Is Burnout a Depressive Condition? A 14-Sample Meta-Analytic and Bifactor Analytic Study

Abstract

There is no consensus on whether burnout constitutes a depressive condition or an original entity requiring specific medical and legal recognition. In this study, we examined burnout–depression overlap using 14 samples of individuals from various countries and occupational domains (N = 12,417). Meta-analytically pooled disattenuated correlations indicated (a) that exhaustion—burnout’s core—is more closely associated with depressive symptoms than with the other putative dimensions of burnout (detachment and efficacy) and (b) that the exhaustion–depression association is problematically strong from a discriminant validity standpoint (r = .80). The overlap of burnout’s core dimension with depression was further illuminated in 14 exploratory structural equation modeling bifactor analyses. Given their consistency across countries, languages, occupations, measures, and methods, our results offer a solid base of evidence in support of the view that burnout problematically overlaps with depression. We conclude by outlining avenues of research that depart from the use of the burnout construct.

Keywords

burnout depression meta-analysis bifactor analysis occupational health

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References

Ahola

Hakanen

J. J.

(2007). Job strain, burnout, and depressive symptoms: A prospective study among dentists. Journal of Affective Disorders, 104(1), 103–110. https://doi.org/10.1016/j.jad.2007.03.004

Ahola

Hakanen

Perhoniemi

Mutanen

(2014). Relationship between burnout and depressive symptoms: A study using the person-centred approach. Burnout Research, 1(1), 29–37. https://doi.org/10.1016/j.burn.2014.03.003

Ahola

Honkonen

Isometsä

Kalimo

Nykyri

Aromaa

Lönnqvist

(2005). The relationship between job-related burnout and depressive disorders—Results from the Finnish Health 2000 Study. Journal of Affective Disorders, 88(1), 55–62. https://doi.org/10.1016/j.jad.2005.06.004

Ahola

Honkonen

Virtanen

Kivimäki

Isometsä

Aromaa

Lönnqvist

(2007). Interventions in relation to occupational burnout: The population-based health 2000 study. Journal of Occupational and Environmental Medicine, 49(9), 943–952. https://doi.org/10.1097/JOM.0b013e31813736e3

Ahola

Väänänen

Koskinen

Kouvonen

Shirom

(2010). Burnout as a predictor of all-cause mortality among industrial employees: A 10-year prospective register-linkage study. Journal of Psychosomatic Research, 69(1), 51–57. https://doi.org/10.1016/j.jpsychores.2010.01.002

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.).

Arthurs

Steele

R. J.

Hudson

Baron

Thombs

B. D.

(2012). Are scores on English and French versions of the PHQ-9 comparable? An assessment of differential item functioning. PLOS ONE, 7(12), Article e52028. https://doi.org/10.1371/journal.pone.0052028

Bakker

A. B.

Schaufeli

W. B.

Demerouti

Janssen

P. P. M.

Van Der Hulst

Brouwer

(2000). Using equity theory to examine the difference between burnout and depression. Anxiety, Stress, & Coping, 13(3), 247–268. https://doi.org/10.1080/10615800008549265

Beck

A. T.

Alford

B. A.

(2009). Depression: Causes and treatment (2nd ed.). University of Pennsylvania Press.

10.

Beck

A. T.

Beck

R. W.

(1972). Screening depressed patients in family practice. Postgraduate Medicine, 52(6), 81–85. https://doi.org/10.1080/00325481.1972.11713319

11.

Beck

A. T.

Steer

R. A.

Brown

G. K.

(1996). Manual for the Beck Depression Inventory-II. The Psychological Corporation.

12.

Beck

A. T.

Steer

R. A.

Brown

G. K.

(1998). Inventaire de Dépression de Beck [Beck Depression Inventory] (2nd ed.). Les Éditions du Centre de Psychologie Appliquée.

13.

Becker

B. J.

(2009). Model-based meta-analysis. In Cooper

H. M.

Hedges

L. V.

Valentine

(Eds.), The handbook of research synthesis and meta-analysis (2nd ed., pp. 377–395). Russell Sage Foundation.

14.

Bianchi

(2015). A reflection on the measurement of the burnout syndrome. Academic Emergency Medicine, 22(3), 378. https://doi.org/10.1111/acem.12611

15.

Bianchi

(2018). Burnout is more strongly linked to neuroticism than to work-contextualized factors. Psychiatry Research, 270, 901–905. https://doi.org/10.1016/j.psychres.2018.11.015

16.

Bianchi

(2020). Do burnout and depressive symptoms form a single syndrome? Confirmatory factor analysis and exploratory structural equation modeling bifactor analysis. Journal of Psychosomatic Research, 131, Article 109954. https://doi.org/10.1016/j.jpsychores.2020.109954

17.

Bianchi

Boffy

Hingray

Truchot

Laurent

(2013). Comparative symptomatology of burnout and depression. Journal of Health Psychology, 18(6), 782–787. https://doi.org/10.1177/1359105313481079

18.

Bianchi

Brisson

(2019). Burnout and depression: Causal attributions and construct overlap. Journal of Health Psychology, 24(11), 1574–1580. https://doi.org/10.1177/1359105317740415

19.

Bianchi

da Silva Nogueira

(2019). Burnout is associated with a depressive interpretation style. Stress and Health, 35(5), 642–649. https://doi.org/10.1002/smi.2897

20.

Bianchi

Janin

(2019). Burnout, depression and paranoid ideation: A cluster-analytic study. Occupational Medicine, 69(1), 35–38. https://doi.org/10.1093/occmed/kqy150

21.

Bianchi

Laurent

(2015). Emotional information processing in depression and burnout: An eye-tracking study. European Archives of Psychiatry and Clinical Neuroscience, 265(1), 27–34. https://doi.org/10.1007/s00406-014-0549-x

22.

Bianchi

Laurent

Schonfeld

I. S.

Bietti

L. M.

Mayor

(2020). Memory bias toward emotional information in burnout and depression. Journal of Health Psychology, 25(10-11), 1567–1575. https://doi.org/10.1177/1359105318765621

23.

Bianchi

Manzano-García

Rolland

J.-P.

(2021). Is burnout primarily linked to work-situated factors? A relative weight analytic study. Frontiers in Psychology, 11, Article 623912. https://doi.org/10.3389/fpsyg.2020.623912

24.

Bianchi

Mirkovic

(2020). Is Machiavellianism associated with depression? A cluster-analytic study. Personality and Individual Differences, 152, 109594. https://doi.org/10.1016/j.paid.2019.109594

25.

Bianchi

Rolland

J.-P.

Salgado

J. F.

(2018). Burnout, depression, and borderline personality: A 1,163-participant study. Frontiers in Psychology, 8, Article 2336. https://doi.org/10.3389/fpsyg.2017.02336

26.

Bianchi

Schonfeld

I. S.

(2016). Burnout is associated with a depressive cognitive style. Personality and Individual Differences, 100, 1–5. https://doi.org/10.1016/j.paid.2016.01.008

27.

Bianchi

Schonfeld

I. S.

(2020). The Occupational Depression Inventory: A new tool for clinicians and epidemiologists. Journal of Psychosomatic Research, 138, Article 110249. https://doi.org/10.1016/j.jpsychores.2020.110249

28.

Bianchi

Schonfeld

I. S.

Laurent

(2014). Is burnout a depressive disorder? A re-examination with special focus on atypical depression. International Journal of Stress Management, 21(4), 307–324. https://doi.org/10.1037/a0037906

29.

Bianchi

Schonfeld

I. S.

Laurent

(2018a). Burnout syndrome and depression. In Kim

Y.-K.

(Ed.), Understanding depression: Volume 2. Clinical manifestations, diagnosis and treatment (pp. 187–202). Springer Nature. https://doi.org/10.1007/978-981-10-6577-4_14.

30.

Bianchi

Schonfeld

I. S.

Laurent

(2018b). When fatigue symptoms are associated with . . . fatigue symptoms. Psychiatry Research, 263, 284. https://doi.org/10.1016/j.psychres.2017.06.056

31.

Bianchi

Schonfeld

I. S.

Laurent

(2019). Burnout: Moving beyond the status quo. International Journal of Stress Management, 26(1), 36–45. https://doi.org/10.1037/str0000088

32.

Bianchi

Schonfeld

I. S.

Vandel

Laurent

(2017). On the depressive nature of the “burnout syndrome”: A clarification. European Psychiatry, 41, 109–110. https://doi.org/10.1016/j.eurpsy.2016.10.008

33.

Bianchi

Schonfeld

I. S.

Verkuilen

(2020). A five-sample confirmatory factor analytic study of burnout–depression overlap. Journal of Clinical Psychology, 25(10–11), 1567–1575. https://doi.org/10.1002/jclp.22927

34.

Boersma

Lindblom

(2009). Stability and change in burnout profiles over time: A prospective study in the working population. Work & Stress, 23(3), 264–283. https://doi.org/10.1080/02678370903265860

35.

Brown

G. W.

Harris

(1978). Social origins of depression: A study of psychiatric disorder in women. Free Press.

36.

Carney

R. M.

Freedland

K. E.

(2017). Depression and coronary heart disease. Nature Reviews Cardiology, 14, 145–155. https://doi.org/10.1038/nrcardio.2016.181

37.

Casey

B. J.

Craddock

Cuthbert

B. N.

Hyman

S. E.

Lee

F. S.

Ressler

K. J.

(2013). DSM-5 and RDoC: Progress in psychiatry research? Nature Reviews Neuroscience, 14(11), 810–814. https://doi.org/10.1038/nrn3621

38.

Center for Suicide Prevention. (2020). The workplace and suicide prevention. https://www.suicideinfo.ca/resource/workplace-suicide-prevention/

39.

Cheung

M. W.-L.

(2015). Meta-analysis: A structural equation modeling approach. Wiley.

40.

Cox

Tisserand

Taris

(2005). The conceptualization and measurement of burnout: Questions and directions. Work & Stress, 19(3), 187–191. https://doi.org/10.1080/02678370500387109

41.

DeCou

C. R.

Schumann

M. E.

(2018). On the iatrogenic risk of assessing suicidality: A meta-analysis. Suicide and Life-Threatening Behavior, 48(5), 531–543. https://doi.org/10.1111/sltb.12368

42.

Dohrenwend

B. P.

(2000). The role of adversity and stress in psychopathology: Some evidence and its implications for theory and research. Journal of Health and Social Behavior, 41(1), 1–19. https://doi.org/10.2307/2676357

43.

Fisher

Tipton

Zhipeng

(2017). robumeta: Robust variance meta-regression (Version 2.0) [Computer software]. Comprehensive R Archive Network. https://CRAN.R-project.org/package=robumeta

44.

Gilbert

(2006). Evolution and depression: Issues and implications. Psychological Medicine, 36(3), 287–297. https://doi.org/10.1017/S0033291705006112

45.

Gotlib

I. H.

Hammen

C. L.

(2014). Handbook of depression (3rd ed.). Guilford Press.

46.

Greenberg

P. E.

Fournier

A. A.

Sisitsky

Pike

C. T.

Kessler

R. C.

(2015). The economic burden of adults with major depressive disorder in the United States (2005 and 2010). The Journal of Clinical Psychiatry, 76(2), 155–162. https://doi.org/10.4088/JCP.14m09298

47.

Guglielmi

R. S.

Tatrow

(1998). Occupational stress, burnout, and health in teachers: A methodological and theoretical analysis. Review of Educational Research, 68(1), 61–99. https://doi.org/10.3102/00346543068001061

48.

Hakanen

J. J.

Bakker

A. B.

(2017). Born and bred to burn out: A life-course view and reflections on job burnout. Journal of Occupational Health Psychology, 22(3), 354–364. https://doi.org/10.1037/ocp0000053

49.

Hakanen

J. J.

Bakker

A. B.

Demerouti

(2005). How dentists cope with their job demands and stay engaged: the moderating role of job resources. European Journal of Oral Sciences, 113(6), 479–487. https://doi.org/10.1111/j.1600-0722.2005.00250.x

50.

Hakanen

J. J.

Peeters

(2015). How do work engagement, workaholism, and the work-to-family interface affect each other? A 7-year follow-up study. Journal of Occupational and Environmental Medicine, 57(6), 601–609. https://doi.org/10.1097/jom.0000000000000457

51.

Hakanen

J. J.

Peeters

M. C. W.

Perhoniemi

(2011). Enrichment processes and gain spirals at work and at home: A 3-year cross-lagged panel study. Journal of Occupational and Organizational Psychology, 84(1), 8–30. https://doi.org/10.1111/j.2044-8325.2010.02014.x

52.

Hakanen

J. J.

Peeters

M. C. W.

Schaufeli

W. B.

(2018). Different types of employee well-being across time and their relationships with job crafting. Journal of Occupational Health Psychology, 23(2), 289–301. https://doi.org/10.1037/ocp0000081

53.

Hakanen

J. J.

Perhoniemi

Toppinen-Tanner

(2008). Positive gain spirals at work: From job resources to work engagement, personal initiative and work-unit innovativeness. Journal of Vocational Behavior, 73(1), 78–91. https://doi.org/10.1016/j.jvb.2008.01.003

54.

Hakanen

J. J.

Schaufeli

W. B.

(2012). Do burnout and work engagement predict depressive symptoms and life satisfaction? A three-wave seven-year prospective study. Journal of Affective Disorders, 141(2), 415–424. https://doi.org/10.1016/j.jad.2012.02.043

55.

Hakanen

J. J.

Schaufeli

W. B.

Ahola

(2008). The Job Demands-Resources model: A three-year cross-lagged study of burnout, depression, commitment, and work engagement. Work & Stress, 22(3), 224–241. https://doi.org/10.1080/02678370802379432

56.

Halbesleben

J. R. B.

Demerouti

(2005). The construct validity of an alternative measure of burnout: Investigating the English translation of the Oldenburg Burnout Inventory. Work & Stress, 19(3), 208–220. https://doi.org/10.1080/02678370500340728

57.

Hare

D. L.

Toukhsati

S. R.

Johansson

Jaarsma

(2014). Depression and cardiovascular disease: A clinical review. European Heart Journal, 35(21), 1365–1372. https://doi.org/10.1093/eurheartj/eht462

58.

Haslam

Holland

Kuppens

(2012). Categories versus dimensions in personality and psychopathology: A quantitative review of taxometric research. Psychological Medicine, 42(5), 903–920. https://doi.org/10.1017/s0033291711001966

59.

Hautzinger

Bailer

(1993). Allgemeine Depressions Skala (ADS): Manual [General Depression Scale (ADS): Manual]. Beltz.

60.

Health Promotion Switzerland. (2020). Workplace health management (WHM): Job stress index. https://healthpromotion.ch/workplace-health-management/principles-and-studies/job-stress-index.html

61.

Hedges

L. V.

Tipton

Johnson

M. C.

(2010). Robust variance estimation in meta-regression with dependent effect size estimates. Research Synthesis Methods, 1(1), 39–65. https://doi.org/10.1002/jrsm.5

62.

James

S. L.

Abate

K. H.

Abay

S. M.

Abbafati

Abbasi

Abbastabar

Abd-Allah

Abdela

Abdelalim

Abdollahpour

Abdulkader

R. S.

Abebe

Abera

S. F.

Abil

O. Z.

Abraha

H. N.

Abu-Raddad

L. J.

Abu-Rmeileh

N. M. E.

Accrombessi

M. M. K.

. . .Murray

C. J. L.

(2018). Global, regional, and national incidence, prevalence, and years lived with disability for 354 diseases and injuries for 195 countries and territories, 1990-2017: A systematic analysis for the Global Burden of Disease Study 2017. The Lancet, 392(10159), 1789–1858. https://doi.org/10.1016/S0140-6736(18)32279-7

63.

Jansson-Frojmark

Lindblom

(2010). Is there a bidirectional link between insomnia and burnout? A prospective study in the Swedish workforce. International Journal of Behavioral Medicine, 17(4), 306–313. https://doi.org/10.1007/s12529-010-9107-8

64.

Judd

L. L.

Schettler

P. J.

Coryell

Akiskal

H. S.

Fiedorowicz

J. G.

(2013). Overt irritability/anger in unipolar major depressive episodes: Past and current characteristics and implications for long-term course. JAMA Psychiatry, 70(11), 1171–1180. https://doi.org/10.1001/jamapsychiatry.2013.1957

65.

Kaltiala-Heino

Rimpelä

Rantanen

Laippala

(1999). Finnish modification of the 13-item Beck Depression Inventory in screening an adolescent population for depressiveness and positive mood. Nordic Journal of Psychiatry, 53(6), 451–457. https://doi.org/10.1080/080394899427700

66.

Karasek

Brisson

Kawakami

Houtman

Bongers

Amick

(1998). The Job Content Questionnaire (JCQ): An instrument for internationally comparative assessments of psychosocial job characteristics. Journal of Occupational Health Psychology, 3(4), 322–355. https://doi.org/10.1037/1076-8998.3.4.322

67.

Kasl

S. V.

(1978). Epidemiological contributions to the study of work stress. In Cooper

C. L.

Payne

(Eds.), Stress at work (pp. 3–48). Wiley.

68.

Keller

A. C.

Meier

L. L.

Elfering

Semmer

N. K.

(2020). Please wait until I am done! Longitudinal effects of work interruptions on employee well-being. Work & Stress, 34(2), 148–167. https://doi.org/10.1080/02678373.2019.1579266

69.

Kotov

Krueger

R. F.

Watson

Achenbach

T. M.

Althoff

R. R.

Bagby

R. M.

Brown

T. A.

Carpenter

W. T.

Caspi

Clark

L. A.

Eaton

N. R.

Forbes

M. K.

Forbush

K. T.

Goldberg

Hasin

Hyman

S. E.

Ivanova

M. Y.

Lynam

D. R.

Markon

. . .Zimmerman

(2017). The Hierarchical Taxonomy of Psychopathology (HiTOP): A dimensional alternative to traditional nosologies. Journal of Abnormal Psychology, 126(4), 454–477. https://doi.org/10.1037/abn0000258

70.

Koutsimani

Montgomery

Georganta

(2019). The relationship between burnout, depression, and anxiety: A systematic review and meta-analysis. Frontiers in Psychology, 10, Article 284. https://doi.org/10.3389/fpsyg.2019.00284

71.

Kristensen

T. S.

Borritz

Villadsen

Christensen

K. B.

(2005). The Copenhagen Burnout Inventory: A new tool for the assessment of burnout. Work & Stress, 19(3), 192–207. https://doi.org/10.1080/02678370500297720

72.

Kroenke

Spitzer

R. L.

Williams

J. B. W.

(2001). The PHQ-9: Validity of a brief depression severity measure. Journal of General Internal Medicine, 16(9), 606–613. https://doi.org/10.1046/j.1525-1497.2001.016009606.x

73.

Kupferberg

Bicks

Hasler

(2016). Social functioning in major depressive disorder. Neuroscience & Biobehavioral Reviews, 69, 313–332. https://doi.org/10.1016/j.neubiorev.2016.07.002

74.

Kuster

Orth

Meier

L. L.

(2012). Rumination mediates the prospective effect of low self-esteem on depression: A five-wave longitudinal study. Personality and Social Psychology Bulletin, 38(6), 747–759. https://doi.org/10.1177/0146167212437250

75.

Kuster

Orth

Meier

L. L.

(2013). High self-esteem prospectively predicts better work conditions and outcomes. Social Psychological and Personality Science, 4(6), 668–675. https://doi.org/10.1177/1948550613479806

76.

Leiter

M. P.

Durup

(1994). The discriminant validity of burnout and depression: A confirmatory factor analytic study. Anxiety, Stress, & Coping, 7(4), 357–373. https://doi.org/10.1080/10615809408249357

77.

Leiter

M. P.

Hakanen

J. J.

Ahola

Toppinen-Tanner

Koskinen

Väänänen

(2013). Organizational predictors and health consequences of changes in burnout: A 12-year cohort study. Journal of Organizational Behavior, 34(7), 959–973. https://doi.org/10.1002/job.1830

78.

LeMoult

Gotlib

I. H.

(2019). Depression: A cognitive perspective. Clinical Psychology Review, 69, 51–66. https://doi.org/10.1016/j.cpr.2018.06.008

79.

Lindblom

Linton

Fedeli

Bryngelsson

I.-L.

(2006). Burnout in the working population: Relations to psychosocial work factors. International Journal of Behavioral Medicine, 13(1), 51–59. https://doi.org/10.1207/s15327558ijbm1301_7

80.

Lisspers

Nygren

Soderman

(1997). Hospital Anxiety and Depression scale (HAD): Some psychometric data for a Swedish sample. Acta Psychiatrica Scandinavica, 96(4), 281–286. https://doi.org/10.1111/j.1600-0447.1997.tb10164.x

81.

Lupien

S. J.

Sasseville

François

Giguère

C. E.

Boissonneault

Plusquellec

Godbout

Xiong

Potvin

Kouassi

Lesage

(2017). The DSM5/RDoC debate on the future of mental health research: Implication for studies on human stress and presentation of the signature bank. Stress, 20(1), 2–18. https://doi.org/10.1080/10253890.2017.1286324

82.

Madsen

I. E. H.

Lange

Borritz

Rugulies

(2015). Burnout as a risk factor for antidepressant treatment—a repeated measures time-to-event analysis of 2936 Danish human service workers. Journal of Psychiatric Research, 65, 47–52. https://doi.org/10.1016/j.jpsychires.2015.04.004

83.

Madsen

I. E. H.

Nyberg

S. T.

Magnusson Hanson

L. L.

Ferrie

J. E.

Ahola

Alfredsson

Kivimaki

(2017). Job strain as a risk factor for clinical depression: Systematic review and meta-analysis with additional individual participant data. Psychological Medicine, 47(8), 1342–1356. https://doi.org/10.1017/s003329171600355x

84.

Marsh

H. W.

Morin

A. J.

Parker

P. D.

Kaur

(2014). Exploratory structural equation modeling: An integration of the best features of exploratory and confirmatory factor analysis. Annual Review of Clinical Psychology, 10, 85–110. https://doi.org/10.1146/annurev-clinpsy-032813-153700

85.

Maslach

Jackson

S. E.

Leiter

M. P.

(2016). Maslach Burnout Inventory manual (4th ed.). Consulting Psychologists Press.

86.

Maslach

Leiter

M. P.

(2008). Early predictors of job burnout and engagement. Journal of Applied Psychology, 93(3), 498–512. https://doi.org/10.1037/0021-9010.93.3.498

87.

Maslach

Leiter

M. P.

(2016). Understanding the burnout experience: Recent research and its implications for psychiatry. World Psychiatry, 15(2), 103–111. https://doi.org/10.1002/wps.20311

88.

Maslach

Schaufeli

W. B.

Leiter

M. P.

(2001). Job burnout. Annual Review of Psychology, 52(1), 397–422. https://doi.org/10.1146/annurev.psych.52.1.397

89.

Mather

Blom

Svedberg

(2014). Stressful and traumatic life events are associated with burnout—a cross-sectional twin study. International Journal of Behavioral Medicine, 21(6), 899–907. https://doi.org/10.1007/s12529-013-9381-3

90.

McDonald

R. P.

(1999). Test theory: A unified treatment. Erlbaum.

91.

Meier

L. L.

Cho

(2019). Work stressors and partner social undermining: Comparing negative affect and psychological detachment as mechanisms. Journal of Occupational Health Psychology, 24(3), 359–372. https://doi.org/10.1037/ocp0000120

92.

Meier

L. L.

Spector

P. E.

(2013). Reciprocal effects of work stressors and counterproductive work behavior: A five-wave longitudinal study. Journal of Applied Psychology, 98(3), 529–539. https://doi.org/10.1037/a0031732

93.

Meier

L. L.

Tschudi

Meier

C. A.

Dvorak

Zeller

(2014). When general practitioners don’t feel appreciated by their patients: Prospective effects on well-being and work–family conflict in a Swiss Longitudinal Study. Family Practice, 32(2), 181–186. https://doi.org/10.1093/fampra/cmu079

94.

Melamed

Shirom

Toker

Shapira

(2006). Burnout and risk of type 2 diabetes: A prospective study of apparently healthy employed persons. Psychosomatic Medicine, 68(6), 863–869. https://doi.org/10.1097/01.psy.0000242860.24009.f0

95.

Melchior

Caspi

Milne

B. J.

Danese

Poulton

Moffitt

T. E.

(2007). Work stress precipitates depression and anxiety in young, working women and men. Psychological Medicine, 37(8), 1119–1129. https://doi.org/10.1017/S0033291707000414

96.

Melnick

E. R.

Powsner

S. M.

Shanafelt

T. D.

(2017). In reply—Defining physician burnout, and differentiating between burnout and depression. Mayo Clinic Proceedings, 92(9), 1456–1458. https://doi.org/10.1016/j.mayocp.2017.07.005

97.

Mezuk

Eaton

W. W.

Albrecht

Golden

S. H.

(2008). Depression and type 2 diabetes over the lifespan: A meta-analysis. Diabetes Care, 31(12), 2383–2390. https://doi.org/10.2337/dc08-0985

98.

Morin

A. J. S.

Arens

A. K.

Marsh

H. W.

(2016). A bifactor exploratory structural equation modeling framework for the identification of distinct sources of construct-relevant psychometric multidimensionality. Structural Equation Modeling: A Multidisciplinary Journal, 23(1), 116–139. https://doi.org/10.1080/10705511.2014.961800

99.

Muthén

L. K.

Muthén

B. O.

(2017). Mplus user’s guide (8th ed.).

100.

Nabi

Singh-Manoux

Ferrie

J. E.

Marmot

M. G.

Melchior

Kivimäki

(2009). Hostility and depressive mood: Results from the Whitehall II prospective cohort study. Psychological Medicine, 40(3), 405–413. https://doi.org/10.1017/S0033291709990432

101.

Orth

Clark

D. A.

Donnellan

M. B.

Robins

R. W.

(2021). Testing prospective effects in longitudinal research: Comparing seven competing cross-lagged models. Journal of Personality and Social Psychology, 120(4), 1013–1034. https://doi.org/10.1037/pspp0000358

102.

Orth

Robins

R. W.

Meier

L. L.

Conger

R. D.

(2016). Refining the vulnerability model of low self-esteem and depression: Disentangling the effects of genuine self-esteem and narcissism. Journal of Personality and Social Psychology, 110(1), 133–149. https://doi.org/10.1037/pspp0000038

103.

Pickles

Angold

(2003). Natural categories or fundamental dimensions: On carving nature at the joints and the rearticulation of psychopathology. Development and Psychopathology, 15(3), 529–551. https://doi.org/10.1017/S0954579403000282

104.

Pines

A. M.

(2004). Adult attachment styles and their relationship to burnout: A preliminary, cross-cultural investigation. Work & Stress, 18(1), 66–80. https://doi.org/10.1080/02678370310001645025

105.

Podsakoff

P. M.

MacKenzie

S. B.

Lee

J. Y.

Podsakoff

N. P.

(2003). Common method biases in behavioral research: A critical review of the literature and recommended remedies. Journal of Applied Psychology, 88(5), 879–903. https://doi.org/10.1037/0021-9010.88.5.879

106.

Prins

D. J.

van Vendeloo

S. N.

Brand

P. L. P.

Van der Velpen

de Jong

van den Heijkant

Van der Heijden

F. M. M. A.

Prins

J. T.

(2019). The relationship between burnout, personality traits, and medical specialty. A national study among Dutch residents. Medical Teacher, 41(5), 584–590. https://doi.org/10.1080/0142159X.2018.1514459

107.

Pryce

C. R.

Azzinnari

Spinelli

Seifritz

Tegethoff

Meinlschmidt

(2011). Helplessness: A systematic translational review of theory and evidence for its relevance to understanding and treating depression. Pharmacology & Therapeutics, 132(3), 242–267. https://doi.org/10.1016/j.pharmthera.2011.06.006

108.

Qiao

Schaufeli

W. B.

(2011). The convergent validity of four burnout measures in a Chinese sample: A confirmatory factor-analytic approach. Applied Psychology, 60(1), 87–111. https://doi.org/10.1111/j.1464-0597.2010.00428.x

109.

Radloff

L. S.

(1977). The CES-D scale: A self-report depression scale for research in the general population. Applied Psychological Measurement, 1(3), 385–401. https://doi.org/10.1177/014662167700100306

110.

R Core Team. (2020). R: A language and environment for statistical computing (Version 4.0.0) [Computer software]. Vienna, Austria: R Foundation for Statistical Computing.

111.

Rodriguez

Reise

S. P.

Haviland

M. G.

(2016a). Applying bifactor statistical indices in the evaluation of psychological measures. Journal of Personality Assessment, 98(3), 223–237. https://doi.org/10.1080/00223891.2015.1089249

112.

Rodriguez

Reise

S. P.

Haviland

M. G.

(2016b). Evaluating bifactor models: Calculating and interpreting statistical indices. Psychological Methods, 21(2), 137–150. https://doi.org/10.1037/met0000045

113.

Rodríguez-Sánchez

A. M.

Hakanen

J. J.

Perhoniemi

Salanova

(2013). With a little help from my assistant: Buffering the negative effects of emotional dissonance on dentist performance. Community Dentistry and Oral Epidemiology, 41(5), 415–423. https://doi.org/10.1111/cdoe.12038

114.

Rolls

E. T.

(2016). A non-reward attractor theory of depression. Neuroscience & Biobehavioral Reviews, 68, 47–58. https://doi.org/10.1016/j.neubiorev.2016.05.007

115.

Rössler

Hengartner

Ajdacic-Gross

Angst

(2015). Predictors of burnout: Results from a prospective community study. European Archives of Psychiatry and Clinical Neuroscience, 265(1), 19–25. https://doi.org/10.1007/s00406-014-0512-x

116.

Rotenstein

L. S.

Torre

Ramos

M. A.

Rosales

R. C.

Guille

Sen

Mata

D. A.

(2018). Prevalence of burnout among physicians: A systematic review. JAMA, 320(11), 1131–1150. https://doi.org/10.1001/jama.2018.12777

117.

Rotenstein

L. S.

Zhao

Mata

D. A.

Guille

Sen

(2021). Substantial overlap between factors predicting symptoms of depression and burnout among medical interns. Journal of General Internal Medicine, 36, 240–242. https://doi.org/10.1007/s11606-020-05664-x

118.

Rydmark

Wahlberg

Ghatan

P. H.

Modell

Nygren

Å.

Ingvar

Åsberg

Heilig

(2006). Neuroendocrine, cognitive and structural imaging characteristics of women on longterm sickleave with job stress-induced depression. Biological Psychiatry, 60(8), 867–873. https://doi.org/10.1016/j.biopsych.2006.04.029

119.

Saarinen

Hintsanen

Hakulinen

Pulkki-Råback

Lehtimäki

Raitakari

Keltikangas-Järvinen

(2018). The co-occurrence between depressive symptoms and paranoid ideation: A population-based longitudinal study. Journal of Affective Disorders, 229, 48–55. https://doi.org/10.1016/j.jad.2017.12.045

120.

Sánchez-Meca

López-López

J. A.

López-Pina

J. A.

(2013). Some recommended statistical analytic practices when reliability generalization studies are conducted. British Journal of Mathematical and Statistical Psychology, 66(3), 402–425. https://doi.org/10.1111/j.2044-8317.2012.02057.x

121.

Schaufeli

W. B.

(2017). Burnout: A short socio-cultural history. In Neckel

Schaffner

A. K.

Wagner

(Eds.), Burnout, fatigue, exhaustion: An interdisciplinary perspective on a modern affliction (pp. 105–127). Palgrave Macmillan.

122.

Schaufeli

W. B.

Enzmann

(1998). The burnout companion to study and practice: A critical analysis. Taylor & Francis.

123.

Schaufeli

W. B.

Taris

T. W.

(2005). The conceptualization and measurement of burnout: Common ground and worlds apart. Work & Stress, 19(3), 256–262. https://doi.org/10.1080/02678370500385913

124.

Schonfeld

I. S.

(2018, July 3). When we say ‘physician burnout,’ we really mean depression. Medscape Psychiatry. https://www.medscape.com/viewarticle/898662

125.

Schonfeld

I. S.

Bianchi

(2016). Burnout and depression: Two entities or one? Journal of Clinical Psychology, 72(1), 22–37. https://doi.org/10.1002/jclp.22229

126.

Schonfeld

I. S.

Bianchi

Palazzi

(2018). What is the difference between depression and burnout? An ongoing debate. Rivista di Psichiatria, 53(4), 218–219. https://doi.org/10.1708/2954.29699

127.

Schonfeld

I. S.

Chang

C.-H.

(2017). Occupational health psychology: Work, stress, and health. Springer.

128.

Schonfeld

I. S.

Verkuilen

Bianchi

(2019a). An exploratory structural equation modeling bi-factor analytic approach to uncovering what burnout, depression, and anxiety scales measure. Psychological Assessment, 31(8), 1073–1079. https://doi.org/10.1037/pas0000721

129.

Schonfeld

I. S.

Verkuilen

Bianchi

(2019b). Inquiry into the correlation between burnout and depression. Journal of Occupational Health Psychology, 24(6), 603–616. https://doi.org/10.1037/ocp0000151

130.

Schwenk

T. L.

Gold

K. J.

(2018). Physician burnout—A serious symptom, but of what? JAMA, 320(11), 1109–1110. https://doi.org/10.1001/jama.2018.11703

131.

Seligman

M. E. P.

(1975). Helplessness: On depression, development, and death. W. H. Freeman.

132.

Seppälä

Hakanen

Mauno

Perhoniemi

Tolvanen

Schaufeli

(2015). Stability and change model of job resources and work engagement: A seven-year three-wave follow-up study. European Journal of Work and Organizational Psychology, 24(3), 360–375. https://doi.org/10.1080/1359432X.2014.910510

133.

Shirom

(2005). Reflections on the study of burnout. Work & Stress, 19(3), 263–270. https://doi.org/10.1080/02678370500376649

134.

Shirom

Melamed

(2006). A comparison of the construct validity of two burnout measures in two groups of professionals. International Journal of Stress Management, 13(2), 176–200. https://doi.org/10.1037/1072-5245.13.2.176

135.

Simons

D. J.

Shoda

Lindsay

D. S.

(2017). Constraints on Generality (COG): A proposed addition to all empirical papers. Perspectives on Psychological Science, 12(6), 1123–1128. https://doi.org/10.1177/1745691617708630

136.

Spector

P. E.

(2006). Method variance in organizational research: Truth or urban legend? Organizational Research Methods, 9(2), 221–232. https://doi.org/10.1177/1094428105284955

137.

Swider

B. W.

Zimmerman

R. D.

(2010). Born to burnout: A meta-analytic path model of personality, job burnout, and work outcomes. Journal of Vocational Behavior, 76(3), 487–506. https://doi.org/10.1016/j.jvb.2010.01.003

138.

Taris

T. W.

(2006a). Bricks without clay: On urban myths in occupational health psychology. Work & Stress, 20(2), 99–104. https://doi.org/10.1080/02678370600893410

139.

Taris

T. W.

(2006b). Is there a relationship between burnout and objective performance? A critical review of 16 studies. Work & Stress, 20(4), 316–334. https://doi.org/10.1080/02678370601065893

140.

Tipton

(2015). Small sample adjustments for robust variance estimation with meta-regression. Psychological Methods, 20(3), 375–393. https://doi.org/10.1037/met0000011

141.

Toker

Melamed

Berliner

Zeltser

Shapira

(2012). Burnout and risk of coronary heart disease: A prospective study of 8838 employees. Psychosomatic Medicine, 74(8), 840–847. https://doi.org/10.1097/PSY.0b013e31826c3174

142.

Tyssen

(2018). What is the level of burnout that impairs functioning? Journal of Internal Medicine, 283(6), 594–596. https://doi.org/10.1111/joim.12769

143.

Ursin

Eriksen

H. R.

(2004). The cognitive activation theory of stress. Psychoneuroendocrinology, 29(5), 567–592. https://doi.org/10.1016/S0306-4530(03)00091-X

144.

U.S. Bureau of Labor Statistics. (2020). Workplace injuries. https://www.bls.gov/data/#injuries

145.

Verkuilen

Bianchi

Schonfeld

I. S.

Laurent

(2020). Burnout–depression overlap: Exploratory structural equation modeling bifactor analysis and network analysis. Assessment. Advance online publication. https://doi.org/10.1177/1073191120911095

146.

Weinberger

A. H.

Gbedemah

Martinez

A. M.

Nash

Galea

Goodwin

R. D.

(2017). Trends in depression prevalence in the USA from 2005 to 2015: Widening disparities in vulnerable groups. Psychological Medicine, 48(8), 1308–1315. https://doi.org/10.1017/S0033291717002781

147.

Wichers

(2014). The dynamic nature of depression: A new micro-level perspective of mental disorder that meets current challenges. Psychological Medicine, 44(7), 1349–1360. https://doi.org/10.1017/S0033291713001979

148.

Willner

Scheel-Krüger

Belzung

(2013). The neurobiology of depression and antidepressant action. Neuroscience & Biobehavioral Reviews, 37(10), 2331–2371. https://doi.org/10.1016/j.neubiorev.2012.12.007

149.

Wojciechowski

F. L.

Strik

Falger

Lousberg

Honig

(2000). The relationship between depressive and vital exhaustion symptomatology post-myocardial infarction. Acta Psychiatrica Scandinavica, 102(5), 359–365. https://doi.org/10.1034/j.1600-0447.2000.102005359.x

150.

World Health Organization. (2017). Depression and other common mental disorders: Global health estimates.

151.

World Health Organization. (2019) ICD-11 for mortality and morbidity statistics. https://icd.who.int/browse11_2019-04/l-m/en#/http%3A%2F%2Fid.who.int%2Ficd%2Fentity%2F129180281

152.

Mata

Furman

D. J.

Whitmer

A. J.

Gotlib

I. H.

Thompson

R. J.

(2017). Anticipatory and consummatory pleasure and displeasure in major depressive disorder: An experience sampling study. Journal of Abnormal Psychology, 126(2), 149–159. https://doi.org/10.1037/abn0000244

153.

Wurm

Vogel

Holl

Ebner

Bayer

Morkl

Szilagyi

I. S.

Hotter

Kapfhammer

H. P.

Hofmann

(2016). Depression-burnout overlap in physicians. PLOS ONE, 11(3), Article e0149913. https://doi.org/10.1371/journal.pone.0149913

154.

Zigmond

A. S.

Snaith

R. P.

(1983). The Hospital Anxiety and Depression Scale. Acta Psychiatrica Scandinavica, 67(6), 361–370. https://doi.org/10.1111/j.1600-0447.1983.tb09716.x

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