Although a lot of authors struggle with the burnout definition, many of them believe to know what burnout is and publish articles about it (“I can't define it, but I know what it is!”). Often references are made to burnout questionnaires, in particular to the Maslach Burnout Inventory (MBI) ( 5). Concrete diagnostic criteria to categorize burnout as a disorder according to DSM or ICD standards does not exist to this day. Nevertheless, the hope that “burnout research” in psychiatry, psychology, psychotherapy, neurophysiology and the social sciences will find a concrete concept that is viable for various scientific and therapeutic issues and ultimately also for political implications has not been fulfilled. There are more than 140 suggested burnout definitions in the literature ( 2, 4). In these contexts “burnout” was discussed and expected to be treated, preferably by methods aiming for relief, rest and relaxation ( 2, 3). Burnout was first recognized in social professions, later in all occupational related subjects where people experienced stress and in situations of perceived overwork. Since the first publication on the burnout topic 1974, in which the psychotherapist Herbert Freudenberger literally described the phenomenon in relation to his own body and mental state, an infinite amount on the subject of burnout has been published ( 1). Parallel detection of ICD/DSM diagnoses from an expert perspective and subjective perturbation models are considered appropriate. Psychiatric research on the burnout–phenomenon ignores problems of definition resulting from different perspectives: It may meet societal expectations, but does not fulfill scientific criteria, and therefore is not suitable to establish an objective diagnosis and treatment. Nevertheless, the phenomenon of burnout in the ICD-11 is considered to be categorized as a work-related disorder.
An expert consensus on the diagnostic criteria and the conceptual location, whether as an independent disorder or as a risk, could not be agreed on. These could not be confirmed empirically. Different development–models of burnout were proposed, assumed to depict a quasi-natural process. Burnout–symptomatology's main characteristic, the experience of exhaustion, is unspecific. Since the first description of burnout in 1974 until today, more than 140 definitions have been suggested. The “burnout” phenomenon, supposedly caused by work related stress, is a challenge for academic psychiatry both conceptually and professionally.
Andreas Hillert 1 * Arnd Albrecht 2 Ulrich Voderholzer 1
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