Burnout–Depression Overlap: Exploratory Structural Equation Modeling Bifactor Analysis and Network Analysis

Abstract

Burnout has been viewed as a work-induced condition combining exhaustion, cynicism, and professional inefficacy. Using correlational analyses, an exploratory structural equation modeling bifactor analysis, structural regression analyses, and a network analysis, we examined the claim that burnout should not be mistaken for a depressive syndrome. The study involved 1,258 educational staff members. Burnout was assessed with the Maslach Burnout Inventory–General Survey and depression with the Patient Health Questionnaire–9 and the Hospital Anxiety and Depression Scale. Illegitimate work tasks and work–nonwork interferences were additionally measured. We notably found that (a) on average, exhaustion, cynicism, and professional inefficacy correlated less strongly with each other than with depression; (b) exhaustion―burnout’s core―was more strongly associated with depression than with either cynicism or professional inefficacy; (c) the Patient Health Questionnaire–9 did not correlate more strongly with the Hospital Anxiety and Depression Scale than with exhaustion; (d) exhaustion and depression loaded primarily on a general distress/dysphoria factor in the exploratory structural equation modeling bifactor analysis; (e) on average, burnout and depression were related to job stressors in a similar manner; (f) work–nonwork interferences were strongly linked to distress/dysphoria. Overall, burnout showed no syndromal unity and lacked discriminant validity. Clinicians should systematically assess depressive symptoms in individuals presenting with a complaint of “burnout.”