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Notwithstanding its large burden and costs, burnout (see Nature 591, 489–491; 2021) remains an elusive concept.

Burnout research “tends to be patchy, applies a range of different instruments … and is not always carried out by the most authoritative organizations”. That was the conclusion of a 2018 report by the European Foundation for the Improvement of Living and Working Conditions (see go.nature.com/2nw2jh3). There are no agreed diagnostic criteria; burnout differs from prolonged fatigue in its prognosis and risk factors. There are no robust biomarkers; disciplines have their own definitions of burnout, and self-reporting questionnaires use different cut-off values (L. S. Rotenstein et al. J. Am. Med. Assoc. 320, 1131–1150; 2018). Particularly at the more severe end of the spectrum, burnout overlaps considerably with depression (R. Bianchi et al. Am. J. Psychiatry 176, 79; 2019).

On top of this, countries vary in the status they assign to burnout. In some nations — the Netherlands is one — burnout is a recognized disease. In others, including the United States, it is mainly regarded as a non-medical syndrome, with obvious implications for insurance.

To recognize, prevent and treat burnout for individuals, professionals, organizations and society, an integrated scientific framework will be pivotal.



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