Burnout und/oder Depression?

Zusammenfassung

Burnout hat sich in Deutschland im klinischen Alltag etabliert, obwohl es sich nach ICD-10 lediglich um eine Zusatzdiagnose handelt und es keine allgemein gültigen Behandlungsempfehlungen gibt. Seit Jahren wird die Sinnhaftigkeit des Konstruktes „Burnout” in der Medizin diskutiert. Eine Reihe von Studien der vergangenen Jahre beschäftigte sich mit den Überschneidungen von Burnout und Depression, ohne jedoch zu einem konstruktiven Umgang mit Burnout zu gelangen. Der Artikel gibt einen Überblick über die Überschneidungen von Burnout und Depression hinsichtlich ihrer Konzepte und der bekannten neurobiologischen Mechanismen sowie über die Erkenntnisse aus Studien zur Überlappung der beiden Konstrukte. Abschließend erfolgt ein kurzer Ausblick auf mögliche künftige Forschungsansätze zur besseren Differenzierung und Therapiespezifizierung bei Burnout und Depression im Sinne der RDoC-Initiative.

Summary

Burnout has become established in clinical routine in Germany, although it is only an additional diagnosis in ICD-10 and there are no valid treatment recommendations. The function of the construct “burnout” is discussed in the medical field for years. A number of studies in the last years focused on the overlap of burnout and depression without leading to a constructive use of burnout. This article reviews the overlap of burnout and depression with regard to their conception, the neurobiological mechanisms so far known, and the findings from studies on the overlap of the both constructs. Finally a short perspective is given on possible future research, which may lead to better differentiation and specific therapeutic interventions in burnout and depression, referring to the RDoC-initiative.

Schlüsselwörter

Burnout - Depression - Überlappung

Keywords

Burnout - depression - overlap

• Literatur

• 1 Faktenblatt BKK Gesundheitsreport. 2015 Available from: URL:http://www.bkk-dachverband.de/ fileadmin/publikationen/gesundheitsatlas/FaktenblattBKKGesundheitsatlas2015.pdf.
• 2 Kurth BM. Erste Ergebnisse aus der “Studie zur Gesundheit Erwachsener in Deutschland“. (DEGS) Bundesgesundheitsblatt 2013; 55: 980-990.
• 3 Busch MA, Maske UE, Ryl L, Schlack R, Hapke U. Prävalenz von depressiver Symptomatik und diagnostizierter Depression bei Erwachsenen in Deutschland. Bundesgesundheitsblatt-Gesundheitsforschung-Gesundheitsschutz 2013; 56 (5–6): 733-739.
• 4 Rebscher H. (Hrsg.). Gesundheitsreport 2016. Analyse der Arbeitsunfähigkeitsdaten. Schwerpunkt: Gender und Gesundheit: Heidelberg: medhochzwei Verlag GmbH; 2016: 9-31.
• 5 Korczak D, Kister C, Huber B. Differentialdiagnostik des Burnout-Syndroms. HTA-Bericht 105. Köln: Deutsches Institut für Medizinische Dokumentation und Information (DIMDI). 2010: 13.
• 6 Dilling H, Mombour W, Schmidt MH, Schulte-Markwort E. (Hrsg.). Internationale Klassifikation psychischer Störungen. ICD-10 Kapitel V (F). Diagnostische Kriterien für Forschung und Praxis. Bern: Huber; 2011: 132-140.
• 7 Bahlmann J, Angermeyer MC, Schomerus G. “Burnout “statt “Depression “– eine Strategie zur Vermeidung von Stigma?. Psychiatrische Praxis 2013; 40 (02) 78-82.
• 8 Berger M, Linden M, Schramm E, Hillert A, Vo-derholzer U, Maier W. Positionspapier der Deut-schen Gesellschaft für Psychiatrie, Psychotherapie und Nervenheilkunde (DGPPN) zum Thema Burnout. Der Nervenarzt 2012; 04: 537-543.
• 9 Rydmark I, Wahlberg K, Ghatan PH, Modell S, Nygren Å, Ingvar M, Asberg M, Heilig M. Neuro-endocrine, cognitive and structural imaging char-acteristics of women on longterm sickleave with job stress–induced depression. Biological psy-chiatry 2006; 60 (08) 867-873.
• 10 Ahola K, Honkonen T, Isometsä E, Kalimo R, Ny-kyri E, Aromaa A, Lönnqvist J. The relationship between job-related burnout and depressive disorders-results from the Finnish Health 2000 Study. Journal of affective disorders 2005; 88 (01) 55-62.
• 11 Iacovides A, Fountoulakis KN, Kaprinis S, Kaprinis G. The relationship between job stress, burnout and clinical depression. Journal of affective disorders 2003; 75 (03) 209-221.
• 12 Schonfeld IS. Burnout in teachers: Is it burnout or is it depression?. 1991 Available from URL: http://www.eric.ed.gov/ PDFS/ED335329.pdf.
• 13 Shirom A. Reflections on the study of burnout. Work & Stress 2005; 19 (03) 263-270.
• 14 Glas DC, McKnight JD. Perceived control, depressive symptomatology, and professional burnout: A review of the evidence. Psychology and Health 1996; 11: 23-48.
• 15 Schaufeli W B, Enzmann D. The burnout companion to study and practice. A critical analysis. London: Taylor & Francis; 1998
• 16 Bradley HB. Communitiy-based treatment for young adults offenders. Crime and Delinquencies 1969; 15: 359-379.
• 17 Freudenberger HJ. Staff burnout. Journal of social issues 1974; 30 (01) 159-165.
• 18 Maslach C, Jackson SH. Maslach Burnout Inventory Manual. 3. Aufl. Palo Alto (CA): Consulting Psychologists Press; 1996
• 19 Rösing I. Ist die Burnout-Forschung ausgebrannt. Analyse und Kritik der internationalen BurnoutForschung. 3. Auflage. Kröning: Asanger; 2011
• 20 Burisch M. Das Burnout-Syndrom. Theorie der inneren Erschöpfung. 3. überarb. Auflage. Berlin, Heidelberg: Springer; 2006: 145-233.
• 21 Maslach C, Leiter MP. The Truth About Burnout. San Francisco: Jossey-Bass; 1997
• 22 Falkai P, Wittchen HU. (Hrsg.). American Psychiatric Association: Diagnostisches und statistisches Manual psychischer Störungen DSM-5. 1. Auflage. Göttingen: Hogrefe; 2015
• 23 Bianchi R, Boffy C, Hingray C, Truchot D, Laurent E. Comparative symptomatology of burnout and depression. Journal of Health Psychology 2013; 18 (06) 782-787.
• 24 Van Dam A, Eling PATM, Keijsers GPJ, Becker ES. Do employees with burnout prefer low-effort performance strategies?. Transactions on Occupational Ergonomics and Human Factors 2013; 01 (03) 190-201.
• 25 Maslach C, Schaufeli W, Leiter M. Job burnout. Annual Review of Psychology 2001; 52: 397-422.
• 26 Pines AM. Burnout: An existential perspective. In: Schaufeli WB, Maslach C, Marek T. (eds). Series in applied psychology: Social issues and questions. Professional burnout: Recent developments in theory and research. Philadelphia: Taylor & Francis; 1993: 33-51.
• 27 Edelwich J, Brodsky A. Burn-out: Stages of disillusionment in the helping professions. (Vol. 1). New York: Human Sciences Press; 1980: 23-28.
• 28 Demerouti E, Bakker AB, Nachreiner F, Schaufeli WB. The job demands-resources model of burnout. Journal of Applied psychology 2001; 86 (03) 499-512.
• 29 Schaufeli WB, Bakker AB. Job demands, job resources, and their relationship with burnout and engagement: A multisample study. Journal of organizational Behavior 2004; 25 (03) 293-315.
• 30 Siegrist J. Adverse health effects of high-effort/ low-reward conditions. Journal of occupational health psychology 1996; 01 (01) 27-41.
• 31 Van Vegchel N, De Jonge J, Bosma H, Schaufeli W. Reviewing the effort–reward imbalance model: drawing up the balance of 45 empirical studies. Social science & medicine 2005; 60 (05) 1117-1131.
• 32 Rasmussen V, Turnell A, Butow P, Juraskova I, Kirsten L, Wiener L, Patenaude A, Hoekstra-Weebers J, Grassi L. Burnout among psychosocial oncologists: an application and extension of the effort–reward imbalance model. Psycho Oncology. 2016. 25(2): 194-202 A316..
• 33 Loerbroks A, Meng H, Chen ML, Herr R, Angerer P, Li J. Primary school teachers in China: associations of organizational justice and effort–reward imbalance with burnout and intentions to leave the profession in a cross-sectional sample. International archives of occupational and environmental health 2014; 87 (07) 695-703.
• 34 Wang Y, Ramos A, Wu H, Liu L, Yang X, Wang J, Wang L. Relationship between occupational stress and burnout among Chinese teachers: a cross-sectional survey in Liaoning, China. International archives of occupational and environmental health 2015; 88 (05) 589-597.
• 35 Griffin J M, Greiner BA, Stansfeld SA, Marmot M. The effect of self-reported and observed job conditions on depression and anxiety symptoms: a comparison of theoretical models. Journal of occupational health psychology 2007; 12 (04) 334-349.
• 36 Larisch M, Joksimovic L, von dem Knesebeck O, Starke D, Siegrist J. Berufliche Gratifikationskrisen und depressive Symptome. Psychotherapie Psychosomatik Medizinische Psychologie 2003; 53 (05) 223-228.
• 37 Rösler U, Stephan U, Hoffmann K, Morling K, Müller A, Rau R. Psychosoziale Merkmale der Arbeit, Überforderungserleben und Depressivität. Zeitschrift für Arbeits-und Organisationspsychologie 2008; 52 (04) 191-203.
• 38 Avanzi L, Zaniboni S, Balducci C, Fraccaroli F. The relation between overcommitment and burnout: does it depend on employee job satisfaction?. Anxiety, Stress, & Coping 2014; 27 (04) 455-465.
• 39 Waldmann C, Wolfradt U, Klement A, Fuchs S, Riemenschneider H, Heise M. Zum Zusammenhang zwischen Persönlichkeitsmerkmalen und Burnout-Risiken. Prävention und Gesundheitsförderung 2017; 12 (01) 61-67.
• 40 Bühler KE, Eitel I. Biografie und Persönlichkeit bei Depressiven, sonstigen psychiatrischen Patienten und nicht-klinischen Probanden. Nervenheilkunde 2007; 26 (04) 301-308.
• 41 Jardine R. Martin NG, Henderson AS, Rao DC. Genetic covariation between neuroticism and the symptoms of anxiety and depression. Genetic Epidemiology 1984; 01 (02) 89-107.
• 42 Kendler K S, Neale MC, Kessler RC, Heath AC, Eaves LJ. A longitudinal twin study of personality and major depression in women. Archives of general psychiatry 1993; 50 (11) 853-862.
• 43 Tsutsumi A, Kayaba K, Theorell T, Siegrist J. Association between job stress and depression among Japanese employees threatened by job loss in a comparison between two complementary jobstress models. Scandinavian journal of work, environment & health 2001; 146-153.
• 44 Bowlby EJM. Loss-Sadness and Depression: Attachment and Loss. (Vol. 3) London: Random House; 2008: 245-261.
• 45 Bifulco A, Moran PM, Ball C, Bernazzani O. Adult attachment style. I: Its relationship to clinical depression. Social psychiatry and psychiatric epidemiology 2002; 37 (02) 50-59.
• 46 Hölzel L, Härter M, Reese C, Kriston L. Risk factors for chronic depression – a systematic review. Journal of affective disorders 2011; 129 (01) 1-13.
• 47 Wiersma JE, Hovens JG, van Oppen P, Giltay EJ, van Schaik DJ, Beekman AT, Penninx BW. The importance of childhood trauma and childhood life events for chronicity of depression in adults. Journal of Clinical Psychiatry 2009; 70 (07) 983-989.
• 48 Wolfersdorf M. Zur tiefenpsychologischen Psychodynamik bei der Depression. Psychotherapie 2008; 13 (01) 87-98.
• 49 Schauenburg H. Bindung und Depression. PiDPsychotherapie im Dialog 2016; 17 (03) 28-31.
• 50 Plaisier I, de Bruijn JG, de Graaf R, ten Have M, Beekman AT, Penninx BW. The contribution of working conditions and social support to the onset of depressive and anxiety disorders among male and female employees. Social science & medicine 2007; 64 (02) 401-410.
• 51 Kivimaki M, Virtanen M, Vartia M, Elovainio M, Vahtera J, Keltikangas-Jarvinen L. Workplace bullying and the risk of cardiovascular disease and depression. Occupational and Environmental Medicine 2003; 60 (10) 779-783.
• 52 Zapotoczky HG. Lerntheoretische Konzepte der Depression. Psychopathology 1976; 09 (02) 74-83.
• 53 Lewinsohn PM, Sullivan J M, Grosscup SJ. Changing reinforcing events: An approach to the treatment of depression. Psychotherapy: Theory, Research & Practice 1980; 17 (03) 322-334.
• 54 Beck AT. Thinking and depression: II. Theory and therapy. Archives of general psychiatry 1964; 10 (06) 561-571.
• 55 Gomes AR, Faria S, Gonçalves AM. Cognitive appraisal as a mediator in the relationship between stress and burnout. Work & Stress 2013; 27 (04) 351-367.
• 56 Tops M, Van Peer JM, Wijers AA, Korf J. Acute cortisol administration reduces subjective fatigue in healthy women. Psychophysiology 2006; 43 (06) 653-656.
• 57 Tops M, Boksem MA, Wijers AA, Van Duinen H, Den Boer JA, Meijman TF, Korf J. The psychobiology of burnout: are there two different syndromes?. Neuropsychobiology 2007; 55 (3–4): 143-150.
• 58 Lorist MM, Boksem MA, Ridderinkhof KR. Impaired cognitive control and reduced cingulate activity during mental fatigue. Cognitive Brain Research 2005; 24 (02) 199-205.
• 59 Van Praag HM, Korf J, Lakke JPWF, Schut T. Dopamine metabolism in depressions, psychoses, and Parkinson’s disease: the problem of the specificity of biological variables in behaviour disorders. Psychological Medicine 1975; 05 (02) 138-146.
• 60 Lambert G, Johansson M, Ågren H, Friberg P. Reduced brain norepinephrine and dopamine release in treatment-refractory depressive illness: evidence in support of the catecholamine hypothesis of mood disorders. Archives of General Psychiatry 2000; 57 (08) 787-793.
• 61 Roy A, Agren H, Pickar D, Linnoila M, Doran AR, Cutler NR, Paul SM. Reduced CSF concentrations of homovanillic acid and homovanillic acid to 5-hydroxyindoleacetic acid ratios in depressed patients: relationship to suicidal behavior and dexamethasone nonsuppression. American journal of psychiatry 1986; 143 (12) 1539-1545.
• 62 Hasler G, Drevets WC, Manji HK, Charney DS. Discovering endophenotypes for major depression. Neuropsychopharmacology 2004; 29 (10) 1765-1781.
• 63 Cannon DM, Klaver JM, Peck SA, Rallis-Voak D, Erickson K, Drevets WC. Dopamine type-1 receptor binding in major depressive disorder assessed using positron emission tomography and [11C] NNC-112. Neuropsychopharmacology 2009; 34 (05) 1277-1287.
• 64 Meyer JH, McNeely HE, Sagrati S, Boovariwala A, Martin K, Verhoeff NPL, Wilson AA, Houle S. Elevated putamen D2 receptor binding potential in major depression with motor retardation: an [11C] raclopride positron emission tomography study. American Journal of Psychiatry 2006; 163 (09) 1594-1602.
• 65 Keedwell P A, Andrew C, Williams SC, Brammer MJ, Phillips ML. The neural correlates of anhedonia in major depressive disorder. Biological psychiatry 2005; 58 (11) 843-853.
• 66 Drevets WC, Gautier C, Price JC, Kupfer DJ, Kinahan PE, Grace AA, Price JL, Mathis CA. Amphetamine-induced dopamine release in human ventral striatum correlates with euphoria. Biological psychiatry 2001; 49 (02) 81-96.
• 67 Surguladze S, Brammer MJ, Keedwell P, Giampietro V, Young AW, Travis MJ, Williams SCR, Phillips ML. A differential pattern of neural response toward sad versus happy facial expressions in major depressive disorder. Biological psychiatry 2005; 57 (03) 201-209.
• 68 Epstein J, Pan H, Kocsis J H, Yang Y, Butler T, Chusid J, Hochberg H, Murrough J, Strohmayer E, Ster E, Silbersweig DA. Lack of ventral striatal response to positive stimuli in depressed versus normal subjects. American Journal of Psychiatry 2006; 163 (10) 1784-1790.
• 69 Tremblay LK, Naranjo CA, Cardenas L, Herrmann N, Busto UE. Probing brain reward system function in major depressive disorder: altered response to dextroamphetamine. Archives of general psychiatry 2002; 59 (05) 409-416.
• 70 Harvey PO, Pruessner J, Czechowska Y, Lepage M. Individual differences in trait anhedonia: a structural and functional magnetic resonance imaging study in non-clinical subjects. Molecular psychiatry 2007; 12 (08) 767-775.
• 71 McFarland BR, Klein DN. Emotional reactivity in depression: diminished responsiveness to anticipated reward but not to anticipated punishment or to nonreward or avoidance. Depression and anxiety 2009; 26 (02) 117-122.
• 72 Henriques JB, Davidson RJ. Decreased responsiveness to reward in depression. Cognition & Emotion 2000; 14 (05) 711-724.
• 73 Elliott R, Sahakian BJ, McKay AP, Herrod JJ, Robbins TW, Paykel ES. Neuropsychological impairments in unipolar depression: the inuence of perceived failure on subsequent performance. Psychological Medicine 1996; 26: 975-989.
• 74 Ruchsow M, Herrnberger B, Beschoner P, Grön G, Spitzer M, Kiefer M. Error processing in major depressive disorder: Evidence from event-related potentials. Journal of psychiatric research 2006; 40 (01) 37-46.
• 75 Durning SJ, Costanzo M, Artino Jr AR, Dyrbye LN, Beckman TJ, Schuwirth L, Holmboe E, Roy MJ, Wittich CM, Lippner RS, van der Vleuten C. Functional neuroimaging correlates of burnout among internal medicine residents and faculty members. Frontiers in psychiatry 2013; 04: 131.
• 76 Qin S, Hermans EJ, van Marle HJ, Luo J, Fernández G. Acute psychological stress reduces working memory-related activity in the dorsolateral pre-frontal cortex. Biological Psychiatry 2009; 66 (01) 25-32.
• 77 Nakata H, Sakamoto K, Ferretti A, Perrucci MG, Del Gratta C, Kakigi R, Romani GL. Somatomotor inhibitory processing in humans: an eventrelated functional MRI study. Neuroimage 2008; 39 (04) 1858-1866.
• 78 Ciaramidaro A, Adenzato M, Enrici I, Erk S, Pia L, Bara BG, Walter H. The intentional network: how the brain reads varieties of intentions. Neuropsychologia 2007; 45 (13) 3105-3113.
• 79 Cavanna AE, Trimble MR. The precuneus: a review of its functional anatomy and behavioural correlates. Brain 2006; 129 (03) 564-583.
• 80 Spielberg JM, Miller GA, Engels AS, Herrington JD, Sutton BP, Banich MT, Heller W. Trait approach and avoidance motivation: lateralized neural activity associated with executive function. Neuroimage 2011; 54 (01) 661-670.
• 81 Bora E, Fornito A, Pantelis C, Yucel M. Gray matter abnormalities in Major Depressive Disorder: a meta-analysis of voxel based morphometry studies. Journal of Affective Disorders 2012; 138: 9-18.
• 82 Koolschijn PCMP, van Haren NE, Lensvelt GJMulders, Pol H, Hilleke E, Kahn RS. Brain volume abnormalities in major depressive disorder: A metaanalysis of magnetic resonance imaging studies. Human brain mapping 2009; 30 (11) 3719-3735.
• 83 Fitzgerald PB, Laird AR, Maller J, Daskalakis ZJ. A metaanalytic study of changes in brain activation in depression. Human brain mapping 2008; 29 (06) 683-695.
• 84 Amodio DM, Frith CD. Meeting of minds: the medial frontal cortex and social cognition. Nature reviews. Neuroscience 2006; 07 (04) 268-277.
• 85 Ridderinkhof KR, Ullsperger M, Crone EA, Nieuwenhuis S. The role of the medial frontal cortex in cognitive control. Science 2004; 306 (5695): 443-447.
• 86 Erk S, Mikschl A, Stier S, Ciaramidaro A, Gapp V, Weber B, Walter H. Acute and sustained effects of cognitive emotion regulation in major depression. Journal of Neuroscience 2010; 30 (47) 15726-15734.
• 87 Price JL, Drevets WC. Neural circuits underlying the pathophysiology of mood disorders. Trends in cognitive sciences 2012; 16 (01) 61-71.
• 88 Baxter LR, Schwartz JM, Phelps ME, Mazziotta JC, Guze BH, Selin CE, Gerner HR, Sumida RM. Reduction of prefrontal cortex glucose metabolism common to three types of depression. Archives of general psychiatry 1989; 46 (03) 243-250.
• 89 Drevets WC, Price JL, Simpson Jr JR, Todd RD, Reich T, Vannier M, Raichle ME. Subgenual prefrontal cortex abnormalities in mood disorders. Nature 1997; 386: 824-827.
• 90 Drevets WC. Neuroimaging studies of mood disorders. Biological psychiatry 2000; 48 (08) 813-829.
• 91 Sullivan RM, Gratton A. Lateralized effects of medial prefrontal cortex lesions on neuroendocrine and autonomic stress responses in rats. Journal of Neuroscience 1999; 19 (07) 2834-2840.
• 92 Nyklíček I, Pop VJ. Past and familial depression predict current symptoms of professional burnout. Journal of Affective Disorders 2005; 88 (01) 63-68.
• 93 Brenninkmeyer V, Van Yperen NW, Buunk BP. Burnout and depression are not identical twins: is decline of superiority a distinguishing feature?. Personality and individual differences 2001; 30 (05) 873-880.
• 94 Bianchi R, Schonfeld IS, Laurent E. Burnout–depression overlap: A review. Clinical psychology review 2005; 36: 28-41.
• 95 Chiu LY, Stewart K, Woo C, Yatham LN, Lam RW. The relationship between burnout and depressive symptoms in patients with depressive disorders. Journal of affective disorders 2015; 172: 361-366.
• 96 Hakanen JJ, Schaufeli WB. Do burnout and work engagement predict depressive symptoms and life satisfaction?. A three-wave seven-year prospective study. Journal of affective disorders 2012; 141 (02) 415-424.
• 97 Thomas NK. Resident burnout. Journal of the American Medical Association 2004; 292: 2880-2889.
• 98 Gottesman II, Gould TD. The endophenotype concept in psychiatry: etymology and strategic intentions. American Journal of Psychiatry 2003; 160 (04) 636-645.
• 99 Charney DS, Barlow DH, Botteron K, Cohen JD, Goldman D, Gur RE, Zalcman SJ. Neuroscience research agenda to guide development of a pathophysiologically based classification system. In: Kupfer DJ, First MB, Regier DA. (eds.). A research agenda for DSM-V. Arlington VA: American Psychiatric Association; 2002: 31-83.
• 100 Kozak MJ, Cuthbert BN. The NIMH research domain criteria initiative: background, issues, and pragmatics. Psychophysiology 2016; 53 (03) 286-297.
• 101 Yee CM, Javitt DC, Miller GA. Replacing DSM categorical analyses with dimensional analyses in psychiatry research: the research domain criteria initiative. Journal of the American Medical Association psychiatry 2015; 72 (12) 1159-1160.