The World Health Organisation (WHO) has included the so-called burnout syndrome in the updated version of the eleventh International Classification of Diseases, which will come into force from January 2022, specifying its characteristics and diagnostic criteria in greater detail than before. According to the document, in particular, although it is not a fully-fledged illness, work-related stress (or stress caused by the absence of work) must be regarded as a syndrome or, more precisely, as one of the factors "that influence the state of health" of an individual. And one that, while not classifiable as a medical condition, can be diagnosed and may require the use of healthcare services.

What is burnout

The term burnout, which can be rendered in Italian as "esaurimento" (exhaustion), refers to a condition of stress and psychophysical distress first identified by psychologist Herbert Freudenberger in 1974. Initially it was associated with workers in the social care and healthcare sectors or, more generally, with workers in constant contact with people in difficulty: doctors, psychologists, social workers, nurses, but also educators, law enforcement officers, lawyers and so on. In these cases, burnout manifests above all as a difficulty on the part of workers in maintaining the necessary emotional detachment, and as a tendency to internalise the distress experienced by those in their care. More recently, the possibility of suffering from burnout syndrome has been extended to all categories of workers, taking on the broader connotation of work-related stress, usually linked to an excessive professional workload, to frustrating, alienating or overly stressful working conditions, to a lack of recognition (whether moral or financial) or an absence of fairness in the workplace. To a workplace that, as the WHO itself writes, is poorly managed.

The symptoms of burnout

Work-related burnout involves a state of emotional exhaustion, frustration and cynicism. Those affected gradually lose interest in and enthusiasm for their work, or even end up avoiding the workplace — consciously or otherwise — taking refuge in absenteeism. On a physical level, it can be associated with symptoms such as insomnia and physical deterioration, while on a strictly psychological level it can be accompanied by depression, alcohol or psychotropic drug abuse, and even suicidal tendencies. The absence of work, the loss of a job, or the prolonged and fruitless search for employment can also give rise to a similar psychophysical condition.

What the WHO has decided

"Burnout is included in the eleventh revision of the International Classification of Diseases (ICD-11) as an occupational phenomenon (work-related stress) – reads the World Health Organisation website – It is not classified as a medical condition (…) This condition refers specifically to phenomena occurring in the occupational context and should not be applied to experiences in other areas of life." The UN agency has also provided guidelines for doctors on diagnosis, which should be based on symptoms such as exhaustion, disengagement from work and reduced professional efficacy, and should begin with the exclusion of illnesses and other syndromes with a similar presentation. No guidance has yet been provided, however, on possible treatments, although recourse to appropriate psychological or psychotherapeutic support is advisable. This is not, in any case, the first "official" recognition of this syndrome, which was already included in the previous international classification, but the WHO has now defined it in greater detail and clarified the possibility of diagnosing it.