Medicine and Health Sciences Commons^™

Depression, Anxiety, Post-Traumatic Stress Disorder And A History Of Pervasive Gender-Based Violence Among Women Asylum Seekers Who Have Undergone Female Genital Mutilation/Cutting: A Retrospective Case Review, Hazel Lever, Deborah Ottenheimer, Jimmitti Teysir, Elizabeth Singer, Holly G. Atkinson

Publications and Research

We sought to evaluate the frequency of anxiety, depression, PTSD, and any experiences of violence in women who had undergone Female Genital Mutilation/Cutting (FGM/C) and were seeking asylum in the United States. We undertook a retrospective qualitative descriptive study of FGM/C cases seen in an asylum clinic over a 2-year period. Standardized questionnaires provided quantitative scores for anxiety, depression and PTSD. Clients’ personal and physician medical affidavits were analyzed for experiences of violence. Of the 13 cases, anxiety and depression were exhibited by 92 and 100% of women, while all seven women screened for PTSD had symptoms. Qualitative analysis revealed …

Post-Traumatic Stress Disorder And Cardiovascular Diseases: A Cohort Study Of Men And Women Involved In Cleaning The Debris Of The World Trade Center Complex, Molly Remsch, Zoey Laskaris, Janine D. Flory, Consuelo Mora-Mclaughlin, Alfredo Morabia

Publications and Research

BACKGROUND: To determine whether post-traumatic stress disorder (PTSD) is a risk factor for myocardial infarction (MI) and stroke, beyond the expected effects from recognized cardiovascular risk factors and depression.

METHODS AND RESULTS: World Trade Center-Heart is an observational prospective cohort study of 6481 blue-collar first responders nested within the World Trade Center Health Program in New York City. Baseline measures in 2012 and 2013 included blood pressure, weight and height, and blood lipids. PTSD, depression, smoking, and dust exposure during the 2001 cleanup were self-reported. During the 4-year follow-up, outcomes were assessed through (1) interview-based incident, nonfatal MI, and stroke, …

Burnout Research: Eyes Wide Shut, Irvin Sam Schonfeld, Eric Laurent, Renzo Bianchi

Publications and Research

In a study published in a recent issue of Critical Care Medicine, Colville and Smith (2017) found modest overlap between burnout and depression and assumed that burnout and depression are distinct entities. For four reasons, we think that the study is seriously flawed. First, Colville and Smith assessed burnout symptoms with an abbreviated version of the Maslach Burnout Inventory (MBI), the psychometric properties of which are unclear. Second, they used clinically and theoretically arbitrary cutoff scores for categorizing burnout, a modus operandi that, unfortunately, has become commonplace in studies of medical professionals. Third, participants could be categorized as “burned out” …

Burnout Syndrome And Depression, Renzo Bianchi, Irvin Sam Schonfeld, Eric Laurent

Publications and Research

In this chapter, we proposed an overview of burnout, from the introduction of the construct in the mid-1970s to the growing realization that the syndrome was better conceived of as a depressive condition. Recent studies have shown that the distinction between burnout and depression is problematic, both theoretically and empirically. The history of burnout research suggests that transdisciplinary communication and methodological standards should be strengthened to avoid the proliferation of constructs that, in fact, refer to the same phenomena. Construct proliferation, a transgression of the scientific canon of parsimony, is considered a major problem today because it undermines theory building …

A Neglected Problem In Burnout Research, Renzo Bianchi, Irvin Sam Schonfeld, Eric Laurent

Publications and Research

Although we share with Eckleberry-Hunt et al. (2018) some of their criticisms regarding the problematic conceptualization of burnout, we are perplexed by the authors’ silence regarding burnout–depression overlap, which is arguably the most troubling problem attached to the burnout construct. The extensive research suggests that burnout reflects a combination of depressive responses. The emotional exhaustion component of burnout involves fatigue and depressed mood, two diagnostic criteria for depressive disorders. Maslach et al. (2001) wrote that there is “a predominance of dysphoric symptoms” in burnout. Depersonalization symptoms are commonly found in depressed individuals. Diminished personal accomplishment reflects well-known depressive manifestations of …

On The “Bubble” Of Burnout's Prevalence Estimates, Eric Laurent, Irvin Sam Schonfeld, Renzo Bianchi, Laura Hawryluck, Peter G. Brindley

Publications and Research

Hawryluck and Brindley (2018) addressed the issue of burnout—a syndrome thought to be induced by job stress—among critical care medicine (CCM) practitioners. Although we agree that the practice of CCM can be stressful, relying on burnout as an indicator of the practitioners’ response to occupational adversity is unwarranted. Despite its popularity, burnout remains poorly defined. Disconcertingly, investigators have widely relied on the Maslach Burnout Inventory (MBI) for “diagnosing” burnout in spite of the fact that the MBI is not a diagnostic instrument.Experiencing fatigue or distancing oneself from one’ work—what burnout is about—is not necessarily a sign of ill-being in itself. …

Interpretation Bias Toward Ambiguous Information In Burnout And Depression, Renzo Bianchi, Eric Laurent, Irvin Sam Schonfeld, Jay Verkuilen, Chantal Berna

Publications and Research

Burnout has been defined as a job-related syndrome combining pervasive fatigue and loss of motivation. In recent years, evidence has mounted that burnout may reflect a depressive condition. In this study, we expanded on past investigations of burnout-depression overlap by focusing on interpretation biases toward ambiguous information among the two entities. We conducted a web-based study involving 1056 participants (83% female; mean age: 42.87). Burnout symptoms were assessed with the Shirom-Melamed Burnout Measure and depressive symptoms with the PHQ-9. The Ambiguous Scenarios Test (AST), a measure of interpretation bias validated among dysphoric individuals, was the outcome of interest. The AST …

When We Say 'Physician Burnout,' We Really Mean Depression, Irvin Sam Schonfeld

Publications and Research

There has been controversy regarding the extent to which burnout overlaps depression. I enumerate eight reasons explaining to why depression is at the heart of burnout. Some of these reasons pertain to the highly similar work-related causes of burnout and depression, burnout adherents' faulty categorical and dimensional conceptualizations of burnout and depression, problematically high correlations between emotional exhaustion (the core of burnout) and depressive symptoms, research on physicians and dentists that underline burnout-depression overlap, and the problem of alexithymia being similarly related to burnout and depression. Suggestions for addressing the problem of burnout-depression among physicians are presented.

Is A Meta-Analytic Approach To Burnout’S Prevalence Timely?, Eric Laurent, Irvin Sam Schonfeld, Renzo Bianchi

Publications and Research

Cañadas‐De la Fuente et al. performed a meta‐analysis of the prevalence of emotional exhaustion, depersonalization, and diminished personal accomplishment—the three definitional components of the burnout syndrome—among nursing professionals working in oncology units. All in all, their meta‐analysis was inconclusive because of the very state of burnout research. Because there is mounting evidence that burnout is a depressive condition, we recommend that investigators focus on depression, rather than burnout, in occupational health research and practice.

What Is The Difference Between Depression And Burnout? An Ongoing Debate, Irvin Sam Schonfeld, Renzo Bianchi, Stefano Palazzi

Publications and Research

Il burnout è concepito come una sindrome che si sviluppa in risposta a condizioni di lavoro cronicamente avverse. Si ritiene che il burnout comporti esaurimento emotivo, depersonalizzazione e riduzione della realizzazione personale. Storicamente, tuttavia, il burnout è stato difficile da separare dalla depressione. In effetti, i sintomi del burnout coincidono con i sintomi della depressione. L'evidenza della validità discriminante del burnout nei confronti della depressione è debole, sia a livello empirico sia a livello teorico. L'esaurimento emotivo, il nucleo del burnout, riflette una combinazione di umore depresso e affaticamento / perdita di energia e si correla molto bene con altri …