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25th European Congress of Psychiatry / European Psychiatry 41S (2017) S106–S169



A person-centered approach to

burnout-depression overlap

A. Lichtenthäler , R. Bianchi

University of Neuchâtel, Institute of Work and Organizational

Psychology, Neuchâtel, Switzerland

Corresponding author.


Burnout has widely infiltrated the popular culture

and has been extensively studied in both psychiatry and psy-

chology. However, there are currently no consensual or binding

diagnostic criteria for burnout. A major obstacle to the elevation

of burnout to the status of nosological category is the overlap of

burnout with depression.


We examined whether burnout and depressive symp-

toms can be distinguished fromeach other using a person-centered



A total of 1759 French schoolteachers took part in

the present study (77% female; mean age: 41; mean length of

employment: 15). Burnout symptoms were assessed with the

Shirom-Melamed Burnout Measure (14 items) and depressive

symptoms with a dedicated module of the Patient Health Ques-

tionnaire (9 items). Data were primarily processed using two-step

cluster analysis. Correlation analysis and analysis of variance

(ANOVA) were additionally carried out.


Considered as continuous variables, burnout and depres-

sion were found to be closely intertwined (


= 0.81; disat-

tenuated correlation: 0.91). Our cluster analysis revealed four

different participant profiles, identifiable as “minimal burnout-

depression” (


= 542; 31%), “low burnout-depression” (


= 566;

32%), “medium burnout-depression” (


= 412; 23%), and “high

burnout-depression” (


= 239; 14%). Burnout anddepressionplayed

equivalently important roles in cluster construction. Our ANOVA

confirmed that the four clusters differed from each other in terms

of burnout and depressive symptoms.


Our findings are consistent with the view that the

burnout syndrome is depressive in nature. A diagnostic category

dedicated to burnout may therefore not be needed.

Disclosure of interest

The authors have not supplied their decla-

ration of competing interest.


Is it time to characterize burnout as a

depressive syndrome? A review of

recent research

R. Bianchi

1 ,

, I.S. Schonfeld


, E. Laurent



University of Neuchâtel, Institute of Work and Organizational

Psychology, Neuchâtel, Switzerland


The City College of the City University of New York, Department of

Psychology, New York City, NY, USA


University of Franche-Comté, Department of Psychology, Besanc¸ on,


Corresponding author.


More than 40 years after the introduction of the con-

struct in the literature, the status of “burnout” remains unclear.

Whether burnout is anything other than a depressive syndrome

has been increasingly discussed in recent years.


We examined the extent towhich burnout can be con-

sidered distinct from depression.


We reviewed the literature dedicated to burnout-

depression overlap over the last decade.


Recent research suggests that burnout and depression

overlap in terms of (a) etiology, with (chronic) unresolvable stress

a common, key causal factor, (b) clinical picture and course, with

burnout and depressive manifestations inextricably linked such

that they increase or decrease together over time, (c) cognitive

biases, with burnout and depressive symptoms similarly predict-

ing increased attention to negative stimuli and decreased attention

to positive stimuli, (d) dispositional correlates (e.g, neuroticism,

rumination, pessimism), and (e) allostatic load—an index of the bio-

logical cost of adaptation to life adversity. Hypocortisolismhas been

linked to both burnout and depression with atypical features—a

highly prevalent form of depression. The often-invoked argument

that burnout is singularized by its job-related character is actually

invalid given that (a) depression can also be job-related and (b) the

“job-relatedness” of a syndrome is not nosologically discriminant

in itself.


Robust evidence that burnout overlaps with depres-

sion has accumulated in recent years. The burnout construct is

unlikely to capture a distinct pathological phenomenon. We pro-

pose that burnout be characterized as a depressive syndrome for

the sake of conceptual parsimony, theoretical clarity, and effective

public health policies.

Disclosure of interest

The authors have not supplied their decla-

ration of competing interest.


Antidepressants augmented with

aripiprazole in the treatment of major

depressive disorder

S. Bise

1 ,

, G. Sulejmanpasic


, D. Begic


, M. Ahmic



Psychiatric hospital, women, Sarajevo, Bosnia and Herzegovina


Clinical Center University of Sarajevo, Psychiatric clinic, intensive

care, Sarajevo, Bosnia and Herzegovina


Psychiatric hospital, intensive care, Sarajevo, Bosnia and



Psychiatric hospital, men, Sarajevo, Bosnia and Herzegovina

Corresponding author.


Major depressive disorder (MDD) does not con-

sistently respond to any single antidepressant (AD) therapy.

Adjunctive therapy with atypical antipsychotics (AA) showed

higher response rates compared with AD monotherapy. Aripipra-

zole, an oral quinolinone, is the first AA agent to be approved in the

US as adjunctive treatment in adult patients with MDD.

Aim The aim was to evaluate the efficacy and safety of adjunctive

low-dose aripiprazole combined with AD versus AD monotherapy

in patients with MDD with minimal improvement after 4 weeks of

prior AD monotherapy.


Ten patients with MDD and a history of minimal

improvement to 4 weeks of AD monotherapy (escitalopram

10–15mg/day, sertralin 50–100mg/day) were included in this

study. The patients were randomly assigned to 2 groups: one (


= 5)

with AD plus aripiprazole 5–7.5mg/day and the other (


= 5) with

AD alone. After baseline assessment, the subjects were followed up

at weeks 2, and 4. The primary efficacy was the mean change in

(HAM-D17) and CGI-I.


The aripiprazole group exhibited significantly better effi-

cacy than the AD group in mean total score changes of HAM-D17

and CGI from the baseline to weeks 2, and 4. The item “work and

social activities” of HAM-D 17 showed significant improvement at

week 4, and the item “somatic symptoms (GI)” showed significant

improvement at week 2.


Adjunctive aripiprazole therapy significantly

improved depressive symptoms in MDD who didn’t respond to

AD monotherapy. Aripiprazole augmentation is an efficacious,

well-tolerated and safe treatment for patients with MDD.

Disclosure of interest

The authors have not supplied their decla-

ration of competing interest.