Hillert Andreas
Fortschr Neurol Psychiatr. 2024 May;92(5):194-208. doi: 10.1055/a-2256-4439. Epub 2024 May 16.
Burnout, historically the successor to neurasthenia, is considered an exhaustion phenomenon caused by prolonged work-related stress. The very concept of "being burned out" implies an image that is immediately understandable and concise to any layperson. Academic psychiatry and psychology pose conceptual challenges to this popular model, which was first published in 1974 by the German-American psychotherapist Herbert Freudenberger. To date, more than 140 definitions of burnout have been proposed. All of the main features of burnout, especially the experience of exhaustion, are non-specific. Various burnout development models have been proposed, which were assumed to represent a quasi-natural process. None could be confirmed empirically. An expert consensus on the diagnostic criteria and conceptual classification, whether as an independent disorder or as a risk condition, could not be achieved. Nevertheless, burnout is classified as a work-related disorder in the ICD-11. Current findings indicate that the experience of burnout among members of the baby boomer generation often reflects their high performance expectations of themselves, while the identical subjective feeling in Generation Z is often associated with missing or unsustainable professional goals. The research on the burnout phenomenon, which largely ignores the fact that burnout - in the absence of reliable diagnostic criteria - must be considered a subjective model, meets social expectations but does not meet scientific criteria. A parallel recording of ICD/DSM diagnoses and subjective disorder models is recommended in everyday therapeutic practice in order to meet the needs of both sides.
职业倦怠,从历史角度来看是神经衰弱的后继者,被认为是一种由长期工作压力导致的疲惫现象。“精疲力竭”这一概念本身所蕴含的形象,对任何外行人来说都能立刻理解且简洁明了。学术精神病学和心理学对这个于1974年由德裔美国心理治疗师赫伯特·弗洛登伯格首次发表的流行模型提出了概念上的挑战。迄今为止,已经提出了140多种职业倦怠的定义。职业倦怠的所有主要特征,尤其是疲惫感,都是非特异性的。已经提出了各种职业倦怠发展模型,这些模型被假定代表一个类似自然的过程。但没有一个能得到实证证实。关于诊断标准和概念分类,无论是作为一种独立的病症还是一种风险状况,都无法达成专家共识。尽管如此,职业倦怠在《国际疾病分类第11版》(ICD - 11)中被归类为与工作相关的病症。当前研究结果表明,婴儿潮一代成员的职业倦怠体验往往反映了他们对自己的高绩效期望,而Z世代相同的主观感受通常与缺失或不可持续的职业目标有关。对职业倦怠现象的研究,很大程度上忽略了在缺乏可靠诊断标准的情况下,职业倦怠必须被视为一种主观模型这一事实,它满足了社会期望,但不符合科学标准。为了满足双方需求,建议在日常治疗实践中同时记录ICD/DSM诊断和主观病症模型。