.wikipedia.org/wiki/Occupational_burnout#Sydney_Burnout_Measure)
- [3\.7 Lesser known burnout scales](https://en.wikipedia.org/wiki/Occupational_burnout#Lesser_known_burnout_scales)
- [3\.8 Other instruments that measure burnout](https://en.wikipedia.org/wiki/Occupational_burnout#Other_instruments_that_measure_burnout)
- [4 Different types of burnout](https://en.wikipedia.org/wiki/Occupational_burnout#Different_types_of_burnout)
Toggle Different types of burnout subsection
- [4\.1 Caregiver burnout in the context of unpaid caregiving](https://en.wikipedia.org/wiki/Occupational_burnout#Caregiver_burnout_in_the_context_of_unpaid_caregiving)
- [4\.2 Spouse burnout](https://en.wikipedia.org/wiki/Occupational_burnout#Spouse_burnout)
- [4\.3 Teacher burnout](https://en.wikipedia.org/wiki/Occupational_burnout#Teacher_burnout)
- [4\.4 Athlete burnout](https://en.wikipedia.org/wiki/Occupational_burnout#Athlete_burnout)
- [4\.5 Autistic burnout](https://en.wikipedia.org/wiki/Occupational_burnout#Autistic_burnout)
- [5 Relationship with other conditions](https://en.wikipedia.org/wiki/Occupational_burnout#Relationship_with_other_conditions)
Toggle Relationship with other conditions subsection
- [5\.1 Endocrine findings](https://en.wikipedia.org/wiki/Occupational_burnout#Endocrine_findings)
- [6 Risk factors](https://en.wikipedia.org/wiki/Occupational_burnout#Risk_factors)
- [7 Effects](https://en.wikipedia.org/wiki/Occupational_burnout#Effects)
- [8 Treatment and prevention](https://en.wikipedia.org/wiki/Occupational_burnout#Treatment_and_prevention)
Toggle Treatment and prevention subsection
- [8\.1 Primary prevention](https://en.wikipedia.org/wiki/Occupational_burnout#Primary_prevention)
- [8\.2 Secondary and tertiary prevention](https://en.wikipedia.org/wiki/Occupational_burnout#Secondary_and_tertiary_prevention)
- [9 See also](https://en.wikipedia.org/wiki/Occupational_burnout#See_also)
- [10 Notes](https://en.wikipedia.org/wiki/Occupational_burnout#Notes)
- [11 References](https://en.wikipedia.org/wiki/Occupational_burnout#References)
- [12 Further reading](https://en.wikipedia.org/wiki/Occupational_burnout#Further_reading)
- [13 External links](https://en.wikipedia.org/wiki/Occupational_burnout#External_links)
Toggle the table of contents
# Occupational burnout
47 languages
- [ۧÙŰč۱ۚÙŰ©](https://ar.wikipedia.org/wiki/%D8%A7%D8%AD%D8%AA%D8%B1%D8%A7%D9%82_%D9%86%D9%81%D8%B3%D9%8A_%D9%85%D9%87%D9%86%D9%8A "ۧŰŰȘŰ±Ű§Ù ÙÙŰłÙ Ù
ÙÙÙ â Arabic")
- [Avañe'áșœ](https://gn.wikipedia.org/wiki/Tete%C3%B1eko%27%C3%B5i "Teteñeko'Ă”i â Guarani")
- [AzÉrbaycanca](https://az.wikipedia.org/wiki/T%C3%BCk%C9%99nmi%C5%9Flik_sindromu "TĂŒkÉnmiĆlik sindromu â Azerbaijani")
- [ĐДлаŃŃŃĐșĐ°Ń](https://be.wikipedia.org/wiki/%D0%9F%D1%80%D0%B0%D1%84%D0%B5%D1%81%D1%96%D0%B9%D0%BD%D0%B0%D0%B5_%D0%B2%D1%8B%D0%B3%D0%B0%D1%80%D0%B0%D0%BD%D0%BD%D0%B5 "ĐŃĐ°ŃĐ”ŃŃĐčĐœĐ°Đ” ĐČŃгаŃĐ°ĐœĐœĐ” â Belarusian")
- [ĐДлаŃŃŃĐșĐ°Ń (ŃĐ°ŃĐ°ŃĐșĐ”ĐČŃŃĐ°)](https://be-tarask.wikipedia.org/wiki/%D0%AD%D0%BC%D0%B0%D1%86%D1%8B%D0%B9%D0%BD%D0%B0%D0%B5_%D0%B2%D1%8B%D0%B3%D0%B0%D1%80%D0%B0%D0%BD%D1%8C%D0%BD%D0%B5 "ĐĐŒĐ°ŃŃĐčĐœĐ°Đ” ĐČŃгаŃĐ°ĐœŃĐœĐ” â Belarusian (TaraĆĄkievica orthography)")
- [ĐŃлгаŃŃĐșĐž](https://bg.wikipedia.org/wiki/%D0%A1%D0%B8%D0%BD%D0%B4%D1%80%D0%BE%D0%BC_%D0%BD%D0%B0_%D0%BF%D1%80%D0%BE%D1%84%D0%B5%D1%81%D0%B8%D0%BE%D0%BD%D0%B0%D0%BB%D0%BD%D0%BE%D1%82%D0%BE_%D0%B8%D0%B7%D1%87%D0%B5%D1%80%D0%BF%D0%B2%D0%B0%D0%BD%D0%B5 "ĐĄĐžĐœĐŽŃĐŸĐŒ ĐœĐ° ĐżŃĐŸŃĐ”ŃĐžĐŸĐœĐ°Đ»ĐœĐŸŃĐŸ ОзŃĐ”ŃĐżĐČĐ°ĐœĐ” â Bulgarian")
- [CatalĂ ](https://ca.wikipedia.org/wiki/S%C3%ADndrome_d%27esgotament_professional "SĂndrome d'esgotament professional â Catalan")
- [ÄeĆĄtina](https://cs.wikipedia.org/wiki/Syndrom_vyho%C5%99en%C3%AD "Syndrom vyhoĆenĂ â Czech")
- [Cymraeg](https://cy.wikipedia.org/wiki/Gorflino "Gorflino â Welsh")
- [Deutsch](https://de.wikipedia.org/wiki/Burn-out "Burn-out â German")
- [Eesti](https://et.wikipedia.org/wiki/L%C3%A4bip%C3%B5lemiss%C3%BCndroom "LĂ€bipĂ”lemissĂŒndroom â Estonian")
- [EmiliĂ n e rumagnĂČl](https://eml.wikipedia.org/wiki/Sc%C3%B2pi_in_dal_post_ed_lav%C5%8Dr_\(afaticam%C3%A8int\) "ScĂČpi in dal post ed lavĆr (afaticamĂšint) â Emiliano-Romagnolo")
- [Español](https://es.wikipedia.org/wiki/S%C3%ADndrome_de_desgaste_profesional "SĂndrome de desgaste profesional â Spanish")
- [Esperanto](https://eo.wikipedia.org/wiki/Elbrula_sindromo "Elbrula sindromo â Esperanto")
- [Euskara](https://eu.wikipedia.org/wiki/Burn-out_sindrome "Burn-out sindrome â Basque")
- [Ùۧ۱۳Û](https://fa.wikipedia.org/wiki/%D9%81%D8%B1%D8%B3%D9%88%D8%AF%DA%AF%DB%8C_%D8%B4%D8%BA%D9%84%DB%8C "Ù۱۳ÙŰŻÚŻÛ ŰŽŰșÙÛ â Persian")
- [Français](https://fr.wikipedia.org/wiki/Syndrome_d%27%C3%A9puisement_professionnel "Syndrome d'Ă©puisement professionnel â French")
- [íê”ìŽ](https://ko.wikipedia.org/wiki/%EB%B2%88%EC%95%84%EC%9B%83_%EC%A6%9D%ED%9B%84%EA%B5%B0 "ëČìì ìŠíê”° â Korean")
- [ŐŐĄŐ”Ő„ÖŐ„Ő¶](https://hy.wikipedia.org/wiki/%D5%80%D5%B8%D6%82%D5%A6%D5%A1%D5%AF%D5%A1%D5%B6_%D5%A1%D5%B5%D6%80%D5%B8%D6%82%D5%B4 "ŐŐžÖŐŠŐĄŐŻŐĄŐ¶ ŐĄŐ”ÖŐžÖŐŽ â Armenian")
- [à€čà€żà€šà„à€Šà„](https://hi.wikipedia.org/wiki/%E0%A4%B5%E0%A5%8D%E0%A4%AF%E0%A4%BE%E0%A4%B5%E0%A4%B8%E0%A4%BE%E0%A4%AF%E0%A4%BF%E0%A4%95_%E0%A4%AC%E0%A4%B0%E0%A5%8D%E0%A4%A8-%E0%A4%86%E0%A4%89%E0%A4%9F "à€”à„à€Żà€Ÿà€”à€žà€Ÿà€Żà€żà€ à€Źà€°à„à€š-à€à€à€ â Hindi")
- [Bahasa Indonesia](https://id.wikipedia.org/wiki/Keletihan_mental "Keletihan mental â Indonesian")
- [Italiano](https://it.wikipedia.org/wiki/Sindrome_da_burnout "Sindrome da burnout â Italian")
- [ŚąŚŚšŚŚȘ](https://he.wikipedia.org/wiki/%D7%A9%D7%97%D7%99%D7%A7%D7%94_\(%D7%A4%D7%A1%D7%99%D7%9B%D7%95%D7%9C%D7%95%D7%92%D7%99%D7%94\) "Ś©ŚŚŚ§Ś (Ś€ŚĄŚŚŚŚŚŚŚŚ) â Hebrew")
- [ÒĐ°Đ·Đ°ÒŃĐ°](https://kk.wikipedia.org/wiki/%D0%AD%D0%BC%D0%BE%D1%86%D0%B8%D0%BE%D0%BD%D0%B0%D0%BB%D0%B4%D1%8B_%D0%BA%D2%AF%D0%B9%D1%96%D0%BD%D1%83_%D1%81%D0%B8%D0%BD%D0%B4%D1%80%D0%BE%D0%BC%D1%8B "ĐĐŒĐŸŃĐžĐŸĐœĐ°Đ»ĐŽŃ ĐșÒŻĐčŃĐœŃ ŃĐžĐœĐŽŃĐŸĐŒŃ â Kazakh")
- [Magyar](https://hu.wikipedia.org/wiki/Ki%C3%A9g%C3%A9si_szindr%C3%B3ma "KiĂ©gĂ©si szindrĂłma â Hungarian")
- [ĐĐ°ĐșĐ”ĐŽĐŸĐœŃĐșĐž](https://mk.wikipedia.org/wiki/%D0%A1%D0%B8%D0%BD%D0%B4%D1%80%D0%BE%D0%BC_%D0%BD%D0%B0_%D1%80%D0%B0%D0%B1%D0%BE%D1%82%D0%BD%D0%B0_%D0%B8%D1%81%D1%86%D1%80%D0%BF%D0%B5%D0%BD%D0%BE%D1%81%D1%82 "ĐĄĐžĐœĐŽŃĐŸĐŒ ĐœĐ° ŃĐ°Đ±ĐŸŃĐœĐ° ĐžŃŃŃĐżĐ”ĐœĐŸŃŃ â Macedonian")
- [Ù
ۧŰČÙ۱ÙÙÛ](https://mzn.wikipedia.org/wiki/%D9%81%D8%B1%D8%B3%D9%88%D8%AF%DA%AF%DB%8C_%D8%B4%D8%BA%D9%84%DB%8C "Ù۱۳ÙŰŻÚŻÛ ŰŽŰșÙÛ â Mazanderani")
- [Minangkabau](https://min.wikipedia.org/wiki/Kalatiahan_mental "Kalatiahan mental â Minangkabau")
- [Nederlands](https://nl.wikipedia.org/wiki/Burn-out "Burn-out â Dutch")
- [æ„æŹèȘ](https://ja.wikipedia.org/wiki/%E7%87%83%E3%81%88%E5%B0%BD%E3%81%8D%E7%97%87%E5%80%99%E7%BE%A4 "çăć°œăçć矀 â Japanese")
- [Norsk bokmĂ„l](https://no.wikipedia.org/wiki/Utbrenthet "Utbrenthet â Norwegian BokmĂ„l")
- [Polski](https://pl.wikipedia.org/wiki/Wypalenie_zawodowe "Wypalenie zawodowe â Polish")
- [PortuguĂȘs](https://pt.wikipedia.org/wiki/S%C3%ADndrome_de_burnout "SĂndrome de burnout â Portuguese")
- [RomĂąnÄ](https://ro.wikipedia.org/wiki/Sindromul_burnout "Sindromul burnout â Romanian")
- [Đ ŃŃŃĐșĐžĐč](https://ru.wikipedia.org/wiki/%D0%AD%D0%BC%D0%BE%D1%86%D0%B8%D0%BE%D0%BD%D0%B0%D0%BB%D1%8C%D0%BD%D0%BE%D0%B5_%D0%B2%D1%8B%D0%B3%D0%BE%D1%80%D0%B0%D0%BD%D0%B8%D0%B5 "ĐĐŒĐŸŃĐžĐŸĐœĐ°Đ»ŃĐœĐŸĐ” ĐČŃĐłĐŸŃĐ°ĐœĐžĐ” â Russian")
- [Simple English](https://simple.wikipedia.org/wiki/Occupational_burnout "Occupational burnout â Simple English")
- [SlovenÄina](https://sk.wikipedia.org/wiki/Syndr%C3%B3m_vyhorenia "SyndrĂłm vyhorenia â Slovak")
- [SlovenĆĄÄina](https://sl.wikipedia.org/wiki/Izgorelost "Izgorelost â Slovenian")
- [ĐĄŃĐżŃĐșĐž / srpski](https://sr.wikipedia.org/wiki/%D0%A1%D0%B8%D0%BD%D0%B4%D1%80%D0%BE%D0%BC_%D0%B8%D0%B7%D0%B3%D0%B0%D1%80%D0%B0%D1%9A%D0%B0 "ĐĄĐžĐœĐŽŃĐŸĐŒ ОзгаŃĐ°ŃĐ° â Serbian")
- [Suomi](https://fi.wikipedia.org/wiki/Ty%C3%B6uupumus "Työuupumus â Finnish")
- [Svenska](https://sv.wikipedia.org/wiki/Utbr%C3%A4ndhet "UtbrĂ€ndhet â Swedish")
- [TĂŒrkçe](https://tr.wikipedia.org/wiki/T%C3%BCkenmi%C5%9Flik_sendromu "TĂŒkenmiĆlik sendromu â Turkish")
- [ĐŁĐșŃĐ°ŃĐœŃŃĐșĐ°](https://uk.wikipedia.org/wiki/%D0%95%D0%BC%D0%BE%D1%86%D1%96%D0%B9%D0%BD%D0%B5_%D0%B2%D0%B8%D0%B3%D0%BE%D1%80%D0%B0%D0%BD%D0%BD%D1%8F "ĐĐŒĐŸŃŃĐčĐœĐ” ĐČĐžĐłĐŸŃĐ°ĐœĐœŃ â Ukrainian")
- [ۧ۱ۯÙ](https://ur.wikipedia.org/wiki/%D9%81%D8%B1%D8%B3%D9%88%D8%AF%DA%AF%DB%8C_\(%D9%86%D9%81%D8%B3%DB%8C%D8%A7%D8%AA\) "Ù۱۳ÙŰŻÚŻÛ (ÙÙŰłÛۧŰȘ) â Urdu")
- [Tiáșżng Viá»t](https://vi.wikipedia.org/wiki/H%E1%BB%99i_ch%E1%BB%A9ng_c%C4%83ng_th%E1%BA%B3ng "Há»i chứng cÄng tháșłng â Vietnamese")
- [Walon](https://wa.wikipedia.org/wiki/Bro%C3%BBlaedje_totoute "BroĂ»laedje totoute â Walloon")
- [äžæ](https://zh.wikipedia.org/wiki/%E8%81%B7%E6%A5%AD%E5%80%A6%E6%80%A0 "è·æ„ćŠæ â Chinese")
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From Wikipedia, the free encyclopedia
Type of occupational stress
"Burn out" and "Burn Out" redirect here. For other uses, see [Burnout (disambiguation)](https://en.wikipedia.org/wiki/Burnout_\(disambiguation\) "Burnout (disambiguation)").
| | |
|---|---|
|  | This article **may contain [original research](https://en.wikipedia.org/wiki/Wikipedia:No_original_research "Wikipedia:No original research")**. Please [improve it](https://en.wikipedia.org/w/index.php?title=Occupational_burnout&action=edit) by [verifying](https://en.wikipedia.org/wiki/Wikipedia:Verifiability "Wikipedia:Verifiability") the claims made and adding [inline citations](https://en.wikipedia.org/wiki/Wikipedia:Citing_sources#Inline_citations "Wikipedia:Citing sources"). Statements consisting only of original research should be removed. *(February 2025)* *([Learn how and when to remove this message](https://en.wikipedia.org/wiki/Help:Maintenance_template_removal "Help:Maintenance template removal"))* |
Medical condition
| Occupational burnout | |
|---|---|
| Other names | Burn-out, exhaustion disorder, neurasthenia |
| [](https://en.wikipedia.org/wiki/File:Man_Overworked_At_Work.jpg) | |
| A person who is experiencing [psychological stress](https://en.wikipedia.org/wiki/Psychological_stress "Psychological stress") | |
| [Specialty](https://en.wikipedia.org/wiki/Medical_specialty "Medical specialty") | [Psychology](https://en.wikipedia.org/wiki/Psychology "Psychology") [](https://www.wikidata.org/wiki/Q327988?uselang=en#P1995 "Edit this on Wikidata") |
| [Symptoms](https://en.wikipedia.org/wiki/Signs_and_symptoms "Signs and symptoms") | [Emotional exhaustion](https://en.wikipedia.org/wiki/Emotional_exhaustion "Emotional exhaustion"), [depersonalization](https://en.wikipedia.org/wiki/Depersonalization "Depersonalization"), reduced personal accomplishment,[\[1\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-Maslach-1)[\[2\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-Maslach2-2) [fatigue](https://en.wikipedia.org/wiki/Fatigue "Fatigue")[\[3\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-copenhagenburn-3) |
| [Differential diagnosis](https://en.wikipedia.org/wiki/Differential_diagnosis "Differential diagnosis") | [Major depressive disorder](https://en.wikipedia.org/wiki/Major_depressive_disorder "Major depressive disorder") |
The ICD-11 of the [World Health Organization](https://en.wikipedia.org/wiki/World_Health_Organization "World Health Organization") (WHO) describes **occupational burnout** as a work-related phenomenon resulting from chronic workplace stress that has not been successfully managed. According to the WHO, symptoms include "feelings of energy depletion or exhaustion; increased mental distance from one's job, or feelings of negativism or cynicism related to one's job; and reduced professional efficacy."[\[4\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-4)
Occupational burnout is classified as an occupational phenomenon but is not recognized by the WHO as a [medical](https://en.wikipedia.org/wiki/Disease "Disease") or [psychiatric](https://en.wikipedia.org/wiki/Mental_disorder "Mental disorder") condition.[\[5\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-Bulletin,_2023-5) Social psychologist Christina Maslach and colleagues made clear that burnout does not constitute "a single, one-dimensional phenomenon."[\[6\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-6) However, national health bodies in some European countries do recognize it as such,[\[7\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-Lastovkova_2018-7) and it is also independently recognized by some health practitioners.[\[8\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-van_Dam_2021-8) Nevertheless, a body of evidence suggests that what is termed burnout is a depressive condition, that is to say, indistinct from, and overlaps with, depression.[\[9\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-S&B,_2025-9)
## History
\[[edit](https://en.wikipedia.org/w/index.php?title=Occupational_burnout&action=edit§ion=1 "Edit section: History")\]
Kaschka, Korczak, and Broich (2011)[\[10\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-Burnout:_A_Fashionable_Diagnosis-10) advanced the view that burnout is described in the [Book of Exodus](https://en.wikipedia.org/wiki/Book_of_Exodus "Book of Exodus") (18:17â18).[\[10\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-Burnout:_A_Fashionable_Diagnosis-10) In the *New International Version* of the *Bible*, [Moses](https://en.wikipedia.org/wiki/Moses "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."[\[11\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-11) [Gordon Parker](https://en.wikipedia.org/wiki/Gordon_Parker_\(psychiatrist\) "Gordon Parker (psychiatrist)") suggested that the ancient European concept of [acedia](https://en.wikipedia.org/wiki/Acedia "Acedia") refers to burnout and not depression as many others believe.[\[12\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-Parker_2021-12)[\[13\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-Parker_2021_2-13)
By 1834, the German concept of *Berufskrankheiten* ([occupational diseases](https://en.wikipedia.org/wiki/Occupational_disease "Occupational disease")) had become established. The concept reflected adverse work-related effects on mental and physical health.[\[14\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-14) In 1869, New York neurologist [George Beard](https://en.wikipedia.org/wiki/George_Miller_Beard "George Miller Beard") used the term "[neurasthenia](https://en.wikipedia.org/wiki/Neurasthenia "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."[\[15\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-15) The concept soon became popular, and many in the United States believed themselves to suffer from it. Some came to call it "Americanitis".[\[16\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-16) Beard broadened the potential symptoms of neurasthenia such that the disorder could be the source of almost any symptom or behaviour.[\[17\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-17) Don R. Lipsitt would later wonder if the term "burnout" was similarly too broadly defined to be useful.[\[18\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-18) 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.[\[19\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-:3-19) The [rest cure](https://en.wikipedia.org/wiki/Rest_cure "Rest cure") was a commonly prescribed treatment for neurasthenia in the United States, particularly for women. The American doctor [Silas Weir Mitchell](https://en.wikipedia.org/wiki/Silas_Weir_Mitchell_\(physician\) "Silas Weir Mitchell (physician)") often prescribed this treatment. Other treatments included [hypnosis](https://en.wikipedia.org/wiki/Hypnosis "Hypnosis"), [Paul Charles Dubois](https://en.wikipedia.org/wiki/Paul_Charles_Dubois "Paul Charles Dubois")'s cognitive behavioural therapy (this is distinct from and devised much earlier than [Aaron Beck](https://en.wikipedia.org/wiki/Aaron_Beck "Aaron Beck")'s cognitive behavioral therapy), and [Otto Binswanger](https://en.wikipedia.org/wiki/Otto_Binswanger "Otto Binswanger")'s life normalisation therapy.[\[20\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-20)
In 1888, the English neurologist [William Gowers](https://en.wikipedia.org/wiki/William_Gowers_\(neurologist\) "William Gowers (neurologist)") coined the term *occupation neurosis* to describe cramps experienced by writers and pianists ([repetitive strain injury](https://en.wikipedia.org/wiki/Repetitive_strain_injury "Repetitive strain injury")), translating the German concept of *BeschÀftigungsneurosen* (occupational diseases affecting the nerves).[\[21\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-21) The related term *occupational neurosis* came to include a wide range of work-caused anxieties and other mental problems.[\[22\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-22) By the late 1930s, American health professionals had become widely acquainted with the condition.[\[23\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-23) It became known as *berufsneurose* in German.[\[24\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-24) From 1915, the Japanese psychiatrist [Shoma Morita](https://en.wikipedia.org/wiki/Shoma_Morita "Shoma Morita") developed [Morita therapy](https://en.wikipedia.org/wiki/Morita_therapy "Morita therapy") to treat neurasthenia.[\[25\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-25) He had come to have a different understanding of the condition than Beard,[\[26\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-26) preferring to call it *shinkeishitsui*; he published two books about the condition.
In 1957, Swiss psychiatrist [Paul Kielholz](https://en.wikipedia.org/wiki/Paul_Kielholz "Paul Kielholz") coined the term *Erschöpfungsdepression* \[exhaustion-depression\].[\[27\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-27)[\[28\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-28)[\[29\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-29) The concept was one of a number of new depression-subtypes that gained traction in France and Germany during the 1960s.[\[30\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-%C3%85wwn-30) In 1961, British author [Graham Greene](https://en.wikipedia.org/wiki/Graham_Greene "Graham Greene") published the novel *[A Burnt-Out Case](https://en.wikipedia.org/wiki/A_Burnt-Out_Case "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.[\[31\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-31) In 1965, Kielholz publicised therapy for *Erschöpfungsdepression* in the German-speaking world through his book *Diagnose und Therapie der Depressionen fĂŒr den Praktiker* \[*Diagnosis and Treatment of Depression for the Practitioner*\].[\[32\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-32) His work inspired further writing on the topic by German psychiatrist Volker Faust.[\[33\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-:7-33)
In 1968, the second edition of the [American Psychiatric Association](https://en.wikipedia.org/wiki/American_Psychiatric_Association "American Psychiatric Association")'s (APA) *[Diagnostic and Statistical Manual](https://en.wikipedia.org/wiki/Diagnostic_and_Statistical_Manual_of_Mental_Disorders "Diagnostic and Statistical Manual of Mental Disorders")* (*DSM-II*) replaced "[psychophysiologic nervous system reaction](https://en.wikipedia.org/wiki/Psychophysiologic_disorder "Psychophysiologic disorder")" with the condition *neurasthenic neurosis (neurasthenia)*.[\[34\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-34) 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*](https://en.wikipedia.org/wiki/Dependent_personality_disorder "Dependent personality disorder"), 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.[\[35\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-35) Bradley's article has been cited as the first known academic paper to use the term.[\[36\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-Wiley_1996-36)
In 1974, [Herbert Freudenberger](https://en.wikipedia.org/wiki/Herbert_Freudenberger "Herbert Freudenberger"), a German-born American clinical psychologist, used the term "burn-out" in his academic paper "Staff Burn-Out."[\[37\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-staffburnout1-37) The paper was based on his qualitative observations of the volunteer staff (including himself) at a free clinic for drug addicts.[\[37\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-staffburnout1-37) 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 psychologist [Christina Maslach](https://en.wikipedia.org/wiki/Christina_Maslach "Christina Maslach") described burnout in a 1976 magazine article[\[38\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-38) 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](https://en.wikipedia.org/wiki/Elliot_Aronson "Elliot Aronson"), using group workshops, began to treat people having symptoms of burnout.[\[39\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-Pines_&_Aronson-39) Pines collaborated with Maslach[\[40\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-40)[\[41\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-41) in writing essentially data-free papers[\[42\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-42) 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.*[\[43\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-43)
In 1981, Maslach and fellow American psychologist [Susan E. Jackson](https://en.wikipedia.org/wiki/Susan_E._Jackson "Susan E. Jackson") published an instrument for assessing occupational burnout, the [Maslach Burnout Inventory](https://en.wikipedia.org/wiki/Maslach_Burnout_Inventory "Maslach Burnout Inventory") (MBI).[\[2\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-Maslach2-2) It was the first such instrument of its kind, and soon became the most widely used measure of occupational burnout.[\[44\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-SVB2019-44) 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.[\[1\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-Maslach-1)[\[45\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-ReferenceD-45) In 1988, Pines and Aronson wrote the popular book *Career Burnout: Causes and Cures,*[\[39\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-Pines_&_Aronson-39) 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).[\[46\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-46) In 1998, Swedish psychiatrists [Marie Ă
sberg](https://en.wikipedia.org/wiki/Marie_%C3%85sberg "Marie Ă
sberg") and Ă
ke Nygren[\[47\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-47) 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.[\[48\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-48): 16
In 2003, the American psychiatrists Philip M. Liu and David A. Van Liew[\[49\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-Liu-49) 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 also noted 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](https://en.wikipedia.org/wiki/Swedish_Board_of_Health_and_Welfare "Swedish Board of Health and Welfare") created the national ICD condition of "[exhaustion disorder](https://en.wikipedia.org/wiki/Exhaustion_disorder "Exhaustion disorder")" (F43.8A) as a specific "Other reactions to severe stress" (F43.8).[\[50\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-Bes%C3%A8r_2014-50) Treatment programs followed. In December 2007, the Swiss Expert Network on Burnout (SEB) was established.[\[51\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-51) It has since held a number of symposia, and published recommendations for treating burnout.[\[52\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-52)
In 2015, French psychologist Renzo Bianchi and his colleagues published a [literature review](https://en.wikipedia.org/wiki/Literature_review "Literature review") on the burnoutâdepression overlap (based on 92 studies) and concluded that the studies fail to demonstrate the [nosological](https://en.wikipedia.org/wiki/Nosological "Nosological") distinctiveness of the burnout phenomenon.[\[53\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-pmid25638755-53) A number of papers followed that showed the overlap of burnout with depression, suggesting that burnout is a depressive condition.[\[54\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-54)[\[55\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-55)[\[56\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-s30945922-56)
[](https://en.wikipedia.org/wiki/File:Deaths_from_Karoshi.png)
Deaths due to long working hours per 100,000 people (15+), joint study conducted by [World Health Organization](https://en.wikipedia.org/wiki/World_Health_Organization "World Health Organization") and [International Labour Organization](https://en.wikipedia.org/wiki/International_Labour_Organization "International Labour Organization") in 2016.
Also in 2015, the WHO adopted a new conceptualization of "occupational burnout." The conceptualization was consistent with Maslach's.[\[57\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-57) However, occupational burnout was "not itself classified by the WHO as a medical or psychiatric condition or mental disorder."[\[58\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-WHO-2019-58) 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](https://en.wikipedia.org/wiki/Workers%27_compensation "Workers' compensation") payments to affected people.[\[7\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-Lastovkova_2018-7)
In 2020, the Occupational Depression Inventory was published[\[59\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-10.1016-59) and was considered to be a potential replacement for burnout scales such as the MBI.[\[60\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-10.1037-60)
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](https://en.wikipedia.org/wiki/Bodily_distress_disorder "Bodily distress disorder")" (6C20).[\[61\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-61)[\[62\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-62) The WHO also modified their definition of burnout that year.[\[63\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-63) This new edition additionally saw the WHO abolish nation-defined conditions, leading to Sweden's planned end to its specific recognition of exhaustion disorder in 2028.[\[64\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-64)[\[65\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-65)
## Diagnosis
\[[edit](https://en.wikipedia.org/w/index.php?title=Occupational_burnout&action=edit§ion=2 "Edit section: Diagnosis")\]
The two main classification systems for psychiatric disorders are the APA's *[Diagnostic and Statistical Manual of Mental Disorders](https://en.wikipedia.org/wiki/Diagnostic_and_Statistical_Manual_of_Mental_Disorders "Diagnostic and Statistical Manual of Mental Disorders")* (*DSM*, used in North America and elsewhere) and the WHO's *[International Classification of Diseases](https://en.wikipedia.org/wiki/International_Classification_of_Diseases "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).[\[66\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-66) Its definitions for [Adjustment Disorders](https://en.wikipedia.org/wiki/Adjustment_disorder "Adjustment disorder"),[\[67\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-67)[\[68\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-68)[\[49\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-Liu-49) and [Unspecified Trauma- and Stressor-Related Disorder](https://en.wikipedia.org/wiki/Psychological_trauma "Psychological trauma")[\[69\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-69) have been said that in some cases reflect the condition. The 2022 update of the *DSM*, the *DSM-5-TR*, did not include burnout.[\[70\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-70)
The *ICD-10* (1994â2021) classification "burn-out" as a type of non-medical life-management difficulty under code Z73.0.[\[71\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-71) 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."[\[72\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-72) It was also considered one of the "problems related to life-management difficulty."[\[73\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-73) The condition is further defined as being a "state of vital exhaustion," which historically had been called [neurasthenia](https://en.wikipedia.org/wiki/Neurasthenia "Neurasthenia").[\[74\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-74) The *ICD-10* also contained a medical condition category of "F43.8 Other reactions to severe stress."[\[75\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-75)
In 2003, Liu and van Liew[\[49\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-Liu-49) 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](https://en.wikipedia.org/wiki/Adjustment_disorder "Adjustment disorder") with depressed mood.
By 2003, the [Royal Dutch Medical Association](https://en.wikipedia.org/wiki/Royal_Dutch_Medical_Association "Royal Dutch Medical Association") had defined *burnout* as a subtype of [adjustment disorder](https://en.wikipedia.org/wiki/Adjustment_disorder "Adjustment disorder")[\[76\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-sjweh.756-76) as part of the *ICD-10* system. In the Netherlands, *overspannenheid* (overstrain) is a condition that leads to *burnout*.[\[77\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-77) In that country, burnout is included in handbooks and medical staff are trained in its diagnosis and treatment.[\[78\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-Burnout:_35_years_of_research_and_p-78) 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](https://en.wikipedia.org/wiki/Major_depressive_disorder "Major depressive disorder") or [anxiety disorder](https://en.wikipedia.org/wiki/Anxiety_disorder "Anxiety disorder").[\[79\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-79)
A 2013 French study[\[80\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-Bianchi,_Boffy-80) 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.
Several European countries having legally recognized burnout in some way, such as by providing workers' compensation payments.[\[7\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-Lastovkova_2018-7) Legal recognition for financial purposes, however, is not the same as [medical recognition as a discrete disease](https://en.wikipedia.org/wiki/Nosology "Nosology"). 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](https://en.wikipedia.org/wiki/Somatic_symptom_disorder "Somatic symptom disorder")" (*DSM-5*) or "bodily distress disorder" (*ICD-11*).[\[81\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-81)
Rotentstein et al. (2018)[\[82\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-Rotenstein2018-82) in a review of 182 studies of physician burnout identified 142 different definitions of burnout, underlining the great heterogeneity in diagnostic criteria for the condition. When they limited themselves to studies that used the canonical Maslach Burnout Inventory, the study team found 47 distinct definitions of burnout. Marked differences among researchers' conceptualizations of what constitutes burnout have underlined the absence of a [consensus definition](https://en.wikipedia.org/wiki/Definition#In_medicine "Definition").[\[83\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-S&B,_2020-83)
A new version of the *ICD*, *ICD-11*, was released in June 2018, for first use in January 2022.[\[84\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-84) The new version has an entry coded and titled "QD85 Burn-out." The *ICD-11* describes the condition as follows:
> Burn-out is a syndrome conceptualized as resulting from chronic [workplace stress](https://en.wikipedia.org/wiki/Workplace_stress "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.[\[85\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-85)
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.[\[58\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-WHO-2019-58)[\[86\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-86) In a statement made in May 2019, the [WHO](https://en.wikipedia.org/wiki/World_Health_Organization "World Health Organization") 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."[\[87\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-87) The *ICD-11* also has the medical condition "6B4Y Other specified disorders specifically associated with stress,"[\[88\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-:5-88) 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.[\[8\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-van_Dam_2021-8)
The US government's [National Institutes of Health](https://en.wikipedia.org/wiki/National_Institutes_of_Health "National Institutes of Health") includes the condition as "psychological burnout" in its index of the [National Library of Medicine](https://en.wikipedia.org/wiki/National_Library_of_Medicine "National Library of Medicine"),[\[89\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-meshb.nlm.nih.gov-89) 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."[\[89\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-meshb.nlm.nih.gov-89) [SNOMED CT](https://en.wikipedia.org/wiki/SNOMED_CT "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](https://en.wikipedia.org/wiki/Anxiety_disorder "Anxiety disorder").[\[90\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-90) The [Diseases Database](https://en.wikipedia.org/wiki/Diseases_Database "Diseases Database") defines the condition as "professional burnout."[\[91\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-91)
## Instruments used to assess burnout symptoms
\[[edit](https://en.wikipedia.org/w/index.php?title=Occupational_burnout&action=edit§ion=3 "Edit section: Instruments used to assess burnout symptoms")\]
A number of instruments have been developed to assess work-related burnout. The National Academy of Medicine has created an inventory of burnout scales.[\[92\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-92) The core of all of the abovementioned conceptualizations, including that of [Freudenberger](https://en.wikipedia.org/wiki/Herbert_Freudenberger "Herbert Freudenberger"), is exhaustion.[\[93\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-Maslach01-93)[\[94\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-SVB-94)
### Maslach Burnout Inventory
\[[edit](https://en.wikipedia.org/w/index.php?title=Occupational_burnout&action=edit§ion=4 "Edit section: Maslach Burnout Inventory")\]
In 1981, Maslach and Jackson published the first widely used instrument for assessing burnout, the [Maslach Burnout Inventory](https://en.wikipedia.org/wiki/Maslach_Burnout_Inventory "Maslach Burnout Inventory") (MBI).[\[2\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-Maslach2-2) It remains by far the most commonly used instrument to assess the condition.[\[44\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-SVB2019-44) 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),[\[a\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-95) and reduced personal accomplishment.[\[1\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-Maslach-1)[\[2\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-Maslach2-2) The MBI originally focused on human service professionals (e.g., teachers, social workers).[\[2\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-Maslach2-2) 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.[\[1\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-Maslach-1)
The MBI is proprietary. Its cost may be a disincentive that discourages graduate students and young assistant professors from using it.[\[83\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-S&B,_2020-83) There are other conceptualizations of burnout that differ from the conceptualization suggested by Maslach and adopted by the WHO.[\[5\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-Bulletin,_2023-5)
### Oldenburg Burnout Inventory
\[[edit](https://en.wikipedia.org/w/index.php?title=Occupational_burnout&action=edit§ion=5 "Edit section: Oldenburg Burnout Inventory")\]
In 1999, Demerouti and Bakker,[\[95\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-96) with their Oldenburg Burnout Inventory (OLBI), conceptualized burnout in terms of exhaustion and disengagement, linking their conceptualization to the [job demandsâresources model](https://en.wikipedia.org/wiki/Job_demands-resources_model "Job demands-resources model").
### Copenhagen Burnout Inventory
\[[edit](https://en.wikipedia.org/w/index.php?title=Occupational_burnout&action=edit§ion=6 "Edit section: Copenhagen Burnout Inventory")\]
In 2005, Kristensen et al.[\[3\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-copenhagenburn-3) released the public domain Copenhagen Burnout Inventory (CBI). They argued that the definition of burnout should be limited to the fatigue/exhaustion continuum.[\[3\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-copenhagenburn-3)
### Shirom-Melamed Burnout Measure
\[[edit](https://en.wikipedia.org/w/index.php?title=Occupational_burnout&action=edit§ion=7 "Edit section: Shirom-Melamed Burnout Measure")\]
In 2006, Shirom and Melamed with their Shirom-Melamed Burnout Measure (SMBM) conceptualized burnout in terms of physical exhaustion, cognitive weariness, and emotional exhaustion.[\[96\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-97)[\[97\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-Burnout_and_risk_of_coronary_heart-98) The SMBM's emotional exhaustion subscale more clearly embodies Maslach's[\[93\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-Maslach01-93) concept of depersonalization than her concept of emotional exhaustion.[\[44\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-SVB2019-44) This measure has seen some use in Sweden.
### Karolinska Exhaustion Disorder Scale
\[[edit](https://en.wikipedia.org/w/index.php?title=Occupational_burnout&action=edit§ion=8 "Edit section: Karolinska Exhaustion Disorder Scale")\]
In 2014, BesĂšr et al. published the Karolinska Exhaustion Disorder Scale (KEDS),[\[50\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-Bes%C3%A8r_2014-50)[\[98\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-99) 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.
### Sydney Burnout Measure
\[[edit](https://en.wikipedia.org/w/index.php?title=Occupational_burnout&action=edit§ion=9 "Edit section: Sydney Burnout Measure")\]
In 2021, [Gordon Parker](https://en.wikipedia.org/wiki/Gordon_Parker_\(psychiatrist\) "Gordon Parker (psychiatrist)") 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."[\[99\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-100)
### Lesser known burnout scales
\[[edit](https://en.wikipedia.org/w/index.php?title=Occupational_burnout&action=edit§ion=10 "Edit section: Lesser known burnout scales")\]
There are other conceptualizations of burnout embodied in other instruments, including the Hamburg Burnout Inventory,[\[100\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-Wurm_2016-101) the Burnout Assessment Tool,[\[101\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-102) the Burnout Measure,[\[39\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-Pines_&_Aronson-39)[\[102\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-103) and the Meier Burnout Assessment.[\[103\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-104)
### Other instruments that measure burnout
\[[edit](https://en.wikipedia.org/w/index.php?title=Occupational_burnout&action=edit§ion=11 "Edit section: Other instruments that measure burnout")\]
In 1999, Wilmar Schaufeli and Arnold Bakker[\[104\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-UWES-105) published the Utrecht Work Engagement Scale (UWES), an instrument that uses a conceptualisation similar to that of the MBI. However the UWES measures vigour, dedication and absorption, positive counterparts (or polar opposites) of the high-burnout endpoints of the MBI's subscales.[\[104\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-UWES-105)
In 2010, researchers at the [Mayo Clinic](https://en.wikipedia.org/wiki/Mayo_Clinic "Mayo Clinic") used portions of the MBI, along with other comprehensive assessments, to develop the [Well-Being Index](https://en.wikipedia.org/wiki/Well-Being_Index "Well-Being Index"), a nine-item self-assessment tool designed to measure burnout and other dimensions of distress in healthcare workers specifically.[\[105\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-106) The measure has mainly been used in the United States.
The [Occupational Depression Inventory](https://en.wikipedia.org/wiki/Occupational_Depression_Inventory "Occupational Depression Inventory") (ODI)[\[59\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-10.1016-59)[\[9\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-S&B,_2025-9) was published in 2020. The measure covers the nine main symptoms of depression[\[106\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-107) that individuals ascribe to their jobs and quantifies the severity of those work-attributed symptoms.[\[59\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-10.1016-59) The ODI also generates provisional diagnoses of job-ascribed depression.[\[60\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-10.1037-60)[\[83\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-S&B,_2020-83) 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,[\[60\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-10.1037-60) suggesting that the ODI is a suitable replacement for burnout scales like the MBI.[\[83\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-S&B,_2020-83)[\[9\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-S&B,_2025-9)
## Different types of burnout
\[[edit](https://en.wikipedia.org/w/index.php?title=Occupational_burnout&action=edit§ion=12 "Edit section: Different types of burnout")\]
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.
### Caregiver burnout in the context of unpaid caregiving
\[[edit](https://en.wikipedia.org/w/index.php?title=Occupational_burnout&action=edit§ion=13 "Edit section: Caregiver burnout in the context of unpaid caregiving")\]
Main article: [Caregiver stress](https://en.wikipedia.org/wiki/Caregiver_stress "Caregiver stress")
Burnout is thought to affect [caregivers](https://en.wikipedia.org/wiki/Caregivers "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.[\[88\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-:5-88)
### Spouse burnout
\[[edit](https://en.wikipedia.org/w/index.php?title=Occupational_burnout&action=edit§ion=14 "Edit section: Spouse burnout")\]
Malach-Pines (who also published as Ayala Pines)[\[107\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-108) advanced the view that burnout can also occur in connection to the spousal role.[\[108\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-109)[\[109\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-110)
### Teacher burnout
\[[edit](https://en.wikipedia.org/w/index.php?title=Occupational_burnout&action=edit§ion=15 "Edit section: Teacher burnout")\]
Main article: [Teacher burnout](https://en.wikipedia.org/wiki/Teacher_burnout "Teacher burnout")
Burnout in teachers represents a type occupational burnout.[\[110\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-Farber-111)
### Athlete burnout
\[[edit](https://en.wikipedia.org/w/index.php?title=Occupational_burnout&action=edit§ion=16 "Edit section: Athlete burnout")\]
Main article: [Overtraining](https://en.wikipedia.org/wiki/Overtraining "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.[\[111\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-112)
### Autistic burnout
\[[edit](https://en.wikipedia.org/w/index.php?title=Occupational_burnout&action=edit§ion=17 "Edit section: Autistic burnout")\]
Main article: [Autistic burnout](https://en.wikipedia.org/wiki/Autistic_burnout "Autistic burnout")
[Autistic people](https://en.wikipedia.org/wiki/Autism_spectrum "Autism spectrum") are known to experience a state of mental, emotional, or physical exhaustion referred to as [autistic burnout](https://en.wikipedia.org/wiki/Autistic_burnout "Autistic burnout") because of the general stress involved in [masking of autistic traits and behavior](https://en.wikipedia.org/wiki/Autistic_masking "Autistic masking") and the strains associated with living in an [unaccommodating environment](https://en.wikipedia.org/wiki/Autism-friendly "Autism-friendly").[\[112\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-:0-113)[\[113\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-:1-114)[\[114\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-:4-115) Autistic burnout is considered to be distinct from occupational burnout in both [etiology](https://en.wikipedia.org/wiki/Etiology "Etiology") and [presentation](https://en.wikipedia.org/wiki/Presentation_\(medical\) "Presentation (medical)").[\[113\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-:1-114)[\[115\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-:2-116)
## Relationship with other conditions
\[[edit](https://en.wikipedia.org/w/index.php?title=Occupational_burnout&action=edit§ion=18 "Edit section: Relationship with other conditions")\]
Liu and van Liew[\[49\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-Liu-49) 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](https://en.wikipedia.org/wiki/Nosology "Nosology") similar to [depression](https://en.wikipedia.org/wiki/Major_depressive_disorder "Major depressive disorder").[\[116\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-117)[\[117\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-Ahola_2014-118)[\[118\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-Hintsa_2016-119)[\[119\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-Schonfeld_2016-120) 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.[\[80\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-Bianchi,_Boffy-80) 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.[\[120\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-Bianchi_2015-121) The view that burnout is a form of depression has found support.[\[94\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-SVB-94)[\[117\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-Ahola_2014-118)[\[120\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-Bianchi_2015-121)[\[118\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-Hintsa_2016-119) 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.[\[82\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-Rotenstein2018-82)[\[121\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-122) 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.[\[122\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-VBSL-123)[\[94\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-SVB-94) 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.[\[123\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-124)
Maslach[\[93\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-Maslach01-93) 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.[\[56\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-s30945922-56)[\[124\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-125)[\[44\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-SVB2019-44) Burnout is also now often seen as involving the full array of [depressive](https://en.wikipedia.org/wiki/Depression_\(mood\) "Depression (mood)") symptoms (e.g., low [mood](https://en.wikipedia.org/wiki/Mood_\(psychology\) "Mood (psychology)"), [cognitive](https://en.wikipedia.org/wiki/Cognitive_psychology "Cognitive psychology") alterations, [sleep disturbance](https://en.wikipedia.org/wiki/Sleep_disorder "Sleep disorder")).[\[125\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-126)[\[9\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-S&B,_2025-9)
### Endocrine findings
\[[edit](https://en.wikipedia.org/w/index.php?title=Occupational_burnout&action=edit§ion=19 "Edit section: Endocrine findings")\]
Kakiashvili et al.[\[126\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-The_medical_perspective_on_burnout-127) 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 [hypothalamicâpituitaryâadrenal axis](https://en.wikipedia.org/wiki/Hypothalamic%E2%80%93pituitary%E2%80%93adrenal_axis "Hypothalamicâpituitaryâadrenal axis") dysfunction worse. Others have found Kakiashvili et al.'s argument specious.[\[127\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-Bianchi_2014-128)
| Test | [Major depressive disorder](https://en.wikipedia.org/wiki/Major_depressive_disorder "Major depressive disorder") (typically [melancholic depression](https://en.wikipedia.org/wiki/Melancholic_depression "Melancholic depression")) | [Atypical depression](https://en.wikipedia.org/wiki/Atypical_depression "Atypical depression") | [PTSD](https://en.wikipedia.org/wiki/PTSD "PTSD") | Burnout |
|---|---|---|---|---|
| [Cortisol awakening response](https://en.wikipedia.org/wiki/Cortisol_awakening_response "Cortisol awakening response") | â[\[126\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-The_medical_perspective_on_burnout-127) | â[\[128\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-129) | â[\[126\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-The_medical_perspective_on_burnout-127) | â[\[126\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-The_medical_perspective_on_burnout-127)[\[129\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-Moch_2003-130) |
| [Adrenocorticotropic hormone](https://en.wikipedia.org/wiki/Adrenocorticotropic_hormone "Adrenocorticotropic hormone") (ACTH) | â[\[126\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-The_medical_perspective_on_burnout-127) | \-[\[130\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-131) or â[\[129\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-Moch_2003-130) | \- or â[\[126\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-The_medical_perspective_on_burnout-127) | \- or â[\[126\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-The_medical_perspective_on_burnout-127) or â[\[129\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-Moch_2003-130) |
| [Dehydroepiandrosterone sulphate](https://en.wikipedia.org/wiki/Dehydroepiandrosterone_sulphate "Dehydroepiandrosterone sulphate") (DHEA-S) | â[\[126\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-The_medical_perspective_on_burnout-127) | | â or â[\[126\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-The_medical_perspective_on_burnout-127) | â[\[126\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-The_medical_perspective_on_burnout-127) |
| Low dose [dexamethasone suppression test](https://en.wikipedia.org/wiki/Dexamethasone_suppression_test "Dexamethasone suppression test") effect on cortisol | no suppression[\[126\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-The_medical_perspective_on_burnout-127) | | | hypersuppression[\[126\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-The_medical_perspective_on_burnout-127) |
[\[126\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-The_medical_perspective_on_burnout-127)[\[131\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-132)[\[132\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-133)[\[133\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-134)
Despite its name, depression with atypical features, which is seen in the above table, is not a rare form of depression.[\[134\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-135) The cortisol profile in atypical depression, in contrast to that of melancholic depression, is similar to the cortisol profile found in burnout.[\[127\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-Bianchi_2014-128) Commentators advanced the view that burnout differs from depression because the cortisol profile of burnout differs from that of melancholic depression; however, as the above table indicates, burnout's cortisol profile is similar to that of atypical depression.[\[127\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-Bianchi_2014-128)
## Risk factors
\[[edit](https://en.wikipedia.org/w/index.php?title=Occupational_burnout&action=edit§ion=20 "Edit section: Risk factors")\]
Evidence suggests that the etiology of burnout is multifactorial, with personality factors playing an important, long-overlooked role.[\[135\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-Schaufeli_&_Enzmann-136)[\[136\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-137)[\[137\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-138) The researchers identified the prominent personality factor [neuroticism](https://en.wikipedia.org/wiki/Neuroticism "Neuroticism") in the development of burnout. Cognitive dispositional factors implicated in depression have also been found to be implicated in burnout.[\[138\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-139)
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.[\[139\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-Maslach972-140) 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.[\[140\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-141)
The [job demandsâresources model](https://en.wikipedia.org/wiki/Job_demands-resources_model "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.[\[141\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-142) Lack of job resources was associated with the disengagement component of the OLBI. Maslach and her colleagues (2001)[\[93\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-Maslach01-93) 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.[\[142\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-pmid33119345-143) 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.[\[135\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-Schaufeli_&_Enzmann-136)
In a systematic literature review in 2014, the [Swedish Agency for Health Technology Assessment and Assessment of Social Services](https://en.wikipedia.org/wiki/Swedish_Agency_for_Health_Technology_Assessment_and_Assessment_of_Social_Services "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.[\[143\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-144)
## Effects
\[[edit](https://en.wikipedia.org/w/index.php?title=Occupational_burnout&action=edit§ion=21 "Edit section: Effects")\]
In line with the work of [Maslach](https://en.wikipedia.org/wiki/Christina_Maslach "Christina Maslach") and [Jackson](https://en.wikipedia.org/wiki/Susan_E._Jackson "Susan E. Jackson")[\[1\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-Maslach-1)[\[45\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-ReferenceD-45) 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.[\[144\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-145)
[](https://en.wikipedia.org/wiki/File:Smi3224-fig-0002-m.webp)
Symptoms sufferers, past sufferers and health professionals associate with exhaustion disorder.[\[145\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-Linds%C3%A4ter_2023-146)
LindsÀter et al. (2023)[\[145\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-Linds%C3%A4ter_2023-146) 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](https://en.wikipedia.org/wiki/Job_performance "Job performance"),[\[146\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-147) coronary [heart disease](https://en.wikipedia.org/wiki/Heart_disease "Heart disease"),[\[97\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-Burnout_and_risk_of_coronary_heart-98) and [mental health](https://en.wikipedia.org/wiki/Mental_health "Mental health") problems.[\[147\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-148) Emotional symptoms associated with occupational burnout include a lack of interest in work, reduced performance, feelings of helplessness, and trouble sleeping.[\[148\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-Cengage_Learning-149)
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.[\[149\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-pmid34537040-150)
Research on dentists[\[117\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-Ahola_2014-118) and physicians[\[100\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-Wurm_2016-101) 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.[\[150\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-lung-151) 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.[\[151\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-152)
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.[\[152\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-153) They can suffer concentration problems, forgetfulness, increased frustration, and/or feelings of being overwhelmed.[\[153\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-154) They may complain and feel negative, or feel apathetic and believe they have little impact on their coworkers and environment.[\[148\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-Cengage_Learning-149) Occupational burnout is also associated with absenteeism, other time missed from work, and thoughts of quitting.[\[154\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-ReferenceC-155)
As in depression, chronic burnout is also associated with cognitive impairments in [memory](https://en.wikipedia.org/wiki/Memory "Memory") and [attention](https://en.wikipedia.org/wiki/Attention "Attention").[\[155\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-156) Research suggests that burnout can manifest differently between genders, with higher levels of depersonalisation among men and increased emotional exhaustion among women.[\[156\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-157)[\[157\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-158) Other research suggests that people revealing a history of occupational burnout face future hiring discrimination.[\[158\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-159)
## Treatment and prevention
\[[edit](https://en.wikipedia.org/w/index.php?title=Occupational_burnout&action=edit§ion=22 "Edit section: Treatment and prevention")\]
There are thought to be three general types of workplace prevention-related interventions.[\[159\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-160) 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.
### Primary prevention
\[[edit](https://en.wikipedia.org/w/index.php?title=Occupational_burnout&action=edit§ion=23 "Edit section: Primary prevention")\]
See also: [Occupational stress](https://en.wikipedia.org/wiki/Occupational_stress "Occupational stress"), [Caregiver stress](https://en.wikipedia.org/wiki/Caregiver_stress "Caregiver stress"), and [Stress management](https://en.wikipedia.org/wiki/Stress_management "Stress management")
Maslach suggested that preventing burnout requires a combination of organizational change and worker education.[\[139\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-Maslach972-140) She and her co-authors argued that burnout can occur in connection to six areas of work life: workload, control, reward, community, fairness, and values.[\[93\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-Maslach01-93) For example, with regard to workload, an organization should ensure that a worker has adequate resources to meet job demands.[\[93\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-Maslach01-93) With regard to values, clearly stated ethical organizational values are important for employee well-being and commitment.[\[93\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-Maslach01-93) Supportive leadership and relationships with colleagues are also helpful.[\[93\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-Maslach01-93)
HĂ€tinen et al.[\[160\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-H%C3%A4tinen_2007-161) 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.[\[161\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-Van_Dierendonck_1998-162) The intervention was associated with decreases in exhaustion over time but not cynicism or inefficacy, suggesting that a broader approach is required.[\[93\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-Maslach01-93)
[Corporate Social Responsibility](https://en.wikipedia.org/wiki/Corporate_social_responsibility "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.[\[162\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-163) Establishing a sense of [psychological safety](https://en.wikipedia.org/wiki/Psychological_safety "Psychological safety") (the belief that it is safe to speak up) in an organisation helps prevent burnout.[\[163\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-:11-164)[\[164\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-165)[\[165\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-166)[\[166\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-167) Similarly, feeling heard may also help.[\[163\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-:11-164) Increasing workers' [control over their work tasks](https://en.wikipedia.org/wiki/Job_control_\(workplace\) "Job control (workplace)") is another intervention that can reduce exhaustion and [cynicism](https://en.wikipedia.org/wiki/Cynicism_\(contemporary\) "Cynicism (contemporary)").[\[160\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-H%C3%A4tinen_2007-161)
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.[\[167\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-Richardson-168)[\[168\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-Estevez-169) For example, Richardson and Rothstein's (2008)[\[167\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-Richardson-168) meta-analysis of primary workplace interventions included only two high-quality studies that addressed burnout. In their meta-analysis, Estevez Corres et al. (2021)[\[168\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-Estevez-169) 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.
In a qualitative study, Meluch (2023),[\[169\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-170) 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[\[170\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-:10-171) recommended that organizations provide timely accurate information on activities and policies in order to minimize emotional exhaustion.
### Secondary and tertiary prevention
\[[edit](https://en.wikipedia.org/w/index.php?title=Occupational_burnout&action=edit§ion=24 "Edit section: Secondary and tertiary prevention")\]
See also: [Management of depression](https://en.wikipedia.org/wiki/Management_of_depression "Management of depression"), [Treatments for PTSD](https://en.wikipedia.org/wiki/Treatments_for_PTSD "Treatments for PTSD"), and [Anxiety Disorder § Treatment](https://en.wikipedia.org/wiki/Anxiety_Disorder#Treatment "Anxiety Disorder")
Van der Klink and van Dijk (2003)[\[76\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-sjweh.756-76) suggested [stress inoculation training](https://en.wikipedia.org/wiki/Stress_inoculation_training "Stress inoculation training"), [cognitive restructuring](https://en.wikipedia.org/wiki/Cognitive_restructuring "Cognitive restructuring"), and [graded activity](https://en.wikipedia.org/wiki/Systematic_desensitisation "Systematic desensitisation") to help workers with burnout symptoms, although insufficient high-quality research has been carried out on their efficacy. HĂ€tinen et al. (2007)[\[160\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-H%C3%A4tinen_2007-161) listed a number of common secondary and tertiary interventions, including [treatment of any outstanding medical conditions](https://en.wikipedia.org/wiki/Medicine "Medicine"), [stress management](https://en.wikipedia.org/wiki/Stress_management "Stress management"), [time management](https://en.wikipedia.org/wiki/Time_management "Time management"), [depression treatment](https://en.wikipedia.org/wiki/Management_of_depression "Management of depression"), [psychotherapies](https://en.wikipedia.org/wiki/Psychotherapies "Psychotherapies"), [ergonomic improvement](https://en.wikipedia.org/wiki/Ergonomics "Ergonomics") as well as [occupational therapy](https://en.wikipedia.org/wiki/Occupational_therapy "Occupational therapy"), [physical exercise](https://en.wikipedia.org/wiki/Physical_exercise "Physical exercise") and [relaxation](https://en.wikipedia.org/wiki/Relaxation_\(psychology\) "Relaxation (psychology)"). [Mindfulness](https://en.wikipedia.org/wiki/Mindfulness "Mindfulness") therapy has been used to help with occupational burnout in medical practitioners.[\[171\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-172) 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.[\[172\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-pat-173)[\[173\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-ReferenceA2-174)[\[174\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-175)
Farber (2000),[\[175\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-176) 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](https://en.wikipedia.org/wiki/Work%E2%80%93life_balance "Workâlife balance"). The ways in which people spend their non-work time can help to prevent burnout and improve health and well-being.[\[176\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-Woolston-177) Training employees in ways to manage stress in the workplace has been thought to reduce burnout.[\[177\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-178) One study[\[154\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-ReferenceC-155) suggests that social-cognitive processes such as [commitment](https://en.wikipedia.org/wiki/Organizational_commitment "Organizational commitment") to work, [self-efficacy](https://en.wikipedia.org/wiki/Self-efficacy "Self-efficacy"), learned resourcefulness, and [hope](https://en.wikipedia.org/wiki/Hope "Hope") may insulate individuals from experiencing occupational burnout.
Kakiashvili et al.[\[126\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-The_medical_perspective_on_burnout-127) 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](https://en.wikipedia.org/wiki/Cognitive_behavioral_therapy "Cognitive behavioral therapy") (CBT). Salomonsson et al. (2020)[\[178\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-179) 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)[\[179\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-180) had also earlier found that CBT was an effective treatment. [Parker](https://en.wikipedia.org/wiki/Gordon_Parker_\(psychiatrist\) "Gordon Parker (psychiatrist)") et al. (2021)[\[12\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-Parker_2021-12)[\[13\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-Parker_2021_2-13) found that the most useful treatment strategies appear to be talking to someone and seeking support, [walking or other exercise](https://en.wikipedia.org/wiki/Exercise "Exercise"), [mindfulness](https://en.wikipedia.org/wiki/Mindfulness "Mindfulness") and [meditation](https://en.wikipedia.org/wiki/Meditation "Meditation"), [improving sleep](https://en.wikipedia.org/wiki/Sleep "Sleep"), and leaving work completely or taking time off work.
The Swedish national health information service (known as "1177")[\[180\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-181) 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 recommend a three-stage treatment process, made up of a crisis phase, a problem and solution stage, and an application stage.[\[181\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-:6-182) The [Gothenburg](https://en.wikipedia.org/wiki/Gothenburg "Gothenburg") regional government's Institute for Stress Medicine[\[182\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-183) reports 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."[\[183\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-184)
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.[\[168\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-Estevez-169)[\[184\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-Tamminga-185) One study suggests that cognitive behavioral therapy (CBT), which was developed to treat [depression](https://en.wikipedia.org/wiki/Depression_\(mood\) "Depression (mood)"), can help some workers with symptoms of occupational burnout although high-quality research on the application of CBT to treating burnout has been sparse.[\[185\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-186) 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.[\[184\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-Tamminga-185)
## See also
\[[edit](https://en.wikipedia.org/w/index.php?title=Occupational_burnout&action=edit§ion=25 "Edit section: See also")\]
- [Psychology portal](https://en.wikipedia.org/wiki/Portal:Psychology "Portal:Psychology")
- [Allostatic load](https://en.wikipedia.org/wiki/Allostatic_load "Allostatic load")
- [Annual leave](https://en.wikipedia.org/wiki/Annual_leave "Annual leave")
- [Autistic burnout](https://en.wikipedia.org/wiki/Autistic_burnout "Autistic burnout")
- [Boreout](https://en.wikipedia.org/wiki/Boreout "Boreout")
- [Clouding of consciousness](https://en.wikipedia.org/wiki/Clouding_of_consciousness "Clouding of consciousness")
- [Code Lavender](https://en.wikipedia.org/wiki/Code_Lavender "Code Lavender")
- [Critique of work](https://en.wikipedia.org/wiki/Critique_of_work "Critique of work")
- [Depression](https://en.wikipedia.org/wiki/Depression_\(mood\) "Depression (mood)")
- [Effects of overtime](https://en.wikipedia.org/wiki/Effects_of_overtime "Effects of overtime")
- [Four-day workweek](https://en.wikipedia.org/wiki/Four-day_workweek "Four-day workweek")
- [Job strain](https://en.wikipedia.org/wiki/Job_strain "Job strain")
- [Karoshi](https://en.wikipedia.org/wiki/Karoshi "Karoshi")
- [Labor rights](https://en.wikipedia.org/wiki/Labor_rights "Labor rights")
- [Lived experience](https://en.wikipedia.org/wiki/Lived_experience "Lived experience")
- [Occupational Depression Inventory](https://en.wikipedia.org/wiki/Occupational_Depression_Inventory "Occupational Depression Inventory")
- [Occupational stress](https://en.wikipedia.org/wiki/Occupational_stress "Occupational stress")
- [Overwork](https://en.wikipedia.org/wiki/Overwork "Overwork")
- [Paid time off](https://en.wikipedia.org/wiki/Paid_time_off "Paid time off")
- [Presenteeism](https://en.wikipedia.org/wiki/Presenteeism "Presenteeism")
- [Right to rest and leisure](https://en.wikipedia.org/wiki/Right_to_rest_and_leisure "Right to rest and leisure")
- [Six-hour day](https://en.wikipedia.org/wiki/Six-hour_day "Six-hour day")
- [Stress (biological)](https://en.wikipedia.org/wiki/Stress_\(biological\) "Stress (biological)")
- [Stress management](https://en.wikipedia.org/wiki/Stress_management "Stress management")
- [Suicide crisis](https://en.wikipedia.org/wiki/Suicide_crisis "Suicide crisis")
- [Tang ping](https://en.wikipedia.org/wiki/Tang_ping "Tang ping")
- [Teacher burnout](https://en.wikipedia.org/wiki/Teacher_burnout "Teacher burnout")
- [Quiet cracking](https://en.wikipedia.org/wiki/Quiet_cracking "Quiet cracking")
- [Workaholic](https://en.wikipedia.org/wiki/Workaholic "Workaholic")
- [Workload](https://en.wikipedia.org/wiki/Workload "Workload")
- [Writer's block](https://en.wikipedia.org/wiki/Writer%27s_block "Writer's block")
## Notes
\[[edit](https://en.wikipedia.org/w/index.php?title=Occupational_burnout&action=edit§ion=26 "Edit section: Notes")\]
1. **[^](https://en.wikipedia.org/wiki/Occupational_burnout#cite_ref-95)** The term "depersonalization" as used by Maslach and Jackson should not be confused with the [same term](https://en.wikipedia.org/wiki/Depersonalization "Depersonalization") used in psychiatry and clinical psychology as a hallmark of dissociative disorder.
## References
\[[edit](https://en.wikipedia.org/w/index.php?title=Occupational_burnout&action=edit§ion=27 "Edit section: References")\]
1. ^ [***a***](https://en.wikipedia.org/wiki/Occupational_burnout#cite_ref-Maslach_1-0) [***b***](https://en.wikipedia.org/wiki/Occupational_burnout#cite_ref-Maslach_1-1) [***c***](https://en.wikipedia.org/wiki/Occupational_burnout#cite_ref-Maslach_1-2) [***d***](https://en.wikipedia.org/wiki/Occupational_burnout#cite_ref-Maslach_1-3) [***e***](https://en.wikipedia.org/wiki/Occupational_burnout#cite_ref-Maslach_1-4)
Maslach C, Jackson SE, Leiter MP (1996). ["MBI: The Maslach Burnout Inventory: Manual"](https://www.researchgate.net/publication/277816643). Palo Alto: Consulting Psychologists Press.
2. ^ [***a***](https://en.wikipedia.org/wiki/Occupational_burnout#cite_ref-Maslach2_2-0) [***b***](https://en.wikipedia.org/wiki/Occupational_burnout#cite_ref-Maslach2_2-1) [***c***](https://en.wikipedia.org/wiki/Occupational_burnout#cite_ref-Maslach2_2-2) [***d***](https://en.wikipedia.org/wiki/Occupational_burnout#cite_ref-Maslach2_2-3) [***e***](https://en.wikipedia.org/wiki/Occupational_burnout#cite_ref-Maslach2_2-4)
Maslach C, Jackson SE (1981). ["The measurement of experienced burnout"](https://doi.org/10.1002%2Fjob.4030020205). *Journal of Occupational Behaviour*. **2** (2): 99â113\. [doi](https://en.wikipedia.org/wiki/Doi_\(identifier\) "Doi (identifier)"):[10\.1002/job.4030020205](https://doi.org/10.1002%2Fjob.4030020205). [S2CID](https://en.wikipedia.org/wiki/S2CID_\(identifier\) "S2CID (identifier)") [53003646](https://api.semanticscholar.org/CorpusID:53003646).
3. ^ [***a***](https://en.wikipedia.org/wiki/Occupational_burnout#cite_ref-copenhagenburn_3-0) [***b***](https://en.wikipedia.org/wiki/Occupational_burnout#cite_ref-copenhagenburn_3-1) [***c***](https://en.wikipedia.org/wiki/Occupational_burnout#cite_ref-copenhagenburn_3-2)
Kristensen TS, Borritz M, Villadsen E, Christensen KB (2005). "The Copenhagen Burnout Inventory: A new tool for the assessment of burnout". *Work & Stress*. **19** (3): 192â207\. [doi](https://en.wikipedia.org/wiki/Doi_\(identifier\) "Doi (identifier)"):[10\.1080/02678370500297720](https://doi.org/10.1080%2F02678370500297720). [S2CID](https://en.wikipedia.org/wiki/S2CID_\(identifier\) "S2CID (identifier)") [146576094](https://api.semanticscholar.org/CorpusID:146576094).
4. **[^](https://en.wikipedia.org/wiki/Occupational_burnout#cite_ref-4)**
["Burn-out an "occupational phenomenon": International Classification of Diseases"](https://www.who.int/news/item/28-05-2019-burn-out-an-occupational-phenomenon-international-classification-of-diseases). *www.who.int*. Retrieved 2023-11-09.
5. ^ [***a***](https://en.wikipedia.org/wiki/Occupational_burnout#cite_ref-Bulletin,_2023_5-0) [***b***](https://en.wikipedia.org/wiki/Occupational_burnout#cite_ref-Bulletin,_2023_5-1)
Bianchi, R., & Schonfeld, I. S. (2023). Examining the evidence base for burnout. *Bulletin of the World Health Organization, 101*(11), 743â745.
[doi](https://en.wikipedia.org/wiki/Doi_\(identifier\) "Doi (identifier)"):[10\.2471/BLT.23.289996](https://doi.org/10.2471%2FBLT.23.289996)
6. **[^](https://en.wikipedia.org/wiki/Occupational_burnout#cite_ref-6)** Maslach C, Jackson SE, Leiter MP. Maslach Burnout Inventory Manual (4th ed.). Menlo Park: Mind Garden, 2016.
7. ^ [***a***](https://en.wikipedia.org/wiki/Occupational_burnout#cite_ref-Lastovkova_2018_7-0) [***b***](https://en.wikipedia.org/wiki/Occupational_burnout#cite_ref-Lastovkova_2018_7-1) [***c***](https://en.wikipedia.org/wiki/Occupational_burnout#cite_ref-Lastovkova_2018_7-2)
Lastovkova A, Carder M, Rasmussen HM, Sjoberg L, Groene GJ, Sauni R, et al. (April 2018). ["Burnout syndrome as an occupational disease in the European Union: an exploratory study"](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5889935). *Industrial Health*. **56** (2): 160â165\. [Bibcode](https://en.wikipedia.org/wiki/Bibcode_\(identifier\) "Bibcode (identifier)"):[2018IndHe..56..160L](https://ui.adsabs.harvard.edu/abs/2018IndHe..56..160L). [doi](https://en.wikipedia.org/wiki/Doi_\(identifier\) "Doi (identifier)"):[10\.2486/indhealth.2017-0132](https://doi.org/10.2486%2Findhealth.2017-0132). [PMC](https://en.wikipedia.org/wiki/PMC_\(identifier\) "PMC (identifier)") [5889935](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5889935). [PMID](https://en.wikipedia.org/wiki/PMID_\(identifier\) "PMID (identifier)") [29109358](https://pubmed.ncbi.nlm.nih.gov/29109358). "In 9 countries (Denmark, Estonia, France, Hungary, Latvia, Netherlands, Portugal, and Slovakia) burnout syndrome may be acknowledged as an occupational disease. \[emphasis added\]"
8. ^ [***a***](https://en.wikipedia.org/wiki/Occupational_burnout#cite_ref-van_Dam_2021_8-0) [***b***](https://en.wikipedia.org/wiki/Occupational_burnout#cite_ref-van_Dam_2021_8-1)
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## Further reading
\[[edit](https://en.wikipedia.org/w/index.php?title=Occupational_burnout&action=edit§ion=28 "Edit section: Further reading")\]
- Ahola, K., Hakanen, J., Perhoniemi, R., & Mutanen, P. (2014). Relationship between burnout and depressive symptoms: A study using the personcentred approach. *Burnout Research, 1*(1), 29â37. <https://doi.org/10.1016/j.burn.2014.03.003>
- Caputo JS (1991). *Stress and Burnout in Library Service*. Phoenix, AZ: Oryx Press.
- Cordes C, Dougherty T (1996). "A review and integration of research on job burnout". *Academy of Management Review*. **18** (4): 621â656\. [doi](https://en.wikipedia.org/wiki/Doi_\(identifier\) "Doi (identifier)"):[10\.5465/AMR.1993.9402210153](https://doi.org/10.5465%2FAMR.1993.9402210153).
- Freudenberger HJ F (1974). "Staff burnout". *Journal of Social Issues*. **30**: 159â165\. [doi](https://en.wikipedia.org/wiki/Doi_\(identifier\) "Doi (identifier)"):[10\.1111/j.1540-4560.1974.tb00706.x](https://doi.org/10.1111%2Fj.1540-4560.1974.tb00706.x).
- Freudenberger HJ (1980). *Burn-Out: The High Cost of High Achievement*. Anchor Press.
- Freudenberger HJ, North G (1985). *Women's Burnout: How to Spot It, How to Reverse It, and How to Prevent It*. Doubleday.
- Guthier, C., Dormann, C., & Voelkle, M. C. (2020). Reciprocal effects between job stressors and burnout: A continuous time meta-analysis of longitudinal studies. *Psychological Bulletin, 146*(12), 1146â1173. <https://doi.org/10.1037/bul0000304>
- Kristensen, T. S., Borritz, M., Villadsen, E., & Christensen, K. B. (2005). The Copenhagen Burnout Inventory: A new tool for the assessment of burnout. *Work & Stress, 19*(3), 192â207. <https://doi.org/10.1080/02678370500297720>
- Maslach, C. (1976, Sept.). Burned-out. *Human Behavior: The Newsmagazine of the Social Sciences, 5*(9), 16â22.
- Maslach, C. (1978). The client role in staff burn-out. *Journal of Social Issues, 34*(4), 111â124. <https://doi.org/10.1111/j.1540-4560.1978.tb00778.x>
- Maslach, C., & Jackson, S. E. (1981). The measurement of experienced burnout. *Journal of Organizational Behavior, 2*(2), 99â113. <https://doi.org/10.1002/job.4030020205>
- Maslach C, Leiter MP (May 2008). "Early predictors of job burnout and engagement". *The Journal of Applied Psychology*. **93** (3): 498â512\. [Bibcode](https://en.wikipedia.org/wiki/Bibcode_\(identifier\) "Bibcode (identifier)"):[2008JApPs..93..498M](https://ui.adsabs.harvard.edu/abs/2008JApPs..93..498M). [CiteSeerX](https://en.wikipedia.org/wiki/CiteSeerX_\(identifier\) "CiteSeerX (identifier)") [10\.1.1.607.4751](https://citeseerx.ist.psu.edu/viewdoc/summary?doi=10.1.1.607.4751). [doi](https://en.wikipedia.org/wiki/Doi_\(identifier\) "Doi (identifier)"):[10\.1037/0021-9010.93.3.498](https://doi.org/10.1037%2F0021-9010.93.3.498). [PMID](https://en.wikipedia.org/wiki/PMID_\(identifier\) "PMID (identifier)") [18457483](https://pubmed.ncbi.nlm.nih.gov/18457483).
- Maslach, C., & Pines, A. (1977). The burn-out syndrome in the day care setting. *Child Youth Care Forum, 6*(2), 100â113.
- Rapp D, Hughey M, Kreiner G (2021). "Boundary work as a buffer against burnout: Evidence from healthcare workers during the COVID-19 pandemic". *Journal of Applied Psychology*. **106** (8): 1169â1187\. [doi](https://en.wikipedia.org/wiki/Doi_\(identifier\) "Doi (identifier)"):[10\.1037/apl0000951](https://doi.org/10.1037%2Fapl0000951). [PMID](https://en.wikipedia.org/wiki/PMID_\(identifier\) "PMID (identifier)") [34424001](https://pubmed.ncbi.nlm.nih.gov/34424001). [S2CID](https://en.wikipedia.org/wiki/S2CID_\(identifier\) "S2CID (identifier)") [237268483](https://api.semanticscholar.org/CorpusID:237268483).
- Ray B (2002). *An assessment of burnout in academic librarians in America using the Maslach Burnout Inventory*. New Brunswick, NJ: Rutgers University Press.
- Rosch PJ (1998). "Reminiscences of Hans Selye and the birth of 'Stress'". *Stress Medicine*. **14**: 1â6\. [doi](https://en.wikipedia.org/wiki/Doi_\(identifier\) "Doi (identifier)"):[10\.1002/(sici)1099-1700(199801)14:1\<1::aid-smi777\>3.3.co;2-n](https://doi.org/10.1002%2F%28sici%291099-1700%28199801%2914%3A1%3C1%3A%3Aaid-smi777%3E3.3.co%3B2-n).
- Schonfeld, I. S., & Bianchi, R. (2025). *Breaking point: Job stress, occupational depression, and the myth of burnout*. John Wiley. ISBN 978-1-394-24949-7
- Shirom A, Melamed S (2005). "39: Does burnout affect physical health? A review of the evidence.". In Antoniou AS, Cooper CL (eds.). *Research companion to organizational health psychology*. Cheltenham, UK: Edward Elgar. pp. 599â622\.
- Warr P (1999). *Psychology at Work* (4th ed.). London: Penguin.
## External links
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Occupational burnout
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| Readable Markdown | | Occupational burnout | |
|---|---|
| Other names | Burn-out, exhaustion disorder, neurasthenia |
| [](https://en.wikipedia.org/wiki/File:Man_Overworked_At_Work.jpg) | |
| A person who is experiencing [psychological stress](https://en.wikipedia.org/wiki/Psychological_stress "Psychological stress") | |
| [Specialty](https://en.wikipedia.org/wiki/Medical_specialty "Medical specialty") | [Psychology](https://en.wikipedia.org/wiki/Psychology "Psychology") [](https://www.wikidata.org/wiki/Q327988?uselang=en#P1995 "Edit this on Wikidata") |
| [Symptoms](https://en.wikipedia.org/wiki/Signs_and_symptoms "Signs and symptoms") | [Emotional exhaustion](https://en.wikipedia.org/wiki/Emotional_exhaustion "Emotional exhaustion"), [depersonalization](https://en.wikipedia.org/wiki/Depersonalization "Depersonalization"), reduced personal accomplishment,[\[1\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-Maslach-1)[\[2\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-Maslach2-2) [fatigue](https://en.wikipedia.org/wiki/Fatigue "Fatigue")[\[3\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-copenhagenburn-3) |
| [Differential diagnosis](https://en.wikipedia.org/wiki/Differential_diagnosis "Differential diagnosis") | [Major depressive disorder](https://en.wikipedia.org/wiki/Major_depressive_disorder "Major depressive disorder") |
The ICD-11 of the [World Health Organization](https://en.wikipedia.org/wiki/World_Health_Organization "World Health Organization") (WHO) describes **occupational burnout** as a work-related phenomenon resulting from chronic workplace stress that has not been successfully managed. According to the WHO, symptoms include "feelings of energy depletion or exhaustion; increased mental distance from one's job, or feelings of negativism or cynicism related to one's job; and reduced professional efficacy."[\[4\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-4)
Occupational burnout is classified as an occupational phenomenon but is not recognized by the WHO as a [medical](https://en.wikipedia.org/wiki/Disease "Disease") or [psychiatric](https://en.wikipedia.org/wiki/Mental_disorder "Mental disorder") condition.[\[5\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-Bulletin,_2023-5) Social psychologist Christina Maslach and colleagues made clear that burnout does not constitute "a single, one-dimensional phenomenon."[\[6\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-6) However, national health bodies in some European countries do recognize it as such,[\[7\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-Lastovkova_2018-7) and it is also independently recognized by some health practitioners.[\[8\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-van_Dam_2021-8) Nevertheless, a body of evidence suggests that what is termed burnout is a depressive condition, that is to say, indistinct from, and overlaps with, depression.[\[9\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-S&B,_2025-9)
Kaschka, Korczak, and Broich (2011)[\[10\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-Burnout:_A_Fashionable_Diagnosis-10) advanced the view that burnout is described in the [Book of Exodus](https://en.wikipedia.org/wiki/Book_of_Exodus "Book of Exodus") (18:17â18).[\[10\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-Burnout:_A_Fashionable_Diagnosis-10) In the *New International Version* of the *Bible*, [Moses](https://en.wikipedia.org/wiki/Moses "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."[\[11\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-11) [Gordon Parker](https://en.wikipedia.org/wiki/Gordon_Parker_\(psychiatrist\) "Gordon Parker (psychiatrist)") suggested that the ancient European concept of [acedia](https://en.wikipedia.org/wiki/Acedia "Acedia") refers to burnout and not depression as many others believe.[\[12\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-Parker_2021-12)[\[13\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-Parker_2021_2-13)
By 1834, the German concept of *Berufskrankheiten* ([occupational diseases](https://en.wikipedia.org/wiki/Occupational_disease "Occupational disease")) had become established. The concept reflected adverse work-related effects on mental and physical health.[\[14\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-14) In 1869, New York neurologist [George Beard](https://en.wikipedia.org/wiki/George_Miller_Beard "George Miller Beard") used the term "[neurasthenia](https://en.wikipedia.org/wiki/Neurasthenia "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."[\[15\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-15) The concept soon became popular, and many in the United States believed themselves to suffer from it. Some came to call it "Americanitis".[\[16\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-16) Beard broadened the potential symptoms of neurasthenia such that the disorder could be the source of almost any symptom or behaviour.[\[17\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-17) Don R. Lipsitt would later wonder if the term "burnout" was similarly too broadly defined to be useful.[\[18\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-18) 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.[\[19\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-:3-19) The [rest cure](https://en.wikipedia.org/wiki/Rest_cure "Rest cure") was a commonly prescribed treatment for neurasthenia in the United States, particularly for women. The American doctor [Silas Weir Mitchell](https://en.wikipedia.org/wiki/Silas_Weir_Mitchell_\(physician\) "Silas Weir Mitchell (physician)") often prescribed this treatment. Other treatments included [hypnosis](https://en.wikipedia.org/wiki/Hypnosis "Hypnosis"), [Paul Charles Dubois](https://en.wikipedia.org/wiki/Paul_Charles_Dubois "Paul Charles Dubois")'s cognitive behavioural therapy (this is distinct from and devised much earlier than [Aaron Beck](https://en.wikipedia.org/wiki/Aaron_Beck "Aaron Beck")'s cognitive behavioral therapy), and [Otto Binswanger](https://en.wikipedia.org/wiki/Otto_Binswanger "Otto Binswanger")'s life normalisation therapy.[\[20\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-20)
In 1888, the English neurologist [William Gowers](https://en.wikipedia.org/wiki/William_Gowers_\(neurologist\) "William Gowers (neurologist)") coined the term *occupation neurosis* to describe cramps experienced by writers and pianists ([repetitive strain injury](https://en.wikipedia.org/wiki/Repetitive_strain_injury "Repetitive strain injury")), translating the German concept of *BeschÀftigungsneurosen* (occupational diseases affecting the nerves).[\[21\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-21) The related term *occupational neurosis* came to include a wide range of work-caused anxieties and other mental problems.[\[22\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-22) By the late 1930s, American health professionals had become widely acquainted with the condition.[\[23\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-23) It became known as *berufsneurose* in German.[\[24\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-24) From 1915, the Japanese psychiatrist [Shoma Morita](https://en.wikipedia.org/wiki/Shoma_Morita "Shoma Morita") developed [Morita therapy](https://en.wikipedia.org/wiki/Morita_therapy "Morita therapy") to treat neurasthenia.[\[25\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-25) He had come to have a different understanding of the condition than Beard,[\[26\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-26) preferring to call it *shinkeishitsui*; he published two books about the condition.
In 1957, Swiss psychiatrist [Paul Kielholz](https://en.wikipedia.org/wiki/Paul_Kielholz "Paul Kielholz") coined the term *Erschöpfungsdepression* \[exhaustion-depression\].[\[27\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-27)[\[28\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-28)[\[29\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-29) The concept was one of a number of new depression-subtypes that gained traction in France and Germany during the 1960s.[\[30\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-%C3%85wwn-30) In 1961, British author [Graham Greene](https://en.wikipedia.org/wiki/Graham_Greene "Graham Greene") published the novel *[A Burnt-Out Case](https://en.wikipedia.org/wiki/A_Burnt-Out_Case "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.[\[31\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-31) In 1965, Kielholz publicised therapy for *Erschöpfungsdepression* in the German-speaking world through his book *Diagnose und Therapie der Depressionen fĂŒr den Praktiker* \[*Diagnosis and Treatment of Depression for the Practitioner*\].[\[32\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-32) His work inspired further writing on the topic by German psychiatrist Volker Faust.[\[33\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-:7-33)
In 1968, the second edition of the [American Psychiatric Association](https://en.wikipedia.org/wiki/American_Psychiatric_Association "American Psychiatric Association")'s (APA) *[Diagnostic and Statistical Manual](https://en.wikipedia.org/wiki/Diagnostic_and_Statistical_Manual_of_Mental_Disorders "Diagnostic and Statistical Manual of Mental Disorders")* (*DSM-II*) replaced "[psychophysiologic nervous system reaction](https://en.wikipedia.org/wiki/Psychophysiologic_disorder "Psychophysiologic disorder")" with the condition *neurasthenic neurosis (neurasthenia)*.[\[34\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-34) 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*](https://en.wikipedia.org/wiki/Dependent_personality_disorder "Dependent personality disorder"), 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.[\[35\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-35) Bradley's article has been cited as the first known academic paper to use the term.[\[36\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-Wiley_1996-36)
In 1974, [Herbert Freudenberger](https://en.wikipedia.org/wiki/Herbert_Freudenberger "Herbert Freudenberger"), a German-born American clinical psychologist, used the term "burn-out" in his academic paper "Staff Burn-Out."[\[37\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-staffburnout1-37) The paper was based on his qualitative observations of the volunteer staff (including himself) at a free clinic for drug addicts.[\[37\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-staffburnout1-37) 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 psychologist [Christina Maslach](https://en.wikipedia.org/wiki/Christina_Maslach "Christina Maslach") described burnout in a 1976 magazine article[\[38\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-38) 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](https://en.wikipedia.org/wiki/Elliot_Aronson "Elliot Aronson"), using group workshops, began to treat people having symptoms of burnout.[\[39\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-Pines_&_Aronson-39) Pines collaborated with Maslach[\[40\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-40)[\[41\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-41) in writing essentially data-free papers[\[42\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-42) 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.*[\[43\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-43)
In 1981, Maslach and fellow American psychologist [Susan E. Jackson](https://en.wikipedia.org/wiki/Susan_E._Jackson "Susan E. Jackson") published an instrument for assessing occupational burnout, the [Maslach Burnout Inventory](https://en.wikipedia.org/wiki/Maslach_Burnout_Inventory "Maslach Burnout Inventory") (MBI).[\[2\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-Maslach2-2) It was the first such instrument of its kind, and soon became the most widely used measure of occupational burnout.[\[44\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-SVB2019-44) 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.[\[1\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-Maslach-1)[\[45\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-ReferenceD-45) In 1988, Pines and Aronson wrote the popular book *Career Burnout: Causes and Cures,*[\[39\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-Pines_&_Aronson-39) 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).[\[46\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-46) In 1998, Swedish psychiatrists [Marie Ă
sberg](https://en.wikipedia.org/wiki/Marie_%C3%85sberg "Marie Ă
sberg") and Ă
ke Nygren[\[47\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-47) 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.[\[48\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-48): 16
In 2003, the American psychiatrists Philip M. Liu and David A. Van Liew[\[49\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-Liu-49) 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 also noted 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](https://en.wikipedia.org/wiki/Swedish_Board_of_Health_and_Welfare "Swedish Board of Health and Welfare") created the national ICD condition of "[exhaustion disorder](https://en.wikipedia.org/wiki/Exhaustion_disorder "Exhaustion disorder")" (F43.8A) as a specific "Other reactions to severe stress" (F43.8).[\[50\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-Bes%C3%A8r_2014-50) Treatment programs followed. In December 2007, the Swiss Expert Network on Burnout (SEB) was established.[\[51\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-51) It has since held a number of symposia, and published recommendations for treating burnout.[\[52\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-52)
In 2015, French psychologist Renzo Bianchi and his colleagues published a [literature review](https://en.wikipedia.org/wiki/Literature_review "Literature review") on the burnoutâdepression overlap (based on 92 studies) and concluded that the studies fail to demonstrate the [nosological](https://en.wikipedia.org/wiki/Nosological "Nosological") distinctiveness of the burnout phenomenon.[\[53\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-pmid25638755-53) A number of papers followed that showed the overlap of burnout with depression, suggesting that burnout is a depressive condition.[\[54\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-54)[\[55\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-55)[\[56\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-s30945922-56)
[](https://en.wikipedia.org/wiki/File:Deaths_from_Karoshi.png)
Deaths due to long working hours per 100,000 people (15+), joint study conducted by [World Health Organization](https://en.wikipedia.org/wiki/World_Health_Organization "World Health Organization") and [International Labour Organization](https://en.wikipedia.org/wiki/International_Labour_Organization "International Labour Organization") in 2016.
Also in 2015, the WHO adopted a new conceptualization of "occupational burnout." The conceptualization was consistent with Maslach's.[\[57\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-57) However, occupational burnout was "not itself classified by the WHO as a medical or psychiatric condition or mental disorder."[\[58\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-WHO-2019-58) 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](https://en.wikipedia.org/wiki/Workers%27_compensation "Workers' compensation") payments to affected people.[\[7\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-Lastovkova_2018-7)
In 2020, the Occupational Depression Inventory was published[\[59\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-10.1016-59) and was considered to be a potential replacement for burnout scales such as the MBI.[\[60\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-10.1037-60)
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](https://en.wikipedia.org/wiki/Bodily_distress_disorder "Bodily distress disorder")" (6C20).[\[61\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-61)[\[62\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-62) The WHO also modified their definition of burnout that year.[\[63\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-63) This new edition additionally saw the WHO abolish nation-defined conditions, leading to Sweden's planned end to its specific recognition of exhaustion disorder in 2028.[\[64\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-64)[\[65\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-65)
The two main classification systems for psychiatric disorders are the APA's *[Diagnostic and Statistical Manual of Mental Disorders](https://en.wikipedia.org/wiki/Diagnostic_and_Statistical_Manual_of_Mental_Disorders "Diagnostic and Statistical Manual of Mental Disorders")* (*DSM*, used in North America and elsewhere) and the WHO's *[International Classification of Diseases](https://en.wikipedia.org/wiki/International_Classification_of_Diseases "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).[\[66\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-66) Its definitions for [Adjustment Disorders](https://en.wikipedia.org/wiki/Adjustment_disorder "Adjustment disorder"),[\[67\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-67)[\[68\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-68)[\[49\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-Liu-49) and [Unspecified Trauma- and Stressor-Related Disorder](https://en.wikipedia.org/wiki/Psychological_trauma "Psychological trauma")[\[69\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-69) have been said that in some cases reflect the condition. The 2022 update of the *DSM*, the *DSM-5-TR*, did not include burnout.[\[70\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-70)
The *ICD-10* (1994â2021) classification "burn-out" as a type of non-medical life-management difficulty under code Z73.0.[\[71\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-71) 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."[\[72\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-72) It was also considered one of the "problems related to life-management difficulty."[\[73\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-73) The condition is further defined as being a "state of vital exhaustion," which historically had been called [neurasthenia](https://en.wikipedia.org/wiki/Neurasthenia "Neurasthenia").[\[74\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-74) The *ICD-10* also contained a medical condition category of "F43.8 Other reactions to severe stress."[\[75\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-75)
In 2003, Liu and van Liew[\[49\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-Liu-49) 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](https://en.wikipedia.org/wiki/Adjustment_disorder "Adjustment disorder") with depressed mood.
By 2003, the [Royal Dutch Medical Association](https://en.wikipedia.org/wiki/Royal_Dutch_Medical_Association "Royal Dutch Medical Association") had defined *burnout* as a subtype of [adjustment disorder](https://en.wikipedia.org/wiki/Adjustment_disorder "Adjustment disorder")[\[76\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-sjweh.756-76) as part of the *ICD-10* system. In the Netherlands, *overspannenheid* (overstrain) is a condition that leads to *burnout*.[\[77\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-77) In that country, burnout is included in handbooks and medical staff are trained in its diagnosis and treatment.[\[78\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-Burnout:_35_years_of_research_and_p-78) 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](https://en.wikipedia.org/wiki/Major_depressive_disorder "Major depressive disorder") or [anxiety disorder](https://en.wikipedia.org/wiki/Anxiety_disorder "Anxiety disorder").[\[79\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-79)
A 2013 French study[\[80\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-Bianchi,_Boffy-80) 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.
Several European countries having legally recognized burnout in some way, such as by providing workers' compensation payments.[\[7\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-Lastovkova_2018-7) Legal recognition for financial purposes, however, is not the same as [medical recognition as a discrete disease](https://en.wikipedia.org/wiki/Nosology "Nosology"). 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](https://en.wikipedia.org/wiki/Somatic_symptom_disorder "Somatic symptom disorder")" (*DSM-5*) or "bodily distress disorder" (*ICD-11*).[\[81\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-81)
Rotentstein et al. (2018)[\[82\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-Rotenstein2018-82) in a review of 182 studies of physician burnout identified 142 different definitions of burnout, underlining the great heterogeneity in diagnostic criteria for the condition. When they limited themselves to studies that used the canonical Maslach Burnout Inventory, the study team found 47 distinct definitions of burnout. Marked differences among researchers' conceptualizations of what constitutes burnout have underlined the absence of a [consensus definition](https://en.wikipedia.org/wiki/Definition#In_medicine "Definition").[\[83\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-S&B,_2020-83)
A new version of the *ICD*, *ICD-11*, was released in June 2018, for first use in January 2022.[\[84\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-84) The new version has an entry coded and titled "QD85 Burn-out." The *ICD-11* describes the condition as follows:
> Burn-out is a syndrome conceptualized as resulting from chronic [workplace stress](https://en.wikipedia.org/wiki/Workplace_stress "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.[\[85\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-85)
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.[\[58\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-WHO-2019-58)[\[86\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-86) In a statement made in May 2019, the [WHO](https://en.wikipedia.org/wiki/World_Health_Organization "World Health Organization") 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."[\[87\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-87) The *ICD-11* also has the medical condition "6B4Y Other specified disorders specifically associated with stress,"[\[88\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-:5-88) 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.[\[8\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-van_Dam_2021-8)
The US government's [National Institutes of Health](https://en.wikipedia.org/wiki/National_Institutes_of_Health "National Institutes of Health") includes the condition as "psychological burnout" in its index of the [National Library of Medicine](https://en.wikipedia.org/wiki/National_Library_of_Medicine "National Library of Medicine"),[\[89\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-meshb.nlm.nih.gov-89) 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."[\[89\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-meshb.nlm.nih.gov-89) [SNOMED CT](https://en.wikipedia.org/wiki/SNOMED_CT "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](https://en.wikipedia.org/wiki/Anxiety_disorder "Anxiety disorder").[\[90\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-90) The [Diseases Database](https://en.wikipedia.org/wiki/Diseases_Database "Diseases Database") defines the condition as "professional burnout."[\[91\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-91)
## Instruments used to assess burnout symptoms
\[[edit](https://en.wikipedia.org/w/index.php?title=Occupational_burnout&action=edit§ion=3 "Edit section: Instruments used to assess burnout symptoms")\]
A number of instruments have been developed to assess work-related burnout. The National Academy of Medicine has created an inventory of burnout scales.[\[92\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-92) The core of all of the abovementioned conceptualizations, including that of [Freudenberger](https://en.wikipedia.org/wiki/Herbert_Freudenberger "Herbert Freudenberger"), is exhaustion.[\[93\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-Maslach01-93)[\[94\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-SVB-94)
### Maslach Burnout Inventory
\[[edit](https://en.wikipedia.org/w/index.php?title=Occupational_burnout&action=edit§ion=4 "Edit section: Maslach Burnout Inventory")\]
In 1981, Maslach and Jackson published the first widely used instrument for assessing burnout, the [Maslach Burnout Inventory](https://en.wikipedia.org/wiki/Maslach_Burnout_Inventory "Maslach Burnout Inventory") (MBI).[\[2\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-Maslach2-2) It remains by far the most commonly used instrument to assess the condition.[\[44\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-SVB2019-44) 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),[\[a\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-95) and reduced personal accomplishment.[\[1\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-Maslach-1)[\[2\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-Maslach2-2) The MBI originally focused on human service professionals (e.g., teachers, social workers).[\[2\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-Maslach2-2) 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.[\[1\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-Maslach-1)
The MBI is proprietary. Its cost may be a disincentive that discourages graduate students and young assistant professors from using it.[\[83\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-S&B,_2020-83) There are other conceptualizations of burnout that differ from the conceptualization suggested by Maslach and adopted by the WHO.[\[5\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-Bulletin,_2023-5)
### Oldenburg Burnout Inventory
\[[edit](https://en.wikipedia.org/w/index.php?title=Occupational_burnout&action=edit§ion=5 "Edit section: Oldenburg Burnout Inventory")\]
In 1999, Demerouti and Bakker,[\[95\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-96) with their Oldenburg Burnout Inventory (OLBI), conceptualized burnout in terms of exhaustion and disengagement, linking their conceptualization to the [job demandsâresources model](https://en.wikipedia.org/wiki/Job_demands-resources_model "Job demands-resources model").
### Copenhagen Burnout Inventory
\[[edit](https://en.wikipedia.org/w/index.php?title=Occupational_burnout&action=edit§ion=6 "Edit section: Copenhagen Burnout Inventory")\]
In 2005, Kristensen et al.[\[3\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-copenhagenburn-3) released the public domain Copenhagen Burnout Inventory (CBI). They argued that the definition of burnout should be limited to the fatigue/exhaustion continuum.[\[3\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-copenhagenburn-3)
### Shirom-Melamed Burnout Measure
\[[edit](https://en.wikipedia.org/w/index.php?title=Occupational_burnout&action=edit§ion=7 "Edit section: Shirom-Melamed Burnout Measure")\]
In 2006, Shirom and Melamed with their Shirom-Melamed Burnout Measure (SMBM) conceptualized burnout in terms of physical exhaustion, cognitive weariness, and emotional exhaustion.[\[96\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-97)[\[97\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-Burnout_and_risk_of_coronary_heart-98) The SMBM's emotional exhaustion subscale more clearly embodies Maslach's[\[93\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-Maslach01-93) concept of depersonalization than her concept of emotional exhaustion.[\[44\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-SVB2019-44) This measure has seen some use in Sweden.
### Karolinska Exhaustion Disorder Scale
\[[edit](https://en.wikipedia.org/w/index.php?title=Occupational_burnout&action=edit§ion=8 "Edit section: Karolinska Exhaustion Disorder Scale")\]
In 2014, BesĂšr et al. published the Karolinska Exhaustion Disorder Scale (KEDS),[\[50\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-Bes%C3%A8r_2014-50)[\[98\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-99) 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.
### Sydney Burnout Measure
\[[edit](https://en.wikipedia.org/w/index.php?title=Occupational_burnout&action=edit§ion=9 "Edit section: Sydney Burnout Measure")\]
In 2021, [Gordon Parker](https://en.wikipedia.org/wiki/Gordon_Parker_\(psychiatrist\) "Gordon Parker (psychiatrist)") 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."[\[99\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-100)
### Lesser known burnout scales
\[[edit](https://en.wikipedia.org/w/index.php?title=Occupational_burnout&action=edit§ion=10 "Edit section: Lesser known burnout scales")\]
There are other conceptualizations of burnout embodied in other instruments, including the Hamburg Burnout Inventory,[\[100\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-Wurm_2016-101) the Burnout Assessment Tool,[\[101\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-102) the Burnout Measure,[\[39\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-Pines_&_Aronson-39)[\[102\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-103) and the Meier Burnout Assessment.[\[103\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-104)
### Other instruments that measure burnout
\[[edit](https://en.wikipedia.org/w/index.php?title=Occupational_burnout&action=edit§ion=11 "Edit section: Other instruments that measure burnout")\]
In 1999, Wilmar Schaufeli and Arnold Bakker[\[104\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-UWES-105) published the Utrecht Work Engagement Scale (UWES), an instrument that uses a conceptualisation similar to that of the MBI. However the UWES measures vigour, dedication and absorption, positive counterparts (or polar opposites) of the high-burnout endpoints of the MBI's subscales.[\[104\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-UWES-105)
In 2010, researchers at the [Mayo Clinic](https://en.wikipedia.org/wiki/Mayo_Clinic "Mayo Clinic") used portions of the MBI, along with other comprehensive assessments, to develop the [Well-Being Index](https://en.wikipedia.org/wiki/Well-Being_Index "Well-Being Index"), a nine-item self-assessment tool designed to measure burnout and other dimensions of distress in healthcare workers specifically.[\[105\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-106) The measure has mainly been used in the United States.
The [Occupational Depression Inventory](https://en.wikipedia.org/wiki/Occupational_Depression_Inventory "Occupational Depression Inventory") (ODI)[\[59\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-10.1016-59)[\[9\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-S&B,_2025-9) was published in 2020. The measure covers the nine main symptoms of depression[\[106\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-107) that individuals ascribe to their jobs and quantifies the severity of those work-attributed symptoms.[\[59\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-10.1016-59) The ODI also generates provisional diagnoses of job-ascribed depression.[\[60\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-10.1037-60)[\[83\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-S&B,_2020-83) 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,[\[60\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-10.1037-60) suggesting that the ODI is a suitable replacement for burnout scales like the MBI.[\[83\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-S&B,_2020-83)[\[9\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-S&B,_2025-9)
## Different types of burnout
\[[edit](https://en.wikipedia.org/w/index.php?title=Occupational_burnout&action=edit§ion=12 "Edit section: Different types of burnout")\]
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.
### Caregiver burnout in the context of unpaid caregiving
\[[edit](https://en.wikipedia.org/w/index.php?title=Occupational_burnout&action=edit§ion=13 "Edit section: Caregiver burnout in the context of unpaid caregiving")\]
Burnout is thought to affect [caregivers](https://en.wikipedia.org/wiki/Caregivers "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.[\[88\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-:5-88)
Malach-Pines (who also published as Ayala Pines)[\[107\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-108) advanced the view that burnout can also occur in connection to the spousal role.[\[108\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-109)[\[109\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-110)
Burnout in teachers represents a type occupational burnout.[\[110\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-Farber-111)
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.[\[111\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-112)
[Autistic people](https://en.wikipedia.org/wiki/Autism_spectrum "Autism spectrum") are known to experience a state of mental, emotional, or physical exhaustion referred to as [autistic burnout](https://en.wikipedia.org/wiki/Autistic_burnout "Autistic burnout") because of the general stress involved in [masking of autistic traits and behavior](https://en.wikipedia.org/wiki/Autistic_masking "Autistic masking") and the strains associated with living in an [unaccommodating environment](https://en.wikipedia.org/wiki/Autism-friendly "Autism-friendly").[\[112\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-:0-113)[\[113\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-:1-114)[\[114\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-:4-115) Autistic burnout is considered to be distinct from occupational burnout in both [etiology](https://en.wikipedia.org/wiki/Etiology "Etiology") and [presentation](https://en.wikipedia.org/wiki/Presentation_\(medical\) "Presentation (medical)").[\[113\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-:1-114)[\[115\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-:2-116)
## Relationship with other conditions
\[[edit](https://en.wikipedia.org/w/index.php?title=Occupational_burnout&action=edit§ion=18 "Edit section: Relationship with other conditions")\]
Liu and van Liew[\[49\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-Liu-49) 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](https://en.wikipedia.org/wiki/Nosology "Nosology") similar to [depression](https://en.wikipedia.org/wiki/Major_depressive_disorder "Major depressive disorder").[\[116\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-117)[\[117\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-Ahola_2014-118)[\[118\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-Hintsa_2016-119)[\[119\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-Schonfeld_2016-120) 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.[\[80\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-Bianchi,_Boffy-80) 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.[\[120\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-Bianchi_2015-121) The view that burnout is a form of depression has found support.[\[94\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-SVB-94)[\[117\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-Ahola_2014-118)[\[120\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-Bianchi_2015-121)[\[118\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-Hintsa_2016-119) 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.[\[82\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-Rotenstein2018-82)[\[121\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-122) 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.[\[122\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-VBSL-123)[\[94\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-SVB-94) 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.[\[123\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-124)
Maslach[\[93\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-Maslach01-93) 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.[\[56\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-s30945922-56)[\[124\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-125)[\[44\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-SVB2019-44) Burnout is also now often seen as involving the full array of [depressive](https://en.wikipedia.org/wiki/Depression_\(mood\) "Depression (mood)") symptoms (e.g., low [mood](https://en.wikipedia.org/wiki/Mood_\(psychology\) "Mood (psychology)"), [cognitive](https://en.wikipedia.org/wiki/Cognitive_psychology "Cognitive psychology") alterations, [sleep disturbance](https://en.wikipedia.org/wiki/Sleep_disorder "Sleep disorder")).[\[125\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-126)[\[9\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-S&B,_2025-9)
Kakiashvili et al.[\[126\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-The_medical_perspective_on_burnout-127) 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 [hypothalamicâpituitaryâadrenal axis](https://en.wikipedia.org/wiki/Hypothalamic%E2%80%93pituitary%E2%80%93adrenal_axis "Hypothalamicâpituitaryâadrenal axis") dysfunction worse. Others have found Kakiashvili et al.'s argument specious.[\[127\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-Bianchi_2014-128)
| Test | [Major depressive disorder](https://en.wikipedia.org/wiki/Major_depressive_disorder "Major depressive disorder") (typically [melancholic depression](https://en.wikipedia.org/wiki/Melancholic_depression "Melancholic depression")) | [Atypical depression](https://en.wikipedia.org/wiki/Atypical_depression "Atypical depression") | [PTSD](https://en.wikipedia.org/wiki/PTSD "PTSD") | Burnout |
|---|---|---|---|---|
| [Cortisol awakening response](https://en.wikipedia.org/wiki/Cortisol_awakening_response "Cortisol awakening response") | â[\[126\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-The_medical_perspective_on_burnout-127) | â[\[128\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-129) | â[\[126\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-The_medical_perspective_on_burnout-127) | â[\[126\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-The_medical_perspective_on_burnout-127)[\[129\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-Moch_2003-130) |
| [Adrenocorticotropic hormone](https://en.wikipedia.org/wiki/Adrenocorticotropic_hormone "Adrenocorticotropic hormone") (ACTH) | â[\[126\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-The_medical_perspective_on_burnout-127) | \-[\[130\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-131) or â[\[129\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-Moch_2003-130) | \- or â[\[126\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-The_medical_perspective_on_burnout-127) | \- or â[\[126\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-The_medical_perspective_on_burnout-127) or â[\[129\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-Moch_2003-130) |
| [Dehydroepiandrosterone sulphate](https://en.wikipedia.org/wiki/Dehydroepiandrosterone_sulphate "Dehydroepiandrosterone sulphate") (DHEA-S) | â[\[126\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-The_medical_perspective_on_burnout-127) | | â or â[\[126\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-The_medical_perspective_on_burnout-127) | â[\[126\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-The_medical_perspective_on_burnout-127) |
| Low dose [dexamethasone suppression test](https://en.wikipedia.org/wiki/Dexamethasone_suppression_test "Dexamethasone suppression test") effect on cortisol | no suppression[\[126\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-The_medical_perspective_on_burnout-127) | | | hypersuppression[\[126\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-The_medical_perspective_on_burnout-127) |
[\[126\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-The_medical_perspective_on_burnout-127)[\[131\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-132)[\[132\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-133)[\[133\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-134)
Despite its name, depression with atypical features, which is seen in the above table, is not a rare form of depression.[\[134\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-135) The cortisol profile in atypical depression, in contrast to that of melancholic depression, is similar to the cortisol profile found in burnout.[\[127\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-Bianchi_2014-128) Commentators advanced the view that burnout differs from depression because the cortisol profile of burnout differs from that of melancholic depression; however, as the above table indicates, burnout's cortisol profile is similar to that of atypical depression.[\[127\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-Bianchi_2014-128)
Evidence suggests that the etiology of burnout is multifactorial, with personality factors playing an important, long-overlooked role.[\[135\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-Schaufeli_&_Enzmann-136)[\[136\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-137)[\[137\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-138) The researchers identified the prominent personality factor [neuroticism](https://en.wikipedia.org/wiki/Neuroticism "Neuroticism") in the development of burnout. Cognitive dispositional factors implicated in depression have also been found to be implicated in burnout.[\[138\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-139)
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.[\[139\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-Maslach972-140) 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.[\[140\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-141)
The [job demandsâresources model](https://en.wikipedia.org/wiki/Job_demands-resources_model "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.[\[141\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-142) Lack of job resources was associated with the disengagement component of the OLBI. Maslach and her colleagues (2001)[\[93\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-Maslach01-93) 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.[\[142\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-pmid33119345-143) 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.[\[135\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-Schaufeli_&_Enzmann-136)
In a systematic literature review in 2014, the [Swedish Agency for Health Technology Assessment and Assessment of Social Services](https://en.wikipedia.org/wiki/Swedish_Agency_for_Health_Technology_Assessment_and_Assessment_of_Social_Services "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.[\[143\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-144)
In line with the work of [Maslach](https://en.wikipedia.org/wiki/Christina_Maslach "Christina Maslach") and [Jackson](https://en.wikipedia.org/wiki/Susan_E._Jackson "Susan E. Jackson")[\[1\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-Maslach-1)[\[45\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-ReferenceD-45) 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.[\[144\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-145)
[](https://en.wikipedia.org/wiki/File:Smi3224-fig-0002-m.webp)
Symptoms sufferers, past sufferers and health professionals associate with exhaustion disorder.[\[145\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-Linds%C3%A4ter_2023-146)
LindsÀter et al. (2023)[\[145\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-Linds%C3%A4ter_2023-146) 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](https://en.wikipedia.org/wiki/Job_performance "Job performance"),[\[146\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-147) coronary [heart disease](https://en.wikipedia.org/wiki/Heart_disease "Heart disease"),[\[97\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-Burnout_and_risk_of_coronary_heart-98) and [mental health](https://en.wikipedia.org/wiki/Mental_health "Mental health") problems.[\[147\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-148) Emotional symptoms associated with occupational burnout include a lack of interest in work, reduced performance, feelings of helplessness, and trouble sleeping.[\[148\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-Cengage_Learning-149)
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.[\[149\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-pmid34537040-150)
Research on dentists[\[117\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-Ahola_2014-118) and physicians[\[100\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-Wurm_2016-101) 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.[\[150\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-lung-151) 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.[\[151\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-152)
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.[\[152\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-153) They can suffer concentration problems, forgetfulness, increased frustration, and/or feelings of being overwhelmed.[\[153\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-154) They may complain and feel negative, or feel apathetic and believe they have little impact on their coworkers and environment.[\[148\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-Cengage_Learning-149) Occupational burnout is also associated with absenteeism, other time missed from work, and thoughts of quitting.[\[154\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-ReferenceC-155)
As in depression, chronic burnout is also associated with cognitive impairments in [memory](https://en.wikipedia.org/wiki/Memory "Memory") and [attention](https://en.wikipedia.org/wiki/Attention "Attention").[\[155\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-156) Research suggests that burnout can manifest differently between genders, with higher levels of depersonalisation among men and increased emotional exhaustion among women.[\[156\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-157)[\[157\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-158) Other research suggests that people revealing a history of occupational burnout face future hiring discrimination.[\[158\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-159)
## Treatment and prevention
\[[edit](https://en.wikipedia.org/w/index.php?title=Occupational_burnout&action=edit§ion=22 "Edit section: Treatment and prevention")\]
There are thought to be three general types of workplace prevention-related interventions.[\[159\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-160) 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.
Maslach suggested that preventing burnout requires a combination of organizational change and worker education.[\[139\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-Maslach972-140) She and her co-authors argued that burnout can occur in connection to six areas of work life: workload, control, reward, community, fairness, and values.[\[93\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-Maslach01-93) For example, with regard to workload, an organization should ensure that a worker has adequate resources to meet job demands.[\[93\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-Maslach01-93) With regard to values, clearly stated ethical organizational values are important for employee well-being and commitment.[\[93\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-Maslach01-93) Supportive leadership and relationships with colleagues are also helpful.[\[93\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-Maslach01-93)
HĂ€tinen et al.[\[160\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-H%C3%A4tinen_2007-161) 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.[\[161\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-Van_Dierendonck_1998-162) The intervention was associated with decreases in exhaustion over time but not cynicism or inefficacy, suggesting that a broader approach is required.[\[93\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-Maslach01-93)
[Corporate Social Responsibility](https://en.wikipedia.org/wiki/Corporate_social_responsibility "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.[\[162\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-163) Establishing a sense of [psychological safety](https://en.wikipedia.org/wiki/Psychological_safety "Psychological safety") (the belief that it is safe to speak up) in an organisation helps prevent burnout.[\[163\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-:11-164)[\[164\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-165)[\[165\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-166)[\[166\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-167) Similarly, feeling heard may also help.[\[163\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-:11-164) Increasing workers' [control over their work tasks](https://en.wikipedia.org/wiki/Job_control_\(workplace\) "Job control (workplace)") is another intervention that can reduce exhaustion and [cynicism](https://en.wikipedia.org/wiki/Cynicism_\(contemporary\) "Cynicism (contemporary)").[\[160\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-H%C3%A4tinen_2007-161)
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.[\[167\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-Richardson-168)[\[168\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-Estevez-169) For example, Richardson and Rothstein's (2008)[\[167\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-Richardson-168) meta-analysis of primary workplace interventions included only two high-quality studies that addressed burnout. In their meta-analysis, Estevez Corres et al. (2021)[\[168\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-Estevez-169) 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.
In a qualitative study, Meluch (2023),[\[169\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-170) 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[\[170\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-:10-171) recommended that organizations provide timely accurate information on activities and policies in order to minimize emotional exhaustion.
### Secondary and tertiary prevention
\[[edit](https://en.wikipedia.org/w/index.php?title=Occupational_burnout&action=edit§ion=24 "Edit section: Secondary and tertiary prevention")\]
Van der Klink and van Dijk (2003)[\[76\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-sjweh.756-76) suggested [stress inoculation training](https://en.wikipedia.org/wiki/Stress_inoculation_training "Stress inoculation training"), [cognitive restructuring](https://en.wikipedia.org/wiki/Cognitive_restructuring "Cognitive restructuring"), and [graded activity](https://en.wikipedia.org/wiki/Systematic_desensitisation "Systematic desensitisation") to help workers with burnout symptoms, although insufficient high-quality research has been carried out on their efficacy. HĂ€tinen et al. (2007)[\[160\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-H%C3%A4tinen_2007-161) listed a number of common secondary and tertiary interventions, including [treatment of any outstanding medical conditions](https://en.wikipedia.org/wiki/Medicine "Medicine"), [stress management](https://en.wikipedia.org/wiki/Stress_management "Stress management"), [time management](https://en.wikipedia.org/wiki/Time_management "Time management"), [depression treatment](https://en.wikipedia.org/wiki/Management_of_depression "Management of depression"), [psychotherapies](https://en.wikipedia.org/wiki/Psychotherapies "Psychotherapies"), [ergonomic improvement](https://en.wikipedia.org/wiki/Ergonomics "Ergonomics") as well as [occupational therapy](https://en.wikipedia.org/wiki/Occupational_therapy "Occupational therapy"), [physical exercise](https://en.wikipedia.org/wiki/Physical_exercise "Physical exercise") and [relaxation](https://en.wikipedia.org/wiki/Relaxation_\(psychology\) "Relaxation (psychology)"). [Mindfulness](https://en.wikipedia.org/wiki/Mindfulness "Mindfulness") therapy has been used to help with occupational burnout in medical practitioners.[\[171\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-172) 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.[\[172\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-pat-173)[\[173\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-ReferenceA2-174)[\[174\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-175)
Farber (2000),[\[175\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-176) 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](https://en.wikipedia.org/wiki/Work%E2%80%93life_balance "Workâlife balance"). The ways in which people spend their non-work time can help to prevent burnout and improve health and well-being.[\[176\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-Woolston-177) Training employees in ways to manage stress in the workplace has been thought to reduce burnout.[\[177\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-178) One study[\[154\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-ReferenceC-155) suggests that social-cognitive processes such as [commitment](https://en.wikipedia.org/wiki/Organizational_commitment "Organizational commitment") to work, [self-efficacy](https://en.wikipedia.org/wiki/Self-efficacy "Self-efficacy"), learned resourcefulness, and [hope](https://en.wikipedia.org/wiki/Hope "Hope") may insulate individuals from experiencing occupational burnout.
Kakiashvili et al.[\[126\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-The_medical_perspective_on_burnout-127) 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](https://en.wikipedia.org/wiki/Cognitive_behavioral_therapy "Cognitive behavioral therapy") (CBT). Salomonsson et al. (2020)[\[178\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-179) 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)[\[179\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-180) had also earlier found that CBT was an effective treatment. [Parker](https://en.wikipedia.org/wiki/Gordon_Parker_\(psychiatrist\) "Gordon Parker (psychiatrist)") et al. (2021)[\[12\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-Parker_2021-12)[\[13\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-Parker_2021_2-13) found that the most useful treatment strategies appear to be talking to someone and seeking support, [walking or other exercise](https://en.wikipedia.org/wiki/Exercise "Exercise"), [mindfulness](https://en.wikipedia.org/wiki/Mindfulness "Mindfulness") and [meditation](https://en.wikipedia.org/wiki/Meditation "Meditation"), [improving sleep](https://en.wikipedia.org/wiki/Sleep "Sleep"), and leaving work completely or taking time off work.
The Swedish national health information service (known as "1177")[\[180\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-181) 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 recommend a three-stage treatment process, made up of a crisis phase, a problem and solution stage, and an application stage.[\[181\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-:6-182) The [Gothenburg](https://en.wikipedia.org/wiki/Gothenburg "Gothenburg") regional government's Institute for Stress Medicine[\[182\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-183) reports 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."[\[183\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-184)
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.[\[168\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-Estevez-169)[\[184\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-Tamminga-185) One study suggests that cognitive behavioral therapy (CBT), which was developed to treat [depression](https://en.wikipedia.org/wiki/Depression_\(mood\) "Depression (mood)"), can help some workers with symptoms of occupational burnout although high-quality research on the application of CBT to treating burnout has been sparse.[\[185\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-186) 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.[\[184\]](https://en.wikipedia.org/wiki/Occupational_burnout#cite_note-Tamminga-185)
- [Allostatic load](https://en.wikipedia.org/wiki/Allostatic_load "Allostatic load")
- [Annual leave](https://en.wikipedia.org/wiki/Annual_leave "Annual leave")
- [Autistic burnout](https://en.wikipedia.org/wiki/Autistic_burnout "Autistic burnout")
- [Boreout](https://en.wikipedia.org/wiki/Boreout "Boreout")
- [Clouding of consciousness](https://en.wikipedia.org/wiki/Clouding_of_consciousness "Clouding of consciousness")
- [Code Lavender](https://en.wikipedia.org/wiki/Code_Lavender "Code Lavender")
- [Critique of work](https://en.wikipedia.org/wiki/Critique_of_work "Critique of work")
- [Depression](https://en.wikipedia.org/wiki/Depression_\(mood\) "Depression (mood)")
- [Effects of overtime](https://en.wikipedia.org/wiki/Effects_of_overtime "Effects of overtime")
- [Four-day workweek](https://en.wikipedia.org/wiki/Four-day_workweek "Four-day workweek")
- [Job strain](https://en.wikipedia.org/wiki/Job_strain "Job strain")
- [Karoshi](https://en.wikipedia.org/wiki/Karoshi "Karoshi")
- [Labor rights](https://en.wikipedia.org/wiki/Labor_rights "Labor rights")
- [Lived experience](https://en.wikipedia.org/wiki/Lived_experience "Lived experience")
- [Occupational Depression Inventory](https://en.wikipedia.org/wiki/Occupational_Depression_Inventory "Occupational Depression Inventory")
- [Occupational stress](https://en.wikipedia.org/wiki/Occupational_stress "Occupational stress")
- [Overwork](https://en.wikipedia.org/wiki/Overwork "Overwork")
- [Paid time off](https://en.wikipedia.org/wiki/Paid_time_off "Paid time off")
- [Presenteeism](https://en.wikipedia.org/wiki/Presenteeism "Presenteeism")
- [Right to rest and leisure](https://en.wikipedia.org/wiki/Right_to_rest_and_leisure "Right to rest and leisure")
- [Six-hour day](https://en.wikipedia.org/wiki/Six-hour_day "Six-hour day")
- [Stress (biological)](https://en.wikipedia.org/wiki/Stress_\(biological\) "Stress (biological)")
- [Stress management](https://en.wikipedia.org/wiki/Stress_management "Stress management")
- [Suicide crisis](https://en.wikipedia.org/wiki/Suicide_crisis "Suicide crisis")
- [Tang ping](https://en.wikipedia.org/wiki/Tang_ping "Tang ping")
- [Teacher burnout](https://en.wikipedia.org/wiki/Teacher_burnout "Teacher burnout")
- [Quiet cracking](https://en.wikipedia.org/wiki/Quiet_cracking "Quiet cracking")
- [Workaholic](https://en.wikipedia.org/wiki/Workaholic "Workaholic")
- [Workload](https://en.wikipedia.org/wiki/Workload "Workload")
- [Writer's block](https://en.wikipedia.org/wiki/Writer%27s_block "Writer's block")
1. **[^](https://en.wikipedia.org/wiki/Occupational_burnout#cite_ref-95)** The term "depersonalization" as used by Maslach and Jackson should not be confused with the [same term](https://en.wikipedia.org/wiki/Depersonalization "Depersonalization") used in psychiatry and clinical psychology as a hallmark of dissociative disorder.
1. ^ [***a***](https://en.wikipedia.org/wiki/Occupational_burnout#cite_ref-Maslach_1-0) [***b***](https://en.wikipedia.org/wiki/Occupational_burnout#cite_ref-Maslach_1-1) [***c***](https://en.wikipedia.org/wiki/Occupational_burnout#cite_ref-Maslach_1-2) [***d***](https://en.wikipedia.org/wiki/Occupational_burnout#cite_ref-Maslach_1-3) [***e***](https://en.wikipedia.org/wiki/Occupational_burnout#cite_ref-Maslach_1-4)
Maslach C, Jackson SE, Leiter MP (1996). ["MBI: The Maslach Burnout Inventory: Manual"](https://www.researchgate.net/publication/277816643). Palo Alto: Consulting Psychologists Press.
2. ^ [***a***](https://en.wikipedia.org/wiki/Occupational_burnout#cite_ref-Maslach2_2-0) [***b***](https://en.wikipedia.org/wiki/Occupational_burnout#cite_ref-Maslach2_2-1) [***c***](https://en.wikipedia.org/wiki/Occupational_burnout#cite_ref-Maslach2_2-2) [***d***](https://en.wikipedia.org/wiki/Occupational_burnout#cite_ref-Maslach2_2-3) [***e***](https://en.wikipedia.org/wiki/Occupational_burnout#cite_ref-Maslach2_2-4)
Maslach C, Jackson SE (1981). ["The measurement of experienced burnout"](https://doi.org/10.1002%2Fjob.4030020205). *Journal of Occupational Behaviour*. **2** (2): 99â113\. [doi](https://en.wikipedia.org/wiki/Doi_\(identifier\) "Doi (identifier)"):[10\.1002/job.4030020205](https://doi.org/10.1002%2Fjob.4030020205). [S2CID](https://en.wikipedia.org/wiki/S2CID_\(identifier\) "S2CID (identifier)") [53003646](https://api.semanticscholar.org/CorpusID:53003646).
3. ^ [***a***](https://en.wikipedia.org/wiki/Occupational_burnout#cite_ref-copenhagenburn_3-0) [***b***](https://en.wikipedia.org/wiki/Occupational_burnout#cite_ref-copenhagenburn_3-1) [***c***](https://en.wikipedia.org/wiki/Occupational_burnout#cite_ref-copenhagenburn_3-2)
Kristensen TS, Borritz M, Villadsen E, Christensen KB (2005). "The Copenhagen Burnout Inventory: A new tool for the assessment of burnout". *Work & Stress*. **19** (3): 192â207\. [doi](https://en.wikipedia.org/wiki/Doi_\(identifier\) "Doi (identifier)"):[10\.1080/02678370500297720](https://doi.org/10.1080%2F02678370500297720). [S2CID](https://en.wikipedia.org/wiki/S2CID_\(identifier\) "S2CID (identifier)") [146576094](https://api.semanticscholar.org/CorpusID:146576094).
4. **[^](https://en.wikipedia.org/wiki/Occupational_burnout#cite_ref-4)**
["Burn-out an "occupational phenomenon": International Classification of Diseases"](https://www.who.int/news/item/28-05-2019-burn-out-an-occupational-phenomenon-international-classification-of-diseases). *www.who.int*. Retrieved 2023-11-09.
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