Is burnout separable from depression in cluster analysis? A longitudinal study

Abstract

Purpose

Whether burnout and depression represent distinct pathologies is unclear. The aim of this study was to examine whether burnout and depressive symptoms manifest themselves separately from each other or are so closely intertwined as to reflect the same phenomenon.

Methods

A two-wave longitudinal study involving 627 French schoolteachers (73 % female) was conducted. Burnout was assessed with the Maslach Burnout Inventory and depression with the 9-item depression module of the Patient Health Questionnaire.

Results

Burnout and depressive symptoms clustered both at baseline and follow-up. Cluster membership at time 1 (T1) predicted cases of burnout and depression at time 2 (T2), controlling for gender, age, length of employment, lifetime history of depression, and antidepressant intake. Changes in burnout and depressive symptoms from T1 to T2 were found to overlap. Teachers with increasing burnout experienced increases in depression and teachers with decreasing burnout experienced decreases in depression. In addition, emotional exhaustion, the core of burnout, was more strongly associated with depression than with depersonalization, the second dimension of burnout, underlining an inconsistency in the conceptualization of the burnout syndrome.

Conclusions

Our results are consistent with recent findings showing qualitative and quantitative symptom overlap of burnout with depression. The close interconnection of burnout and depression questions the relevance of a nosological distinction between the two entities. Emotional exhaustion and depersonalization, the two main dimensions of burnout, may be better conceptualized as depressive responses to adverse occupational environments than as components of a separate entity.

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Fig. 1

Notes

  1. 1.

    The recruitment procedure that was followed did not allow for an estimation of teachers’ response rate. Indeed, the number of teachers who actually received the survey from their school administrators is unknown.

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Acknowledgments

The authors would like to thank an anonymous reviewer for his/her comments on the psychosocial, rather than clinical or psychiatric, focus of burnout research.

Conflict of interest

On behalf of all authors, the corresponding author states that there is no conflict of interest.

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Correspondence to Renzo Bianchi.

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Bianchi, R., Schonfeld, I.S. & Laurent, E. Is burnout separable from depression in cluster analysis? A longitudinal study. Soc Psychiatry Psychiatr Epidemiol 50, 1005–1011 (2015). https://doi.org/10.1007/s00127-014-0996-8

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Keywords

  • Burnout
  • Cluster analysis
  • Depression
  • Longitudinal study
  • Nosological overlap