Abstract
Aims and method To systematically review the prevalence and associated factors of burnout and stress-related psychiatric disorders among UK doctors. An extensive search was conducted of PubMed, EBSCOhost and British medical journals for studies published over a 20-year span measuring the prevalence of psychiatric morbidity (using the General Health Questionnaire) and burnout (using the Maslach Burnout Inventory).Results Prevalence of psychiatric morbidity ranged from 17 to 52%. Burnout scores for emotional exhaustion ranged from 31 to 54.3%, depersonalisation 17.4 to 44.5% and low personal accomplishment 6 to 39.6%. General practitioners and consultants had the highest scores. Factors significantly associated with increase in the prevalence of burnout and psychiatric morbidity include low job satisfaction, overload, increased hours worked and neuroticism.Clinical implications The results indicate a worryingly high rate of burnout and psychiatric morbidity among UK doctors, which could have a huge negative impact on healthcare provision in general. Factors at personal and organisational levels contribute to burnout and psychiatric morbidity, and so efforts made to counter these problems should target both levels.
Highlights
Factors signi®cantly associated with increase in the prevalence of burnout and psychiatric morbidity include low job satisfaction, overload, increased hours worked and neuroticism
Certain criteria had to be met before a study was included in the units of analysis: (a) it had to answer any of the research questions (b) for the measurement of the prevalence of psychiatric morbidity, the study had to have used any version of the General Health Questionnaire (GHQ), and for the prevalence of burnout syndrome only the Maslach Burnout Inventory (MBI) was considered (c) population group - only medical doctors in the UK irrespective of which organisation they work in (d) minimum sample size of 50 (e) published between January 1993 and December 2013 (f) published in the English language
4 of the 22 studies that reported on psychiatric morbidity found prevalence of less than 21%,26,30,32,46 which is slightly better than 27% found in a study of palliative care physicians in Western Australia.[52]
Summary
Prevalence of psychiatric morbidity ranged from 17 to 52%. Burnout scores for emotional exhaustion ranged from 31 to 54.3%, depersonalisation 17.4 to 44.5% and low personal accomplishment 6 to 39.6%. Doctors have a legal duty broader than that of any other health professional and a responsibility to contribute to the effective running of the organisation in which they work, and to its future direction.[1] In an environment where their health and well-being is not prioritised doctors sometimes become ill, manifesting features of burnout and/or stress-related psychiatric disorders Such psychiatric morbidity, orcaseness', is detected using self-reported instruments such as the General Health Questionnaire (GHQ).[2] Doctors experienceburnout', which is de®ned as a syndrome of exhaustion, cynicism and low professional ef®cacy.[3] Maslach et al[4] described burnout as a prolonged response to chronic emotional and interpersonal stressors on the job, and stated: `What started out as important, meaningful, and challenging work becomes unpleasant, unful®lling, and meaningless. The objectives were to review the prevalence of the syndrome of burnout and psychiatric morbidity, to explore the nature of the relationship between burnout and psychiatric morbidity, and to identify other factors associated with the development and/or perpetuation of those conditions
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