Burnout and depression in nurses: a systematic review and meta-analysis
Abstract
Background Nurses work in stressful and demanding settings and often suffer from depression and burnout. Despite overlapping symptoms, research has been inconclusive regarding the discriminant validity of measures of burnout with regard to measures of depression. Such inconclusive discriminant validity might cause clinicians to fail to recognize and manage depression separately from burnout.Objectives This meta-analysis aimed to clarify the distinctiveness of burnout as a separate construct by examining the size of the relationship between burnout and depression among nurses as well as potential moderators.Method A stepwise method was used by searching 4 databases (PubMed, CINAHL, PsycINFO, and EMBASE) to retrieve published papers in English examining the relationship between burnout and depression among nurses and reporting the effect sizes of their findings.Results We identified a total of 37 eligible studies. The pooled estimate showed a positive association between burnout and depression among nurses (r = 0.403, 95% CI [0.327, 0.474], p < 0.0001) and a slightly higher correlation coefficient for the Emotional Exhaustion subscale of the Maslach Burnout Inventory (MBI) measure (0.494, 95% CI [0.41, 0.57]).Conclusions and implications This review confirms a large burnout - depression correlation in nursing samples, adding to existing literature encompassing a variety of occupations. Future studies should focus on path analysis to assess the causal relationship as well as investigate potential moderators.
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Previous studies relate cognitive fusion and depression to emotional exhaustion, and low levels of resilience with burnout.
“This is consistent with previous studies that relate cognitive fusion (54) and depression (49, 52) to emotional exhaustion, and low levels of resilience with burnout (55, 56).”
From Evolution of burnout syndrome in Spanish healthcare professionals during and after the COVID-19 pandemic: psychosocial variables involved (2025) · cites this paper as [49]
The exponential increase in emotional exhaustion at the onset of the COVID-19 pandemic in HCW has been attributed to increased workload, lack of resources, fear of contagion, and generalized uncertainty.
“This exponential increase in emotional exhaustion at the onset of the COVID-19 pandemic in HCW has been attributed to increased workload, lack of resources, fear of contagion, and generalized uncertainty (49–51).”
From Evolution of burnout syndrome in Spanish healthcare professionals during and after the COVID-19 pandemic: psychosocial variables involved (2025) · cites this paper as [49]
Emotional exhaustion is initially the most affected component of burnout.
“it is initially the most affected component (49–51), as our findings show.”
From Evolution of burnout syndrome in Spanish healthcare professionals during and after the COVID-19 pandemic: psychosocial variables involved (2025) · cites this paper as [49]
Emotional exhaustion is closely related to levels of depressive symptomatology, especially in the early stages of the pandemic.
“According to the existing literature, emotional exhaustion is closely related to levels of depressive symptomatology, especially in the early stages of the pandemic (49, 52).”
From Evolution of burnout syndrome in Spanish healthcare professionals during and after the COVID-19 pandemic: psychosocial variables involved (2025) · cites this paper as [49]
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- Authors
- Chen, C., & Meier, S. T.
- Affiliations
- University at Buffalo, State University of New York (US)
- Corresponding author
- Chen, Chiahui
- Venue
- International Journal of Nursing Studies
- Publisher
- Elsevier BV
- Published
- 2021-12
- Volume
- 124
- Pages
- 104099
- ISSN
- 0020-7489 (ISSN-L)
- OpenAlex
- W3203781834
- Cited by
- 246
- References
- 74
- Citations by year
- 2026: 45 · 2025: 74 · 2024: 60 · 2023: 45 · 2022: 21 · 2021: 1
- FWCI
- 7.87
- Type
- journal article
- Language
- en
- Update notices
- erratum (2022-03-01)
- Open access
- closed
- Licence
- Locations
- International Journal of Nursing Studies (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Health Professions › Occupational Therapy › Occupational Health and Burnout
- Social Sciences › Psychology › Social Psychology › Stress and Burnout Research
- Health Sciences › Health Professions › General Health Professions › Healthcare professionals’ stress and burnout
- Keywords
- burnout, depression, nurses, emotional exhaustion, Maslach Burnout Inventory, discriminant validity, occupational stress, nursing workforce
- MeSH terms
- Burnout, Psychological, Burnout, Professional, Depression, Emotions, Humans, Nurses
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Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
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