Talk:Occupational burnout

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Recent edits
A recent literature review found 142 different definitions of burnout. The study is published in one of the best journals in the world, JAMA. It might be important to mention that, in practice, burnout is defined in a highly heterogeneous manner. Here is the reference of the paper: Rotenstein, L. S., Torre, M., Ramos, M. A., Rosales, R. C., Guille, C., Sen, S., & Mata, D. A. (2018). Prevalence of burnout among physicians: A systematic review. JAMA, 320(11), 1131-1150. doi:10.1001/jama.2018.12777

I support what you say that the sources doesn't meet Identifying reliable sources (medicine), but that doesn't have anything to do with what's been added. The content added are from psychological background. Since the merger the sources provided are acceptable as the Sources 2, 4 & 5 for example. What are your thoughts.59.89.238.130 (talk) 06:07, 22 April 2016 (UTC)


 * Those edits using refs 2, 3 and 4 are just discussing the history of burnout. MEDRS doesn't apply to history sections (and similar), only to medical statements. You were adding medical info. Ref 5 appears to be a textbook, which is also acceptable. Your refs seemed to be more like self-help books (I tried to have another look at your edits, but they have been censored). Also, I'm a little confused by that edit log censorship due to copyright violation. Did you copy text directly from your sources or something? I would recommend you find out more about how wikipedia works before making major edits like this. If you need help, let me know. I would recommend setting up a user account at the very least. That way it's much easier for you to keep track of responses to your edits. --sciencewatcher (talk) 14:38, 22 April 2016 (UTC)


 * Switch on/switch off mechanism, is similar to taking your time-off from work. The psychological term described in the book was "containment" which is defined in "Bion, W. R. Attention and interpretation (1970). Tavistock Publications, London." Finding humor or redefining the trigger humorously or distracting oneself positively(relationships, mindfulness...etc.) is also mentioned to be helpful. The other point that was described was benefits of physical exercise, this could be find in cross-wiki sources also.- That reference is from a self-help book, to avoid being too technical about hormones and all that stuff. The third point was taken from HBR's recent interview with Stephane Kasriel (https://www.linkedin.com/in/kasriel). I too don't have backup of the posted material. The censorship edit log wasn't by you, I thought it was some sort of editor rights. Where can I read about it. Thank you for your reply. I still think the content has the potential to be useful for many. Good day.117.215.193.176 (talk) 12:33, 23 April 2016 (UTC)


 * Self-help books aren't appropriate references for wikipedia for material like this. Also, even if it was appropriate, you can't directly copy from a book - that is why the edit log was censored, because you violated copyright. --sciencewatcher (talk) 18:27, 23 April 2016 (UTC)

RfC about burnout depression
Should the lead of the "occupational burnout" entry mention the problematic connection of burnout to depression? Iss246 (talk) 21:39, 3 November 2020 (UTC)

Older research suggests that they are separate entities. Newer research suggests that there is substantial overlap. One key to this controversy is the problem of comparing scores on BO scales like exhaustion to the presence/absence of a depression diagnosis. That kind of comparison is problematic because any relation between a continuous factor like BO's exhaustion to a binary entity like depression present/absent will have a smaller correlation than the relation between two continuous factors.

Recent research on psychopathology (cited in the latest version of the occupational BO article) indicates that depression is better conceptualized as a dimension (on a continuum) than as a taxon. The latest, most methodologically advanced research (also cited in the article), which treats BO and depression as continuous entities, reveals very high correlations, r >= 0.80. In the social sciences, correlations that high suggest that the two measures involved reflect the same underlying entity. In addition, methodologically advanced research that relies on structural equation modeling bifactor analysis, which takes a granular look at the items in BO and depression scales, suggests the BO's exhaustion items and depression items reflect the same entity. Iss246 (talk) 20:31, 2 November 2020 (UTC)

Survey

 * Yes, but much simplified & better sourced. Coming to this argument cold (notified at WT:MED), this RfC seems odd, with no source given. Reading the article lede - holy moly! It is almost parodically bad, with long lists of overcited claims source to non-WP:MEDRS primary sources being used to undercut what looks like a viable (if rather old) secondary source. The solution should be for article editors to find the one or two WP:BESTSOURCES which consider this question, and drop all the primary cruft. So far as I can see the upshot is that the two have been thought different but the classification is a topic of debate. Stating it in a high-level simple way like this would be a service to our readers. Alexbrn (talk) 07:25, 17 November 2020 (UTC)

User:Alexbrn, you have a point. Probably, the best sources are publications that aggregate many samples, review the literature, or provide an overview of the landscape. I will work on the last paragraph of the lead to winnow it down. Iss246 (talk) 14:50, 17 November 2020 (UTC)


 * This seems a good approach. I do not believe we should even be mentioning this in the lead and if we do it should be simplified greatly. it is still far too convoluted. We should not be relying on primary sources from the same researchers that believe, against scientific consensus, that burnout is the same as depression. The vast majority of reliable sources tell us that depression and burnout are different.Coastalalerts (talk) 22:39, 17 November 2020 (UTC)


 * Comment (Shooting from the hip here, I should read some more literature, bit this is a topic I am interested in.). I feel that the "continuous versus discrete" and "diagnosis versus symptom" discussion feels like two concepts are being glued together when they shouldn't be. The question of whether depression is *caused* by burnout - but requires other symptoms, or the same thing (so requires the same treatment) seems unrelated to discontinuity (e.g. "both stamping on someone's foot, and punching them in the face cause people to cry out in pain, but foot stamping and face punching are distinct entities). The sort of analysis I would want would look at the correlation between a bunch of different factors (and interventions) to try and tease this apart - who knows if it exists. My guess (without evidence) is that burnout has more in common with complex ptsd and or moral injury than depression. The controversy here is that if burnout = depression then i. it might be best treated with anti-depressants, ii. the situation becomes less "environmentally caused", iii. it might be a "chemical imbalance". Talpedia (talk) 23:55, 20 November 2020 (UTC)


 * User:Talpedia, you have a point. We have to be concerned that the research is conducted properly. Recent research on psychopathology suggests that depression is better represented as a continuous factor, like temperature, than as a binary, i.e., you have it or you don't. This is not a trivial distinction. Once we measure depression as a continuous factor (dimensionally), we can correlate depressive symptom scales BO scales that are also measured as continuous factors. This idea has implications for research on depression and BO.
 * The correlation of a binary (you have depression or you don't) with a continuous factor like the emotional exhaustion (EE) dimension of the MBI has a ceiling. In other words, there is a limit to how high the correlation can go because of the lack of variance in a binary. But with depression treated dimensionally, the only limits to how high the correlation with EE can go is measurement error (all psychological scales have some degree of measurement error) and some nuisance factors, such as social desirability bias. When depression is measured dimensionally, its correlation with EE tends to be higher than EE's correlation with depersonalization and personal accomplishment, the other two components of the MBI. Iss246 (talk) 05:19, 30 November 2020 (UTC)


 * Yes, in principle. I think that it's important and helpful to place burnout in the context of similar or related conditions.  Much like we might say that cancer of the throat includes X and Y but not nearby Z, it's helpful and encyclopedic to tell readers how burnout compares and contrasts with depression.  WhatamIdoing (talk) 16:42, 30 November 2020 (UTC)

Discussion
User:VQuakr, the edits I have made reflect a controversy in research on occupational burnout. Older research tends to show that BO and depression are separate entities. Newer research with better methodology tends to show a great deal of overlap of occupational BO, particularly the exhaustion component of BO, with depression. The exhaustion component is the central component of BO. The exhaustion component of BO correlates more highly with depressive symptoms than with either depersonalization and reduced personal accomplishment, the two other but lesser important components of BO. The sources in the article as it is edited now. Iss246 (talk) 21:39, 2 November 2020 (UTC)


 * I don't see why it would be controversial to mention the problematic connection of burnout to depression, but I would suggest highlighting the difference between older research and current research in the body of the article as well.  Excutient Talk 05:25, 4 November 2020 (UTC)
 * Yes. Good thought. I will get to it in a day or two unless someone else does it. Iss246 (talk) 21:18, 4 November 2020 (UTC)
 * The WHO clearly say in 2019 that burnout is not a medical condition or mental disorder. Any talk of burnout being the same as depression is very much experimental and should be reported only when and if it ever starts to be reported that way in sources. We need to report what the sources say. https://www.who.int/mental_health/evidence/burn-out/en/Coastalalerts (talk) 22:38, 4 November 2020 (UTC)
 * User:Coastalalerts, what you wrote confuses a couple of things. First, some researchers have treated BO as a discrete entity, as if it were a disorder. In some countries it is treated as a diagnosis (e.g., Sweden). Second, other researchers have treated BO dimensionally. Depression is a diagnosis. However, research I described above and in the text of the article suggests that it is better treated dimensionally. When BO is treated dimensionally and depression is treated dimensionally, high levels of overlap have been found. Iss246 (talk) 20:46, 5 November 2020 (UTC)
 * The majority of reliable sources like the WHO clearly say in 2019 that burnout is not a medical condition or mental disorder. https://www.who.int/mental_health/evidence/burn-out/en/ How can we include that fact based on what the sources say in the opening paragraphs? Most sources still say burnout is not a mental disorder, is not the same as depression and is not a medical condition. You are talking about a very small minority of the sources saying it is a form of depression. That can be mentioned but should not get precedence in the article because it is a small minority of the sources. That is not what the majority of sources (some very recent) say on burnout. Only what the sources say please.Coastalalerts (talk) 02:10, 6 November 2020 (UTC)
 * Rotenstein et al.'s (Rotenstein, L.S., Torre, M., Ramos, M.A., Rosales, R.C., Guille, C., Sen, S., & Mata, D.A. (2018). Prevalence of burnout among physicians: A systematic review. JAMA, 320, 1131–1150. doi:10.1001/jama.2018.12777) thorough review of the literature contradicts what you assert. Iss246 (talk) 03:16, 6 November 2020 (UTC)
 * The study you refer to Iss246 does not in any way negate the points I am making. https://pubmed.ncbi.nlm.nih.gov/30326495/ Quote from the results section says "Because of inconsistencies in definitions of and assessment methods for burnout across studies, associations between burnout and sex, age, geography, time, specialty, and depressive symptoms could not be reliably determined" If the WHO states burnout and depression are not the same and burnout is a stress-related syndrome not a mental disorder or medical condition. Can I change the wording to reflect what the majority of sources say?Coastalalerts (talk) 22:15, 6 November 2020 (UTC)

user:Coastalalerts, you miss an important point made by Rotenstein et al. There is no clear definition of BO. That is why the prevalence research is all over the place. In addition, most of the research the team cites pertains to BO as a present/absent binary, otherwise one cannot assess BO's prevalence. You earlier rejected that idea.

The study of physicians conducted by Wurm et al. (Wurm, W., Vogel, K., Holl, A., Ebner, C., Bayer, D., Morkl, S., Szilagyi, I. S., Hotter, E., Kapfhammer, H. P., & Hofmann, P. (2016). Depression-burnout overlap in physicians. PLoS ONE, 11(3), e0149913. https://doi.org/10.1371/journal.pone.0149913) indicates considerable depression-BO overlap. Their BO subscales correlated more highly with depressive symptoms than with each other. That is a finding that has been replicated but, more importantly, (emotional) exhaustion, the core of BO, tends to correlate more highly with depressive symptoms than with the other dimensions of BO (e.g., personal accomplishment). Wurm et al. also found that physicians with very high BO scores (severe BO) were 45-46 times more likely than physicians with low scores to meet criteria for depression.

Please don't make any changes. Let's hear from other WP editors.Iss246 (talk) 00:42, 7 November 2020 (UTC)


 * What, so you keep making change after change but other editors cannot? Is that it editor Iss246? The WHO amongst literally hundreds of other sources say burnout is not a medical condition and is instead a stress-related syndrome, yet you continue to cite few single studies and insist that the article says burnout is just depression! That's not what the sources say. As I said earlier and clearly; this newer research of yours is controversial and is against the vast majority of reliable sources saying it is not just depression. Maybe you could undo some of your edits you've been adding while telling other editors they cannot make edits while we discuss things.Coastalalerts (talk) 05:19, 7 November 2020 (UTC)
 * There are thousands of articles about BO. But there are many fewer articles in which BO and depressive symptoms are measured in the same sample. Among the latter articles, there are fewer articles that make it possible to examine the correlation coefficients among the BO subscales and the subscales' correlations with depressive symptom scales. The trend in the research is that (emotional) exhaustion, BO's core, is more closely related to depressive symptoms than to personal accomplishment or depersonalization. So let's hear from other WP editors. Iss246 (talk) 16:32, 7 November 2020 (UTC)
 * Can I ask Iss246 if you are part of the research team (Bianchi, Renzo; Schonfeld, Irvin Sam; Verkuilen, Jay (April 2020). "A five‐sample confirmatory factor analytic study of burnout‐depression overlap". Journal of Clinical Psychology. 76 (4): 801–821) trying to make occupational burnout seem like the same thing as a diagnosis of depression? You seem very familiar with it that's all. That is have you got any conflict of interest with this section you are trying to add to the occupational burnout article. I'm not sure how else to ask that question but it is important to disclose any conflict of interest with articles or article sections I think.Coastalalerts (talk) 09:56, 14 November 2020 (UTC)
 * Wrong 'burb  שלמה  Iss246 (talk) 16:41, 15 November 2020 (UTC
 * Does that mean Iss246 you are or are not one of these researchers - Bianchi, Renzo; Schonfeld, Irvin Sam; Verkuilen, Jay (April 2020). "A five‐sample confirmatory factor analytic study of burnout‐depression overlap" trying to make occupational burnout seem like the same thing as a diagnosis of depression? If there is a conflict of interest editing this article please clarify?Coastalalerts (talk) 23:47, 16 November 2020 (UTC)

Coastalalerts, quit the BS. Srijan Sen, MD, PhD, the Frances and Kenneth Eisenberg Professor of Depression and Neurosciences, University of Michigan, said what we know (https://www.healio.com/news/psychiatry/20190528/who-adds-burnout-to-icd11)

"Another problem is that burnout is classified and conceptualized as a purely workplace-related disorder — that it can be attributed completely to the workplace. But the research to doesn’t seem to indicate that this assertion is true. Instead, burnout looks similar to depression and other psychiatric disorders in that it’s multifactorial and complex. You’re more likely to have symptoms of emotional exhaustion and depersonalization if you’re stressed out at home and having difficulties with your marriage or with kids, or having to care for an older parent or you have a 3-hour commute. Many of the factors that contribute to depression also contribute to burnout."


 * Are you for real Iss246 talking to me like that saying "quit the bullshit. I don't believe I am using any bullshit with you thank you very much! I suggest you listen to what I am saying and what Alexbrn said in their comments about that part of the article and be collegial with me. Also can I assume now you've ignored the question that you are part of the research team Bianchi, Renzo; Schonfeld, Irvin Sam; Verkuilen, Jay (April 2020) A five‐sample confirmatory factor analytic study of burnout‐depression overlap? These are the guys trying to make occupational burnout seem like the same thing as a diagnosis of depression. You seem extremely familiar with their research to try and make it seem like OB and depression are one and the same. I think it is a fair question to ask relating to any conflicts of interest?Coastalalerts (talk) 00:33, 18 November 2020 (UTC)
 * Guys, we don't have a ban in profanity, but I'd like you to consider whether this sort of antagonism is helpful.
 * Coastalalerts, I'd be interested in hearing how something can be a Syndrome but not a Medical condition. At least within the general medical field, all syndromes are medical conditions. WhatamIdoing (talk) 16:52, 30 November 2020 (UTC)
 * WhatamIdoing have you read this from the WHO? https://www.who.int/news/item/28-05-2019-burn-out-an-occupational-phenomenon-international-classification-of-diseases. The majority of reliable sources state burnout is not a medical diagnosis, medical condition or medical disorder. The sources say this. The sources. I'd be interested in what you think after reading the sources. Go google it and then let me know what you think.Coastalalerts (talk) 23:51, 30 November 2020 (UTC)
 * I think that if we say it's a syndrome, and link to Syndrome, and also say it's not any sort of medical condition, that the readers are going to be confused and that editors are going to slap Contradict-inline on the sentence. If, on the other hand, we described it as a "non-medical stress-related situation", I don't think anyone would consider that to be self-contradictory.  (I was going to suggest "stress-related collection of symptoms", but talking about symptoms puts us back into medical territory again.)  WhatamIdoing (talk) 06:25, 1 December 2020 (UTC)
 * User:WhatamIdoing and user:Coastalalerts, you are right. BO is not characterized in the nomenclature as either a medical or a psychiatric disorder. Exhaustion, however, is the commonality in all definitions of BO. Maslach has the exhaustion at the center of BO. Shirom and Melamed (Shirom, A., & Melamed, S. [2006]. A comparison of the construct validity of two burnout measures in two groups of professionals. International Journal of Stress Management, 13, 176–200. http://dx.doi.org/10.1037/1072-5245.13.2.176) have exhaustion as the center of BO. So does Kristensen and colleagues (Kristensen, T. S., Borritz, M., Villadsen, E., & Christensen, K. B. [2005].The Copenhagen Burnout Inventory: A new tool for the assessment of burnout. Work and Stress, 19, 192–207. http://dx.doi.org/10.1080/02678370500297720). So do Demerouti et al. (Demerouti, E., Bakker, A. B., Vardakou, I., & Kantas, A. [2003]. The convergent validity of two burnout instruments: A multitraitmultimethod analysis. European Journal of Psychological Assessment, 19, 12–23. http://dx.doi.org/10.1027//1015-5759.19.1.12).
 * If you read the DSM-5 (page 162), you will see that often the presenting complaint for depressed people seeking help from clinicians is fatigue or exhaustion. Competent clinicians are aware of that. What BO scales measure is that exhaustion. That is why these BO scales have such high correlations with depressive symptom scales. If you look at the two of the nine cardinal symptoms of depression in the DSM, you will see that two of them reflect exhaustion. One of those symptoms is sleep difficulties (either too much or too little). The other is general fatigue.
 * As much as I admire user:coastalalerts his stick-to-itiveness, he is wrong on two accounts. First, he is wrong in claiming that there is abundant evidence indicating that BO is separate from depression. Second, he is wrong in asserting that Freudenberger coined the term "burnout." He provides no sources for the claim. Note that I produced two publications which employed the term before Freudenberger published his 1974 paper. This does not reflect badly on Freudenberger, who was a fine human being. But he wasn't the coiner of the term. Also Schaufeli (Schaufeli, W.B. [2017]. Burnout: A short socio-cultural history. Cham, Switzerland: Palgrave.), who has also collaborated with Maslach, wrote that the sources I cited antedated Freudenberger's use of the term.Iss246 (talk) 02:02, 1 December 2020 (UTC)
 * The ICD-11 does not say "a large body of research," as user:coastalalerts claims. The ICD says nothing about the research. Below is what the ICD-11 says about BO. Moreover, it is wrong on one account. The ICD indicates that BO is work-related. However, some prominent BO researchers, for example Kristensen (Kristensen, T. S., Borritz, M., Villadsen, E., & Christensen, K. B. [2005].The Copenhagen Burnout Inventory: A new tool for the assessment of burnout. Work and Stress, 19, 192–207. http://dx.doi.org/10.1080/02678370500297720), advance the view that BO applies to life domains outside of work. So does Pines (Pines, A., Aronson, E., & Kafry, D. [1981]. Burnout: From tedium to personal growth. New York: The Free Press.).

Here is what the ICD writes about BO. QD85 Burnout

Parent Problems associated with employment or unemployment

Description Burnout is a syndrome conceptualized as resulting from chronic workplace stress that has not been successfully managed. It is characterised 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) a sense of ineffectiveness and lack of accomplishment. Burn-out refers specifically to phenomena in the occupational context and should not be applied to describe experiences in other areas of life.

Exclusions Adjustment disorder (6B43) Disorders specifically associated with stress (6B40-6B4Z) Anxiety or fear-related disorders (6B00-6B0Z) Mood disorders (6A60-6A8Z) Iss246 (talk) 02:39, 1 December 2020 (UTC)

user:Coastalalerts, you used an authorless source to suggest that Freudenberger coined the term "burnout." And the source is wrong. You can't use a source that is wrong. See the book by Schaufeli. I provided two publications with dates that antedated Freudenberger's paper and cited Schaufeli. Not every source is right. Iss246 (talk) 03:34, 1 December 2020 (UTC)


 * I am in the process of finding sources for the Freudenberger coined the term "burnout." Thanks.
 * Here is the latest large scale meta-analyses looking at burnout and depression tell us. What is being peddled here by this editor is contrary to what the sources say. https://www.frontiersin.org/articles/10.3389/fpsyg.2019.00284/full.
 * The wording in the article needs to reflect what the sources say about depression and burnout overlap. They do not say at this point in time at least that burnout is a form of depression! Absolutely they do not. I am concerned this article mainly re-written by this one editor who has completely biased the article by including this one study from 2020 that I asked them about their involvement in and in no way reflects Wikipedia protocol nor what the sources say. That needs to be corrected in my opinion. Can other independent editors check it out please. Thanks.Coastalalerts (talk) 03:43, 1 December 2020 (UTC)
 * This is what the conclusions were from the 2019 systematic review and meta-analyses on the topic of burnout/depression overlap source I have just added to the statement in the article that this other editor keeps removing for no reason. https://www.frontiersin.org/articles/10.3389/fpsyg.2019.00284/full.
 * "Conclusions: Our research aims to clarify the relationship between burnout–depression and burnout–anxiety relationships. Our findings revealed no conclusive overlap between burnout and depression and burnout and anxiety, indicating that they are different and robust constructs. Future studies should focus on utilizing more longitudinal designs in order to assess the causal relationships between these variables"Coastalalerts (talk) 03:53, 1 December 2020 (UTC)
 * And if you look closely at the paper published in Frontiers, you will see that BO correlates with depression "r = 0.749" (standard error = 0.136). This is on page 9. And the authors did not control for measurement error, which is often done in meta-analyses. Controlling for measurement error in BO and depression would cause the correlation to exceed .80. The authors didn't do that. Such a high correlation would indicate that BO and depression scales are measuring the same construct. Iss246 (talk) 04:03, 1 December 2020 (UTC)
 * As to whether the Frontiers paper is any good, I'd leave that to someone like Headbomb, who is interested in which journals are likely to publish decent papers. Frontiers journals are hit-or-miss – some fine, some poor, and perhaps it'd be better to have another set of eyes on that.
 * On the subject of who coined the term, it's not exactly unusual for those attributions to be wrong. A source that announces "first used in 1974" when anybody can see that it was in use no later than 1969 (because it's in H. Bradley, "Community-Based Treatment for Young Adult Offenders", Crime & Delinquency 15 (1969), 359–70) should be omitted with Editorial discretion.  We cannot add material that can't be found in a reliable source, but we also should not repeat their mistakes when we happen to know that they're wrong. WhatamIdoing (talk) 04:14, 1 December 2020 (UTC)
 * Will grab you a few reliable sources shortly wich say he "coined" it.Coastalalerts (talk) 04:18, 1 December 2020 (UTC)
 * In this case, we kind of need sources that aren't demonstrably wrong. This would not be the first time that the man who got credit for coming up with an idea in the 20th century was proven to not be the originator when Google Books made it easy to search millions of sources. WhatamIdoing (talk) 06:13, 1 December 2020 (UTC)
 * I see your point WhatamIdoing.Coastalalerts (talk) 22:39, 1 December 2020 (UTC)
 * I added this edit "A large scale 2019 meta-analyses and systematic review of the literature concluded in their findings that there was "no conclusive overlap between burnout and depression and burnout and anxiety, indicating that they are different and robust constructs". It seems an unremarkable quote from an excellent source, yet Iss246 cancelled it out for no reason and continues to disallow other editors to add anything. I would like to discuss our differences here as I think we should be using high quality reliable sources such as 2019 large scale meta-analyses and systematic review on the topic of overlap between the two constructs. I would be quite interested in WhatamIdoings' thoughts on this or any others including Iss246.Coastalalerts (talk) 05:56, 3 December 2020 (UTC)


 * User:Coastalalerts, I appreciate your turning to a meta-analysis. But the meta-analysis in Frontiers that you turned to is flawed for three reasons. One is that the BO-depression correlation, which the authors for unknown reasons skip over, was .75, very high by social science standards. Second, the correlation did not control for measurement error (for example, getting disattenuated correlation coefficient or using a confirmatory factor analysis to get an estimate without measurement error). If measurement error were controlled, the correlation would be above .80. Third, the authors did not formally compare the correlations of BO subscales with each other and with depression scales. This would shed light on the question of whether BO is a syndrome.
 * The meta-analysis that user:OHpres included in his/her edit was superior to the Frontiers meta-analysis for a couple of reasons. One is that the meta-analysis user:OHpres cited used more up-to-date statistical procedures including confirmatory factor analyses and exploratory structural equation modeling bifactor analyses. The latter is particularly important because it sheds light at a granular level what the items measure. The granular-level analyses indicate that the exhaustion items align very firmly with the depression items. Exhaustion is what is common to all BO scales. Iss246 (talk) 00:04, 4 December 2020 (UTC)
 * You have not provided any other meta-analysis or systematic review Iss246. I have provided the only recent large scale systematic review and meta-analysis on the topic of burnout and depression overlap. You have only produced a single primary source. Have you got a more recent meta-analysis or systematic review? It is important primary sources are not relied on over meta-analyses and systematic reviews.Coastalalerts (talk) 01:06, 4 December 2020 (UTC)
 * User:Coastalalerts, I appreciate your reliance on a meta-analysis. The m-a OHpres used is methodologically superior to the m-a published in Frontiers. OHpres's m-a citation is Bianchi, R., Verkuilen, J., Schonfeld, I. S., Hakanen, J. J., Jansson-Fröjmark, M., Manzano-García, G., Laurent, E., & Meier, L. L. (in press). Is burnout a depressive condition? A 14-sample meta-analytic and bifactor analytic study. Clinical Psychological Science. I will edit the sentence OHpres added to underline the m-a aspect of it. Iss246 (talk) 01:13, 4 December 2020 (UTC)
 * Can I again respectfully ask if you are part of this research team trying to make burnout the same as depression. Are you involved in any of these 2020 studies you and the other editor are citing? You are incredibly familiar with their research and are voraciously trying to have their research trump large scale meta-analyses and systematic reviews on the topic. You also did not answer this question from before?Coastalalerts (talk) 02:22, 4 December 2020 (UTC)
 * Does it matter?
 * The usual approach, when different sources contradict each other, is to say that "Source #1 says X and Source #2 says not-X", and to hope that eventually the field will sort things out and we can some day replace it with "Everyone agrees that Y". WhatamIdoing (talk) 05:16, 4 December 2020 (UTC)
 * I think it does matter if a researcher is trying to push their own study and primary source into articles at the expense of all the other sources. It is called conflict of interest in research and should always be declared. It would be better if they admitted there was a conflict of interest and follow the rules set by Wikipedia on the issue when it arises. What do you think WhatamIdoing. Does that make sense?Coastalalerts (talk) 10:35, 4 December 2020 (UTC)
 * The WP:CITESELF rules do not actually require editors to declare their identity before citing their own publications. I do not agree that citing this one, assuming there is any connection between this editor at this paper, is "at the expense of all the other sources". WhatamIdoing (talk) 06:23, 14 December 2020 (UTC)
 * User:WhatamIdoing and User:Coastalalerts, I edited the par. in question, adhering to the guideline User:WhatamIdoing put forward: "Source #1 says X and Source #2 says not-X." Then I had to do some editing to remove a redundant sentence. Iss246 (talk) 22:33, 4 December 2020 (UTC)
 * I think it would be a great idea if we could all work on the wording of the paragraph here on the talk page together as a team rather than single editors writing their own article and stopping other editors to have any input. I agree with the approach suggested by whatamIdoing, while giving due weight to what the majority of sources say.Coastalalerts (talk) 22:47, 4 December 2020 (UTC)
 * I know a bit about this topic. Depression and burnout have been shown to be different albeit familial symptomology in most studies. Patriciamoorehead (talk) 23:32, 4 December 2020 (UTC)
 * User:Patriciamoorehead, there is more to the story. I balanced the two sets of meta-analyses in the par. in question as per the advice about balancing by User:WhatamIdoing. Iss246 (talk) 23:53, 4 December 2020 (UTC)
 * What other meta-analysis and systematic review are you introducing Iss246 that can be compared and contrasted to the large scale 2019 meta-analysis and systematic review on the topic? You have only produced a couple of primary sources to date and tried to make it seem they are meta-analyses which they are definitely aren't. Single primary sources should not hold the same weight in the article as the majority of sources. I am concerned you are using several sentences in the article to explaining a primary source's results while downplaying what most sources say on the topic of overalap.Coastalalerts (talk) 00:08, 5 December 2020 (UTC)
 * I am maintaining the m-a that OHpres introduced. It comes to a different conclusion than the one by Koutsimani et al. Although you don't do justice to the Koutsimani et al. m-a because you omitted the 0.75 correlation between BO and depression. I rephrased the par. in view of user:WhatamIdoing's recommendation. Iss246 (talk) 00:12, 5 December 2020 (UTC)
 * There has been no other meta-analysis or systematic review introduced by you Iss246 or anybody else. Only a primary source single study.Coastalalerts (talk) 00:31, 5 December 2020 (UTC)
 * This m-a, Bianchi, R., Verkuilen, J., Schonfeld, I. S., Hakanen, J. J., Jansson-Fröjmark, M., Manzano-García, G., Laurent, E., & Meier, L. L. (in press). Is burnout a depressive condition? A 14-sample meta-analytic and bifactor analytic study. Clinical Psychological Science. Iss246 (talk) 00:49, 5 December 2020 (UTC)
 * Maybe we can include it when it is actually published Iss246. You are obviously one of these researchers if you know it is "in-press" are you not? If you have a conflict of interest editing this article on burnout can you please clarify that is your own research?Coastalalerts (talk) 00:55, 5 December 2020 (UTC)

I’m thinking about diving more deeply into subtypes of burnout, specifically in relation to sports. Thoughts? — Preceding unsigned comment added by Mmorrow2 (talk • contribs) 15:03, 2 April 2024 (UTC)

Something for subtypes
In 2007 Mattie Tops et al found that the members of a burnt-out sample had either abnormally high or low blood prolactin levels. This and further experimentation led them to propose that there may be two etiologically different forms of burnout - one lowering dopamine, the other lowering serotonin. They found those with theorised low dopamine responded well to cortisol replacement.


 * Thanks for this suggestion, User:Transient-understanding. Unfortunately, that'll be primary literature, and because of (years and years of) problems with people cherry-picking primary sources that show the "right" viewpoint, Wikipedia is not keen to cite primary literature.  If this has been followed up on/endorsed in a review article (or similar), then we could consider that, but otherwise we should leave it out.  WhatamIdoing (talk) 00:12, 27 July 2021 (UTC)

I’m working on an addition to the subtypes where I will dive into “athlete burnout”. This phenomena is widespread and problematic, specifically in young athletes. I have a few sources backing up some points on this condition. Does anyone have any thoughts on these additions? Mmorrow2 (talk) 14:33, 30 April 2024 (UTC)


 * I’m thinking about doing something similar to the teacher and caregiver sections where I will link a new Wikipedia article titled “athlete burnout”. Currently working on creating that new article to link. Mmorrow2 (talk) 14:55, 30 April 2024 (UTC)
 * Would it be alright if I simply added some commentary under a new subtype of “athlete burnout” or would a new article be completely necessary for this subtype? Open to any and all feedback here. Thank you! Mmorrow2 (talk) 15:07, 30 April 2024 (UTC)

Extended-confirmed-protected edit request on 13 August 2021
I suggest to insert in "Treatment and Prevention" these lines below (see "Rage room" page)

In February 2021, Colline di tristezza, an anonymous Italian artist, proposed to set up rage rooms and crying rooms in hospitals, nursing homes, and schools to decrease the risk of Burnout felt by staff. 5.170.12.238 (talk) 23:39, 13 August 2021 (UTC)
 * Red information icon with gradient background.svg Not done for now: please establish a consensus for this alteration before using the template. I feel this is WP:UNDUE. ScottishFinnishRadish (talk) 00:22, 14 August 2021 (UTC)

Extended-confirmed-protected edit request on 18 September 2021
I suggest that following the sentence The World Health Organization states that "Burn-out refers specifically to phenomena in the occupational context and should not be applied to describe experiences in other areas of life." add the following:

There are voices of criticism regarding the limitation of the area causing burnout to the professional scope only.

Extended-confirmed-protected edit request on 24 September 2021
I suggest that following the sentence The World Health Organization states that "Burn-out refers specifically to phenomena in the occupational context and should not be applied to describe experiences in other areas of life." add the following:

There are voices of criticism regarding the limitation of the area causing burnout to the professional scope only. Failure9x (talk) 12:48, 24 September 2021 (UTC)
 * Red information icon with gradient background.svg Not done for now: I feel we may be giving this criticism undue weight by addressing it when I am not aware of there being any significant coverage or majority opinion on this matter. Not to mention the prominence of it's placement being in the first paragraph of the lead. I would advise striving for consensus prior to attempting to have this edit be made. It may be appropriate to bring up this concern in another fashion, for example. — Sirdog (talk) 00:06, 25 September 2021 (UTC)

edits
Since I am unable to make edits, here are some additional notes I have found that would be helpful in this article. Regarding "effects" of occupational burnout: In healthcare settings, job burnout increases the risk of patient harm due to the lack of taking pride in one's work and job satisfaction.

Regarding "risks" of occupational burnout: Jobs that demand physical labor that has a likelihood of resulting in injury can also burn out an employee.

In regards to "treatment": Employers could prevent having burnt out employees if they provide proper staffing and also provide resources for struggling employees.

Lreitano (talk) 01:19, 28 September 2021 (UTC)Lreitano

Regarding link between BO and Chronic Fatigue Syndrome
Referring to this portion of text: ''It has also been hypothesised that chronic fatigue syndrome is caused by burnout.[78][79] It is suggested that the "burning out" of the body's stress symptom (by any of a wide range of causes) can lead to chronic fatigue. "Occupational burnout" is known for its exhausting effect on sufferers. Overtraining syndrome, a similar but lesser exhausting condition to CFS has been conceptualised as adjustment disorder, a common diagnosis for those burnt out.[80]''

Reference 78 is a non-peer reviewed article not published through any scientific journal. The article itself partially relies on references from a psychological health perspective. It was written in 2015 and remains unreviewed. Reference 79 is an article from 2009, thirteen years ago.

Much research has been done since this date, overwhelmingly indicative that CFS/ME is not a psychiatric/psychological disorder, and that psychological intervention is not curative. Both WHO and NICE categorize CFS/ME as neurological in origin and has stressed that the condition cannot be categorized in the following "malaise and fatigue" diagnosis (in the General signs, symptoms and abnormal findings), or as neurasthenia or Fatigue syndrome in the mental and behavioral disorders category. (ref: https://me-pedia.org/wiki/World_Health_Organization). NICE (UK, 2021) have removed any recommendation relating to either Graded Exercise Therapy or CBT as a curative treatment as the evidence existing for either treatment is of low quality and can be harmful.

I propose removing any reference to Chronic Fatigue Syndrome in this article as there is no current evidence linking it to burnout or any other condition or circumstance where activity levels induce the condition initially, and no evidence linking it to adjustment syndrome. Genericist (talk) 15:34, 6 January 2022 (UTC)

Further to the above with no discussion or objections raised, I have made the proposed changes with citations. Genericist (talk) 09:03, 27 January 2022 (UTC)


 * I think this was a good idea. The ME/CFS connection was hypothesized some years ago, but it does not appear to be either a current theory or a prominent one.  Not mentioning it (though it's still in a comparison table) seems to make the article comply better with the WP:DUE policy. WhatamIdoing (talk) 01:38, 29 July 2023 (UTC)

Copyright problem removed
Prior content in this article duplicated one or more previously published sources. The material was copied from: https://helda.helsinki.fi/bitstream/handle/10138/19788/occupati.pdf?sequence=2&isAllowed=y. Copied or closely paraphrased material has been rewritten or removed and must not be restored, unless it is duly released under a compatible license. (For more information, please see "using copyrighted works from others" if you are not the copyright holder of this material, or "donating copyrighted materials" if you are.)

For legal reasons, we cannot accept copyrighted text or images borrowed from other web sites or published material; such additions will be deleted. Contributors may use copyrighted publications as a source of information, and, if allowed under fair use, may copy sentences and phrases, provided they are included in quotation marks and referenced properly. The material may also be rewritten, providing it does not infringe on the copyright of the original or plagiarize from that source. Therefore, such paraphrased portions must provide their source. Please see our guideline on non-free text for how to properly implement limited quotations of copyrighted text. Wikipedia takes copyright violations very seriously, and persistent violators will be blocked from editing. While we appreciate contributions, we must require all contributors to understand and comply with these policies. Thank you. /wiae /tlk  11:38, 26 May 2022 (UTC)

Burnout and the APA
User Iss246 notes that "The APA cannot believe in and not believe in BO at the same time; BO is not in the DSM. Rotenstein et al.'s (2018) review of research on physician BO have shown that there are 142 different definitions of BO in the literature. With no consensus dx, you can't conclude that 2 in 5 psychiatrists suffer from BO."

And yet read https://psychiatry.org:443/psychiatrists/practice/well-being-and-burnout. Perhaps I "can't conclude that 2 in 5 psychiatrists suffer from [Occupational Burnout]," but the APA is.

In discussing the position of the APA, it is both true and notable that it doesn't include the concept in the DSM, while simultaneously stating 2/5's of it's members have it, and that "Addressing this problem has become one of the most pressing issues for medicine."

What are other people's thoughts? Transient-understanding (talk) 07:10, 15 July 2022 (UTC)


 * I deleted a misleading sentence. The public should not be led to believe that 2 of 5 psychiatrists are suffering from BO when there are no consensus criteria for diagnosing BO. Rotenstein et al. (2018) showed that there 142 different sets of diagnostic criteria for BO in their review of research on MDs. There is little agreement on how to dx BO. Maslach and colleagues (2016) warned against using her MBI for arriving at a dx of BO. If there are no solid, consensus grounds for arriving at a dx of BO, then asserting that 2 out 5 or 10 out of 100 members of a group are suffering from BO is nonsensical and misleads the public, who are the consumers of WP. Iss246 (talk) 00:11, 18 July 2022 (UTC)
 * You're engaging in WP:SYNTH here. It is not up to wikipedia editors to decide that the APA cannot be relied on estimate the prevalence of burnout. sciencewatcher (talk) 23:20, 20 July 2022 (UTC)
 * User:Sciencewatcher, call my edit what you want, what you put back does not belong to WP. You cited a blurb on a website, even if an APA website. It's a blurb, nothing more. If you want to cite something sturdier, cite a journal article showing that 2 out of 5 psychiatrists are suffering from BO. A blurb is not sufficiently notable. If you want to cite a blurb (and I am opposed to that), it should be put together with two facts. One is that the APA does not include BO as a diagnosis. The other is that Rotenstein et al.'s (2018) review of the research literature on physician BO shows 142 different ways BO has be diagnosed. Rotenstein et al. showed that it is not possible to come to a reliable conclusion about BO's prevalence. That material is scattered in the article but it should be next to the APA study. I am going to delete the sentence as not notable. Iss246 (talk) 21:00, 21 July 2022 (UTC)
 * The published view of the APA is notable irrespective of how many people outside the organisation believe the position to be true. By all means quote explanatory material next to it. The paragraph containing the removed text did open saying that the APA's DSM doesn't include burnout as a diagnosis.Transient-understanding (talk) 08:33, 22 July 2022 (UTC)
 * A blurb is a blurb. It is insubstantial. A more substantial document is required to show that 2 out of 5 psychiatrists are estimated to be experiencing BO. Perhaps an article in JAMA Psychiatry or the American Journal of Psychiatry. Moreover, it is not clear that the blurb is the official view of the APA. Cite a substantial document that shows that 2 out of 5 psychiatrists are estimated to be suffering from BO, then I will be okay with including the sentence. I'm not against including the sentence if the scientific documentation is there. Iss246 (talk) 19:43, 22 July 2022 (UTC)

Shakespeare's sonnet
The History section links to Sonnet 138, cited as being believed to be the first printed occurrence of the word "burnout." However, Sonnet 138 does not contain the word "burnout" at all. The phrase "burn out" or even the word "burn" are not present in this sonnet. I can't currently find the right poem, but this needs to be corrected. 2600:6C48:697F:707E:41D3:7836:5EEA:C3A8 (talk) 10:57, 25 April 2023 (UTC)

Wiki Education assignment: Adult Development Fall 2023
— Assignment last updated by Charliejo99 (talk) 21:40, 8 November 2023 (UTC)

Women bear a ...
@MartinPoulter, you were right to delete the plagiarized paragraph that bgins "Women bear a disproportionate burden when it comes to unpaid work...." The paragraph should have been paraphrased the relevant research literature and been more clearly connected to the concept of occupational burnout.

Could an editor who is reading this comment review the deleted paragraph (Deleted 00:05 Greenwich time on 10 Dec 2023)? Find a way to write about women's work at home as an unpaid occupation. Then connect that work to occupational burnout. Thanks. Iss246 (talk) 01:40, 10 December 2023 (UTC)

History portion full of one sentence paragraphs
So hard to read! It should be condensed. TMorata (talk) 19:33, 2 February 2024 (UTC)

Wiki Education assignment: Research Methods in Clinical Psychology
— Assignment last updated by Mmorrow2 (talk) 14:44, 30 April 2024 (UTC)