Burnout symptoms: Depressive manifestations under psychosocial labels?

Burnout, a syndrome involving emotional exhaustion (EE), depersonalization (DP), and a sense of reduced personal accomplishment (rPA), has elicited growing interest among the psychiatry community (Bianchi, Schonfeld, Vandel, & Laurent, 2017). Whether burnout is anything other than a depressive condition, however, has been strongly debated (Bianchi, Schonfeld, & Laurent, in press). In this paper, we argue that burnout symptoms constitute depressive manifestations under psychosocial labels. The EE refers to feelings of being emotionally drained and exhausted by one's work (Maslach, Jackson, & Leiter, 1996, p. 4). The EE thus overlaps in an explicit way with a diagnostic criterion of major depressive episode (MDE), namely, fatigue and loss of energy (Beck & Alford, 2009). The EE is also suggestive of depressed mood (e.g., feelings of sadness, emptiness, and hopelessness), a hallmark of MDE (ibidem). The DP involves “negative, cynical attitudes and feelings about one's clients” (Maslach et al., 1996, p. 4). The DP has been further characterized as an “unfeeling and impersonal response toward recipients of one's service, care, treatment, or instruction” (ibidem). This second dimension of burnout is evocative of the “loss of emotional attachments” (Beck & Alford, 2009, pp. 20‐21) and “avoidance, escapist, and withdrawal wishes” (Beck & Alford, 2009, pp. 29‐30) found in depression. The DP also overlaps with irritability and anger, two common features of MDE (Judd, Schettler, Coryell, Akiskal, & Fiedorowicz, 2013). The rPA, finally, defines a tendency to “evaluate oneself negatively” and to feel incompetent and dissatisfied with one's achievement on the job (Maslach et al., 1996, p. 4). The rPA clearly overlaps with the feelings of worthlessness and the low–self‐esteem that characterize depression (Beck & Alford, 2009). Overall, it can be concluded that burnout symptoms represent depressive symptoms under nonmedical labels. Our analysis supports