The shared and dissociable aspects of burnout, depression, anxiety, and irritability in health professionals during COVID-19 pandemic: A latent and network analysis

Malu Joyce de Amorim Macedo; Clarissa Pinto Pizarro de Freitas; Mariane Bagatin Bermudez; Ana Claudia Souza Vazquez; Giovanni A Salum; Carolina Blaya Dreher

doi:10.1016/j.jpsychires.2023.09.005

The shared and dissociable aspects of burnout, depression, anxiety, and irritability in health professionals during COVID-19 pandemic: A latent and network analysis

J Psychiatr Res. 2023 Oct:166:40-48. doi: 10.1016/j.jpsychires.2023.09.005. Epub 2023 Sep 17.

Authors

Malu Joyce de Amorim Macedo¹, Clarissa Pinto Pizarro de Freitas², Mariane Bagatin Bermudez³, Ana Claudia Souza Vazquez⁴, Giovanni A Salum⁵, Carolina Blaya Dreher⁶

Affiliations

¹ Postgraduate Program in Psychiatry and Behavioral Sciences, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil. Electronic address: malumacedopsiquiatra@gmail.com.
² Postgraduate Program in Psychology, Pontíficia Universidade Católica do Rio de Janeiro (PUC-Rio), Brazil.
³ Postgraduate Program in Psychiatry and Behavioral Sciences, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil.
⁴ Department of Psychology, Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, 90050-170, RS, Brazil.
⁵ Department of Psychiatry and Forensic Medicine, Medical School, Universidade Federal do Rio Grande do Sul, Hospital de Clínicas de Porto Alegre, RS, Brazil.
⁶ Department of Psychiatry and Forensic Medicine, Medical School, Universidade Federal do Rio Grande do Sul, Hospital de Clínicas de Porto Alegre, RS, Brazil; Department of Clinical Medicine, Psychiatry, Medical School, Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, RS, Brazil.

PMID: 37738779
DOI: 10.1016/j.jpsychires.2023.09.005

Abstract

Burnout syndrome (BS) has been classified as an independent 'work-related phenomenon', however, there is still an important discussion on whether BS is a unique clinical construct due to the overlapping symptoms with other domains of negative affect such as symptoms of depression, anxiety, and irritability. Thus, we investigated the common and dissociable aspects between BS and domains of negative affect such as depression, anxiety, and irritability through a cross-sectional study with 3428 essential service professionals from a national project during the COVID-19 pandemic. Participants were assessed with Burnout Assessment Tool (BAT) and the Patient-Reported Outcomes Measurement Information System (PROMIS) scales to assess the severity of depression, anxiety, and irritability. The discriminability between the constructs was investigated using correlation tests, Bifactor Exploratory Structural Equation Modeling Bifactor (ESEM), and network analyzes. The mean correlation among the four subscales of BAT-12 was stronger with each other than with depression, anxiety, and irritability. Both ESEM and network analysis, despite showing shared characteristics, clearly delineated that Burnout domains were dissociable from other domains of negative affect. Our findings corroborate the ICD-11 strategy to include BS as a separate entity that cannot be fully explained by variance accounted for by other domains.

Keywords: Anxious symptoms; Burnout syndrome; Depressive symptoms; Differential diagnosis; Negative affect; Psychometric analysis.