Hillert A
Medizinisch-Psychosomatischen Klinik Roseneck, Prien am Chiemsee.
Versicherungsmedizin. 2008 Dec 1;60(4):163-9.
Since Herbert Freudenbergers "Staff Burnout", published in 1974, burnout has become a synonym for psychosomatic, psychological symptoms and social consequences of a long-lasting workload exceeding an individual's capacity. Without any binding definition, the term burnout is used by patients as well as their doctors and therapists as a medical diagnosis. Described by Freudenberger from a patient's point of view, the term tries to integrate symptoms (fatigue, emotional exhaustion, reduced personal accomplishment and distancing from clients) as well as cause (job strain) of the burnout process. Thus burnout was claimed to have nothing in common with psychiatric disorders. Altogether this burnout concept is fairly plausible and attractive for people suffering from the symptoms. It also lowers the threshold to think about work related and psychosomatic problems and to look for therapeutic support. According to the criteria of modern diagnostic systems like DSM-IV and ICD-10, the attempt to integrate symptoms and causes of a psychosomatic phenomenon in a diagnosis will fail. In ICD-10 burnout only can be found as an--undefined--additional diagnostic term. Scientific data show that people suffering from burnout are a quite heterogeneous group, including people who had once been highly motivated and successful in their business as well as people feeling overworked all their lives. While burnout is not convincing as a diagnostic term, its high popularity highlights the fundamental needs and problems of a changing society, characterised by increasing work related stressors and decreasing social security.
自赫伯特·弗洛登伯格1974年发表《员工倦怠》以来,倦怠已成为身心、心理症状以及长期工作量超过个人承受能力所产生的社会后果的代名词。由于没有任何具有约束力的定义,患者及其医生和治疗师都将倦怠一词用作医学诊断。从患者的角度来看,弗洛登伯格对该术语进行了描述,试图整合倦怠过程的症状(疲劳、情感耗竭、个人成就感降低以及与客户疏远)和原因(工作压力)。因此,倦怠被认为与精神疾病毫无关联。总体而言,这种倦怠概念对有这些症状的人来说相当合理且有吸引力。它也降低了人们思考与工作相关的身心问题并寻求治疗支持的门槛。根据现代诊断系统如《精神疾病诊断与统计手册》第四版(DSM-IV)和《国际疾病分类》第十版(ICD-10)的标准,在诊断中整合身心现象的症状和原因的尝试将会失败。在ICD-10中,倦怠仅作为一个未定义的附加诊断术语出现。科学数据表明,患有倦怠的人是一个相当异类的群体,包括曾经在工作中积极性很高且很成功的人以及一生都感觉工作过度劳累的人。虽然倦怠作为一个诊断术语并不令人信服,但其高知名度凸显了一个不断变化的社会的基本需求和问题,其特点是与工作相关的压力源增加而社会保障减少。