Do burnout and depressive symptoms form a single syndrome? Confirmatory factor analysis and exploratory structural equation modeling bifactor analysis

Objective: The issue of burnout-depression overlap remains contentious. In this study, the question of whether burnout symptoms form a syndrome that is distinct from depression was reexamined. Methods: The study involved 332 employed individuals (65% female; mean age: 34). Burnout symptoms were assessed with the Shirom-Melamed Burnout Measure (SMBM). The SMBM operationalizes burnout based on three interconnected components, namely, physical fatigue, cognitive weariness, and emotional exhaustion. Depressive symptoms were assessed with the PHQ-9, a scale that covers the main manifestations of major depression. Confirmatory factor analysis (CFA) and exploratory structural equation modeling (ESEM) bifactor analysis were conducted. Results: On average, the factors underlying burnout's components correlated more strongly with the Depressive Symptom factor than with each other. Remarkably, such results were obtained even when fatigue-related items were excluded from the depression scale. Second-order CFA revealed that the factors underlying burnout's components and the Depressive Symptom factor were reflective of the same higher-order factor. ESEM bifactor analysis indicated that the general factor accounted for about 2/3 of the common variance extracted. Conclusion Consistent with a growing corpus of research, this study suggests that the burnout-depression distinction is untenable. Because the burnout-depression distinction tends to convey the idea that burnout is not as serious a problem as depression, many people struggling with depression might underestimate the gravity of their condition and not seek help when self-identifying as "burned out." Maintaining a line of demarcation between burnout and depression may thus be problematic from both a scientific and a health management standpoint.