Current issues in relation to burnout's definition, measurement, prevalence and management: A narrative review

In response to high contemporary levels of interest in burnout we overview key issues in relation to its definition, measurement, psychiatric status and management. Defining burnout remains problematic and compromises prevalence estimates. We consider the need to define and differentiate potential differing 'burning out' and 'burnout' states, its presence in those with family responsibilities as well as those formally employed, the differentiation or not of burnout from depression and burnout's optimal management. Arguments for and against it being listed as a psychiatric disorder are noted and operational criteria are provided for manual listing considerations. The weight of evidence argues against burnout and depression being synonymous conditions. We put a case for a diathesis-stress model of burnout weighting predisposing personality styles as well as precipitating factors to advance aetiological and treatment studies as well as practical management. Despite there being no formal support for antidepressant medication, we review data suggesting a potential role and postulate that such medication may be of benefit by modulating a predisposing personality style of neuroticism. Each identified issue is capable of resolution if current limitations to this field of research are recognized and conceded. Finally, we consider the issue of burnout in psychiatrists.