In the eleventh revision of The International Classification of Diseases (ICD-11), which will go into effect in 2022, a new definition for burnout has been added which labels it a “syndrome” resulting from “chronic workplace stress that has not been successfully managed.” However, new research, published in the Journal of Occupational Health Psychology, finds that tools for assessing burnout and depression seem to be measuring the same thing.
“Burnout, which has been conceived of both dimensionally and categorically, is thought to constitute a public health problem. The interest surrounding burnout, however, has coexisted with marked difficulties in characterizing the syndrome. One of the difficulties concern the overlap of burnout with depression,” the researchers, led by Irvan Schonfeld, at the City University of New York, write.
Recent attention has been brought to the growing problem of work-related stress in the United States. According to the World Health Organization, burnout is not considered a medical condition, but an “occupational phenomenon.”
To deal with this “syndrome of work stress,” research recommends healthy boundaries, seeking support, mindfulness, and psychoanalysis. However, researchers have begun to question the difference between burnout and depression, and have asked if such a distinction exists at all. Because research on depression and burnout were conceived and developed in separate fields, it’s not unlikely the concepts may be indistinguishable.
“Although burnout is thought to be work-related…depression is common in the workplace. Research on burnout has largely developed independently of the research conducted in psychiatry, behavioral psychology, and neurobiology on stress-induced conditions such as depression. Consequently, the question of the overlap of burnout symptoms with depressive symptoms has largely been neglected by the pioneers of burnout research,” Schonfeld and colleagues write.
“Depression is best conceived of as a dimensional variable, with clinical depression only representing a section—the high end—of the depressive continuum. When adopting a dimensional approach to depression, no theoretical space is left to the notion that burnout is a phase in the development of depression. When examining burnout and depression consistently by adopting a dimensional approach to both entities, the continuum of burnout appears to parallel the continuum of depression.”
The article examines three studies, including over 3,000 individuals in two countries, conducted in two languages to explore the correlation between burnout and depression. “We investigated the discriminant validity of burnout scales by evaluating the magnitude of the correlation between (latent) burnout and (latent) depression. In each study, we examined the burnout–depression association based on confirmatory factor analysis (CFA), controlling for item-level content overlap.”
After conducting multiple CFAs and deliberately removing items with the potential for content-level overlap, researchers observed high correlations between latent exhaustion (burnout) and latent depression as well as a high correlation between latent exhaustion (burnout) and anxiety. “In the three studies, latent exhaustion, the core of burnout, and latent depression were highly correlated (correlations ranging from .83 to .88). These results cast serious doubt on the discriminant validity of burnout scales.”
“The balance of evidence from the research presented here undermines the view that the discriminant validity of burnout scales is satisfactory. notably, because our results were obtained controlling for item-level content overlap.” The researchers write, “The replication of our findings in three different samples, combined with research that shows that the nomological networks (e.g., relationship to job adversity, stressful life events, social support, work-nonwork interference, attentional, interpretative, and memory biases in the processing of emotional information) for burnout and depression scales are highly parallel. reinforces that view.”
With a growing understanding that depression and burnout may be the same latent variable, researchers suggest moving away from research using the burnout construct. “Nosologically speaking, burnout is undefined; despite more than 40 years of sustained research, the syndrome cannot be diagnosed. This prevents burnout researchers from getting a clear view of workers’ health status. Conclusions from burnout assessments are typically vague and clinically foundationless.”
The authors conclude:
“Depression can be approached from both an individual and a social standpoint, and methods for assessing the weight of occupational factors in the development of depression are available. On these bases, we recommend that occupational health specialists focus on depression rather than burnout to more effectively identify and help suffering workers.”
Schonfeld, I. S., Verkuilen, J., & Bianchi, R. (2019). Inquiry into the correlation between burnout and depression. Journal of occupational health psychology. (Link)