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WHO Redefines Burnout As A 'Syndrome' Linked To Chronic Stress At Work

May 28, 2019
Originally published on May 29, 2019 11:07 am

Updated 7:55 p.m. ET

The World Health Organization is bringing attention to the problem of work-related stress. The group announced this week that it is updating its definition of burnout in the new version of its handbook of diseases, the International Classification of Diseases — ICD-11 — which will go into effect in January 2022

The new definition calls it a "syndrome" and specifically ties burnout to "chronic workplace stress that has not been successfully managed."

Despite earlier reports to the contrary, WHO does not classify the problem as a medical condition. It calls burnout an "occupational phenomenon" and includes it in a chapter on "factors influencing health status or contact with health services."

According to WHO, burnout is characterized by "feelings of energy depletion or exhaustion; increased mental distance from one's job, or feelings of negativism or cynicism related to one's job; and reduced professional efficacy."

Burnout was also included in the previous version of WHO's disease handbook, the ICD-10, in the same category as it now appears. But it was defined simply as a "state of vital exhaustion," Tarik Jasarevic, a spokesperson for WHO, wrote in an email.

The earlier definition "was kind of this weird in-between 'you're not really sick, but you're not fully capable of doing your work,' " says Torsten Voigt, a sociologist at RWTH Aachen University in Germany, who published a review of existing studies on burnout in 2017.

The new definition is now more detailed, he says, and while it's not a major change, it gives people who suffer burnout more legitimacy.

"People who feel burnout are finally fully recognized as having a severe issue," he says. The new definition may be a step toward making it easier for people to get help, at least in some European countries, where health professionals rely on the ICD, he says.

Bringing more clarity to the definition of burnout is important, says Elaine Cheung, a professor of medical social sciences at Northwestern University Feinberg School of Medicine. "There needs to be greater critical discussion on how we can more precisely measure and define this condition," she said in a statement.

She also told NPR that she welcomes the WHO's new definition because it might raise awareness of the problem of burnout not only among health care workers but also individuals and employers.

"I think a lot of people have a lay definition of what burnout may be," she says. "But I think by highlighting the specific facets of burnout ... my hope is that it might create greater awareness."

Cheung says many studies show that certain aspects of workplace culture can increase risk of burnout.

She says employers have a big role in addressing burnout by paying attention to whether employees have a sense of community at work, strong social relationships, a collegial environment, a workload that's not too burdensome, a sense of agency at work, and a healthy work-life balance.

The new WHO definition also requires that to diagnose burnout, mental health professionals have to rule out anxiety, mood disorders and other stress-related disorders.

Cheung thinks that's important. "Burnout is different from depression in that it is tied specifically to our work and our relationship with our work," she says.

Cheung says that understanding this distinction could lead to more targeted research into how to prevent and treat the problem.

WHO also announced it plans to begin developing evidence-based guidelines on mental well-being in the workplace.

: 5/28/19

In a previous version of this story, the name of Aachen University was misspelled as Achen.

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NOEL KING, HOST:

The World Health Organization has a new definition of occupational burnout. It describes it as a syndrome tied to chronic stress at work. NPR's Rhitu Chatterjee has the story.

RHITU CHATTERJEE, BYLINE: The WHO's previous definition of burnout was simply a state of vital exhaustion. This definition is part of the current version of the International Classification of Diseases - or the ICD - a manual that is used by health professionals around the world to diagnose physical and mental illnesses.

Torsten Voigt is a sociologist at RWTH Aachen University in Germany. He says the old definition was vague.

TORSTEN VOIGT: It was kind of this weird in-between you're not really sick and - but you're also not fully capable of doing your work.

CHATTERJEE: The new definition, he says, is much more specific and useful. It links burnout specifically to workplace stress and describes three symptoms. The first is feeling depleted or exhausted.

VOIGT: And then there has to be this mental distance, if you will, from the job or negative feelings towards your workplace.

CHATTERJEE: And the third is reduced professional efficacy. The updated definition of burnout will be part of the new version of the ICD, which goes into effect January 2022. Some researchers are hopeful that the WHO's announcement will influence conversations about burnout in this country, too.

Elaine Cheung is an assistant professor at Northwestern University's Feinberg School of Medicine.

ELAINE CHEUNG: I think a lot of people have a lay definition of what burnout may be. But I think by highlighting the specific facets of burnout, the symptoms associated with burnout - my hope is that it might create greater awareness.

CHATTERJEE: Awareness not just among health workers but also among employers. That's because, Cheung says, many studies show that aspects of workplace culture can increase risk of burnout, factors like...

CHEUNG: How you feel about your sense of community at work and your social relationships, whether it's a collegial environment; facets such as your workload and whether it feels too burdensome, whether or not you feel like you can have a healthy sense of work-life balance.

CHATTERJEE: That's why, Cheung says, employers have a big role in addressing burnout in employees.

Rhitu Chatterjee, NPR News. Transcript provided by NPR, Copyright NPR.