Differentiating 'pure' and comorbid self-identified burnout: Diagnostic and management implications.

Objective: A previous study identified categorically differing scores on the Sydney Burnout Measure (SBM) between individuals with self-identified burnout with ( = 354) or without ( = 188) a history of mental illness. The current study examined whether the SBM's validity held in both scenarios.

Method: The factorial structure and scores on the SBM measure were compared between the two groups.

Does theta burst stimulation have differential benefit for those with melancholic or non-melancholic depression?

Background: To determine if theta burst stimulation (TBS) is of preferential benefit to those with melancholic or non-melancholic depression as an adjunctive treatment for treatment resistant depression (TRD).

Methods: Fifty-two patients receiving TBS at a private psychiatric hospital participated in a naturalistic study. Four diagnostic strategies were used to assign melancholic versus non-melancholic depression subtype status.

Burnout and depression: Points of convergence and divergence.

Background: Debate is ongoing as to whether burnout can be differentiated from depression. This study evaluated whether burnout and depression could be distinguished using a new burnout measure and other variables.

Methods: Scores on the Sydney Burnout Measure (SBM) were compared between participants with self-diagnosed burnout (BO-all group; n = 622) and clinically-diagnosed depression (DEP-all group; n = 90).

Exploring the validity of the Sydney Burnout Measure.

This study aimed to examine the convergent validity of a new measure of burnout, the Sydney Burnout Measure (SBM) by comparison against the field standard measure - the Maslach Burnout Inventory (MBI). A second aim was to consider burnout's association with psychological distress. 1483 dental professionals completed the two burnout measures as well as two measures of psychological distress.

Modelling self-diagnosed burnout as a categorical syndrome.

Objective: There is currently little consensus as to how burnout is best defined and measured, and whether the syndrome should be afforded clinical status. The latter issue would be advanced by determining whether burnout is a singular dimensional construct varying only by severity (and with some level of severity perhaps indicating clinical status), or whether a categorical model is superior, presumably reflecting differing 'sub-clinical' versus 'clinical' or 'burning out' vs 'burnt out' sub-groups. This study sought to determine whether self-diagnosed burnout was best modelled dimensionally or categorically.

The Diagnosis of Burnout: Some Challenges.

Burnout is a topic of high public and research interest, but debate remains as to how the syndrome should best be defined, measured, and diagnosed. In this article, we overview how issues relating to burnout's definition and measurement as well as the debate surrounding its overlap with depression have led to ambiguity surrounding its diagnostic status. We argue for a broader conceptualization of burnout and detail why we position it as distinct from depression, before providing recommendations for clinicians when considering a burnout diagnosis.

The AREDOC project and its implications for the definition and measurement of the bipolar disorders: A summary report.

Objectives: Judging that the (5th ed.) criteria for defining mania/hypomania (and thus bipolar I/II disorders, respectively) would benefit from review, we formed an expert taskforce to derive modified criteria for consideration. The aim of this paper is to summarise the component stages and detail the final recommended criteria.

Is burnout simply a stress reaction?

Whether burnout is synonymous with stress is a question of clinical importance when considering the nosological status and management of both states. The biological changes associated with both stress and burnout suggest considerable overlap. However, we argue that the widespread acceptance by the lay community of burnout as a distinct and relatable syndrome suggests it is worthy of independent designation.

A new machine learning-derived screening measure for differentiating bipolar from unipolar mood disorders.

Background: While there are several accepted screening measures for identifying those with a bipolar disorder, variations in overall classification rates argue for the pursuit of a more discriminating measure. Extant measures, as well as the DSM-5, rate each diagnostic criterion as having equivalent weighting values; an approach which may compromise diagnostic assignment if symptoms vary considerably in their diagnostic sensitivity. We therefore sought to develop a new measure and examine whether a weighted rating scale was superior to one assigning equivalent weightings to each item.

Burnout: modeling, measuring, and managing.

Objective: As burnout has been neglected in medical and psychiatric education, we seek to provide a summary overview.

Methods: We extract salient findings from the published literature and offer some challenges.

Results: We critique the current principal model of burnout, argue for broadening the symptom constructs and for a diathesis-stress model where a perfectionistic personality style is a key predisposing factor, and observe that burnout is not limited by those in formal work.

A Single-Blind Randomized Comparison of Lithium and Lamotrigine as Maintenance Treatments for Managing Bipolar II Disorder.

Purpose/background: No study to date has compared lithium and lamotrigine as maintenance mood stabilizers for bipolar II disorder. The aim of this study was to evaluate and compare these two medications in terms of their maintenance efficacy and side effect profile, thus evaluating their comparative cost/benefit profile.

Methods/procedures: Forty-four subjects with a newly diagnosed bipolar II disorder were randomly assigned to receive either lithium or lamotrigine treatment in a 20-week single-blinded study.

Burnout: Redefining its key symptoms.

Burnout is currently operationalised as comprising of exhaustion, depersonalization and reduced personal accomplishment. However, questions have been raised as to whether this three-factor model accurately characterises the syndrome. We therefore sought to re-examine burnout's key symptoms and to develop a new model of the syndrome.

The utility of daily mood ratings in clinical trials of patients with bipolar II disorder.

Objective: To demonstrate that there can be distinctive differences in information generated by standard interval measures as against using daily monitoring for evaluating progress in those with a bipolar disorder.

Method: We undertook a 20-week study of individuals with a bipolar II disorder randomly assigned to receive either lamotrigine or lithium. Patients were rated on standard measures of depression and hypomania at monthly intervals, and they also completed a daily rating measure of their mood swings.

The biology of burnout: Causes and consequences.

Objectives: Burnout is a state of exhaustion resulting from prolonged and excessive workplace stress. We sought to examine biological underpinnings of burnout, focussing on mechanisms and physical consequences.

Methods: We searched the literature on burnout and evaluated studies examining biological parameters in patient populations (i.

Categorical differentiation of the unipolar and bipolar disorders.

There has been a longstanding debate as to whether the bipolar disorders differ categorically or dimensionally, with some dimensional or spectrum models including unipolar depressive disorders within a bipolar spectrum model. We analysed manic/hypomanic symptom data in samples of clinically diagnosed bipolar I, bipolar II and unipolar patients, employing latent class analyses to determine if separate classes could be identified. Mixture analyses were also undertaken to determine if a unimodal, bimodal or a trimodal pattern was present.

Differentiating mania/hypomania from happiness using a machine learning analytic approach.

Background: This study aimed to improve the accuracy of bipolar disorder diagnoses by identifying symptoms that help to distinguish mania/hypomania in bipolar disorders from general 'happiness' in those with unipolar depression.

Methods: An international sample of 165 bipolar and 29 unipolar depression patients (as diagnosed by their clinician) were recruited. All participants were required to rate a set of 96 symptoms with regards to whether they typified their experiences of manic/hypomanic states (for bipolar patients) or when they were 'happy' (unipolar patients).

Distinguishing burnout from clinical depression: A theoretical differentiation template.

Background: Burnout and clinical depression have been variably viewed as synonymous or as distinctly differing entities - but with few distinguishing features provided. Failure to differentiate the two conditions can lead to compromised clinical management. We sought to enhance the differentiation of burnout and clinical depression by assembling a list of candidate differentiating features.

The bipolar disorders: A case for their categorically distinct status based on symptom profiles.

Background: It is unclear whether the bipolar disorders (i.e. BP-I/BP-II) differ dimensionally or categorically.

Distinguishing burnout from depression: An exploratory qualitative study.

Whether depression and burnout are synonymous or not has been a longstanding debate. Many studies have examined for similarities and differences, but findings have overall been inconclusive, with most studies being quantitative in design. We therefore undertook a qualitative study in which participants who self-identified as having experienced both burnout and depression were asked how they distinguished between the two conditions.

Burnout: Re-examining its key constructs.

There is widespread debate as to how to accurately define and measure burnout. The present study sought to address these issues by inviting participants who self-identified as experiencing burnout to complete a questionnaire covering a large item set of putative burnout features. Bifactor modelling identified a 'general' factor with items capturing exhaustion as well as psychological and cognitive dysfunction.

A Qualitative Reexamination of the Key Features of Burnout.

Burnout is generally defined as a triad of emotional exhaustion, lack of empathy, and reduced professional accomplishment constructs. We sought to determine in an exploratory, qualitative study whether these three constructs adequately represent burnout. Participants who self-identified as experiencing burnout completed a questionnaire that asked about their experiences of the condition.

Revising , Fifth Edition, criteria for the bipolar disorders: Phase I of the AREDOC project.

Objective: To derive new criteria sets for defining manic and hypomanic episodes (and thus for defining the bipolar I and II disorders), an international Task Force was assembled and termed AREDOC reflecting its role of Assessment, Revision and Evaluation of DSM and other Operational Criteria. This paper reports on the first phase of its deliberations and interim criteria recommendations.

Method: The first stage of the process consisted of reviewing , and recent International Classification of Diseases criteria, identifying their limitations and generating modified criteria sets for further in-depth consideration.