Distinguishing burnout from clinical depression: a theoretical differentiation template.

Abstract Background : Burnout and clinical depression have been variably viewed as synonymous or as distinctly differing entities - but with few distinguishing features provided. Failure to differentiate the two conditions can lead to compromised clinical management. We sought to enhance the differentiation of burnout and clinical depression by assembling a list of candidate differentiating features. Methods : In assembling a set of distinguishing clinical features we compared burnout states against the two principal depressive sub-types (i.e. melancholic and non-melancholic depression) rather than against ‘major depression’ per se. Our candidate features were assembled from a review of salient literature, our clinical observations and from a sub-sample of subjects who self-identified as having experienced both burnout and depression and who volunteered differentiating features. Results : We judged that burnout shares few features with melancholic depression. While burnout and non-melancholic depression share a set of symptoms, differences were greater than commonalities. Limitations : Our findings were based on clinical observation and exploratory research rather than being empirical, and thus future studies are needed to evaluate the validity of our results. Conclusions : We position burnout and clinical depression as categorically distinct and suggest that application of our nominated parameters should assist clinical differentiation of the two syndromes.