Emotional burnout as an occupational risk factor in psychiatry: models of clinical manifestation

Professional stress is a key factor in the development of emotional burnout syndrome (EBS), which is particularly prevalent among psychiatrists. The nosological status of EBS is undefined. Studies shows that emotional burnout is conceptually linked to anxiety and depressive disorders.

Objective: analysis of clinical manifestations of EBS by psychiatrists.

Material and methods. The study involved 126 psychiatrists working in Moscow psychiatric hospitals. Respondents completed the Maslach Burnout Inventory (MBI) and the Hospital Anxiety and Depression Scale (HADS). Multiple logistic regression was used. Critically high values in the MBI and its subscales served as dependent variables. The predictors were HADS values, age, and gender of the respondents.

Results. The prevalence of EBS in the study sample was 26.2%, with 14.3% experiencing severe forms. Significant levels of depression and anxiety were demonstrated by 50.8% and 42.9% of respondents, respectively. Established EBS was described by an increase in anxiety [odds ratio (OR) 1.51; 95% confidence interval (CI) 1.30–1.82], the presence of a critical level of depression (OR 10.86; 95% CI 3.47–41.43); and male gender as a factor preventing EBS (OR 0.33; 95% CI 0.10–0.95). Severe EBS was described as a combination of critical levels of anxiety and depression (OR 11.02; 95% CI 3.63–36.76); with age, the chances of severe EBS decreased (OR 0.95; 95% CI 0.90–1.00). Emotional exhaustion as a symptom of EBS was most fully described by the level of anxiety, and ‘depersonalisation’ by the level of depression. Reduction in professional achievements was least predicted by anxiety and depressive symptoms.

Conclusion. Depending on the structure of emotional burnout in psychiatrists, it can manifest clinically as anxiety, depressive symptoms, or a combination of both. Identifying the various clinical manifestations of EBS will be useful for developing specific methods to combat emotional burnout.

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