Suffering from ‘burnout’? So-called alternative medicine can help!

Suffering from ‘burnout’? Mindfulness, yoga, and acupuncture are just three of a plethora of practices that are said to improve ‘burnout’. While there is growing interest in these practices, many employers remain sceptical about their benefits and are hesitant to invest resources in implementing them.

This meta-analysis examined the impact of these practices on burnout and explored potential moderators. The authors followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines to ensure comprehensive and transparent reporting in the identification of eligible studies. Overall, 21 studies were included (8 on mindfulness, 7 on yoga, and 6 on acupuncture), all involving independent samples, with a total of 1,364 participants.

The meta-analytic results showed that all three therapeutic practices have consistent and beneficial effects on reducing burnout. Furthermore, moderation analyses indicated that mindfulness interventions conducted within the work schedule have a significant reduction in burnout, while acupuncture interventions with between 4 or 8 weeks (the more weeks, the better) also reduced burnout. However, no significant moderation effect was observed for yoga interventions.

The authors concluded that overall, the findings provide insights into the effectiveness of these complementary practices in reducing burnout and highlight the need for further research in this area.

As a co-author of the ‘PRISMA’ guidelines, I can assure you that this review did not follow them. I can also assure you that the primary studies are mostly of poor quality and that therefore the evidence for the three therapies is far from conclusive.

But this is not what I want to dwell upon today. I prefer to focus on the diagnosis of ‘burnout‘.

‘Burnout’ may be popular (Medline listed ~300 articles on the subject in the year 2000, while last year the figure had increased to well over 3 000), but it is not a formal diagnosis in clinical frameworks like the DSM-5 or ICD-10. Despite this undeniable fact, ‘burnout’ is now widely used as a psychological and occupational syndrome. ‘Burnout’ is characterized by emotional exhaustion, depersonalization and reduced personal accomplishment, often related to chronic workplace stress. The WHO includes ‘burnout’ in the ICD-11 (code QD85) as an occupational phenomenon, not a medical condition. It is supposed to be quantifiable through tools like the Maslach Burnout Inventory (MBI). ‘Burnout’ overlaps with conditions like depression, anxiety, or adjustment disorders.

‘Burnout’ might thus not even be a distinct entity; symptoms like fatigue or low motivation are certainly not unique. Often ‘burnout’ seems merely to be a buzzword for dysstress. Its validity hinges on self-reporting and clinician judgment and there is no way to confirm anyone’s subjective notion of suffering from ‘burnout’.In other words, people who are a bit stressed and fed up with their work situation can self-diagnose to be ‘burnout’ victims, and nobody can prove them to be wrong.

In view of all this, I ask myself, who would be surprised that mindfulness, yoga, and acupuncture can be shown (in studies of dubious methodological quality) to be effective for ‘burnout’?

It is not hard to predict that many more studies will follow and show that virtually every so-called alternative medicine (SCAM) under the sun is helpful for ‘burnout’ (already, Medline lists ~700 papers on ‘alternative medicine for burnout’). After all, nothing is easier to cure than a condition that did not exist in the first place!