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Burnout and psychiatric morbidity among doctors in the UK: A systematic literature review of prevalence and associated factors
Open accessAbstract
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.
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Levels of psychological distress and burnout among healthcare staff are high.
“High levels of burnout and distress are a long-standing concern in the healthcare workforce [1].”
From A workplace Acceptance and Commitment Therapy (ACT) intervention for improving healthcare staff psychological distress: A randomised controlled trial (2022) · cites this paper as [1]
The Abstract reports worryingly high rates of burnout and psychiatric morbidity among UK doctors, drawing on studies published over a 20-year span. That supports a long-standing concern about doctors, but the review does not establish high levels across the healthcare workforce generally. (LLM, conf=0.83)
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“3% of doctors reported a high level of emotional exhaustion before COVID-19 pandemic, not to mention the extreme turmoil condition after pandemic (Imo, 2017).”
BackgroundInfluentialPhysician burnout in Nigeria: a multicentre, cross-sectional study
Nwosu, A. D. G., Ossai, E. N., Mba, U. C., Anikwe, I., Ewah, R. L., Obande, B. O., & Achor, J. U. (2020) · BMC Health Services Research · doi:10.1186/s12913-020-05710-8 · Cited by 48
Job stress among GPs: associations with practice organisation in 11 high-income countries
Cohidon, C., Wild, P. P., & Senn, N. (2020) · British Journal of General Practice · doi:10.3399/bjgp20x710909 · Cited by 50
Wang, H., Zhou, X., Jia, X., Song, C., Luo, X., Zhang, H., Wu, H., & Ye, J. (2021) · BMC Public Health · doi:10.1186/s12889-021-10891-w · Cited by 44
“the COVID-19 pandemic [3], and as such, exhaustion is”
BackgroundYoussef, D., Youssef, J., Abbas, L. A., Kawtharani, M., & Hassan, H. (2022) · Scientific Reports · doi:10.1038/s41598-022-16095-5 · Cited by 48
Mental health among healthcare workers during the COVID ‐19 pandemic
Smallwood, N., & Willis, K. F. (2021) · Respirology · doi:10.1111/resp.14143 · Cited by 41
Baldwin, S., & George, J. (2021) · BMJ Open · doi:10.1136/bmjopen-2021-054377 · Cited by 39
Witczak-Błoszyk, K., Krysinska, K. E., Andriessen, K., Stańdo, J., & Czabański, A. (2022) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph19031156 · Cited by 41
“In particular, physicians reported higher levels of psycho-physical exhaustion and often used an emotion-oriented coping style, a result reported in previous studies [57,58].”
ResultWright, B., & Richmond Mynett, J. (2019) · BMC Medical Education · doi:10.1186/s12909-019-1712-x · Cited by 38
Payne, A., Rahman, R., Bullingham, R., Vamadeva, S. V., & Alfa‐Wali, M. (2020) · Journal of surgical education · doi:10.1016/j.jsurg.2020.09.009 · Cited by 37
Doctors’ working conditions, wellbeing and hospital quality of care: A multilevel analysis
Teoh, K., Hassard, J., & Cox, T. (2020) · Safety Science · doi:10.1016/j.ssci.2020.105115 · Cited by 35
Martland, R. N., Ma, R., Paleri, V., Valmaggia, L., Riches, S., Firth, J., & Stubbs, B. (2024) · Mental Health and Physical Activity · doi:10.1016/j.mhpa.2024.100577 · Cited by 35
Cohidon, C., Wild, P. P., & Senn, N. (2019) · The Annals of Family Medicine · doi:10.1370/afm.2449 · Cited by 33
“(2) Coordination factors, including working with a case manager, inter-consultation contacts with patients, delays regarding hospital discharge, and care coordination with hospitals and social care institutions.”
BackgroundMental wellbeing and burnout in surgical trainees: implications for the post-COVID-19 era
Kadhum, M., Farrell, S., Hussain, R., & Molodynski, A. (2020) · British journal of surgery · doi:10.1002/bjs.11726 · Cited by 33
Atroszko, P. A., & Atroszko, B. (2020) · Amfiteatru Economic · doi:10.24818/ea/2020/s14/1265 · Cited by 32
Roberts, T., Daniels, J., Hulme, W., Hirst, R., Horner, D., Lyttle, M., Samuel, K., Graham, B., Reynard, C., Barrett, M., et al. (2021) · Emergency Medicine Journal · doi:10.1136/emermed-2020-210438 · Cited by 31
Burnout and depression of medical staff: A chain mediating model of resilience and self-esteem.
Hao, S.-M. (2023) · Journal of Affective Disorders · doi:10.1016/j.jad.2022.12.153 · Cited by 30
Medical students, mental health and the role of resilience – A cross-sectional study
Healy, C., Ryan, Á., Moran, C. N., Harkin, D. W., Doyle, F., & Hickey, A. (2022) · Medical Teacher · doi:10.1080/0142159x.2022.2128735 · Cited by 30
“Burnout, a syndrome conceptualized as resulting from unsuccessfully managed chronic workplace stress (World Health Organization 2019), is common in the medical profession (Imo 2017).”
BackgroundAusterity measures and the transforming role of A&E professionals in a weakening welfare system
Kerasidou, A., & Kingori, P. (2019) · PLoS ONE · doi:10.1371/journal.pone.0212314 · Cited by 30
Burnout in the medical profession: not a rite of passage
Baigent, M. F., & Baigent, R. (2018) · The Medical Journal of Australia · doi:10.5694/mja17.00891 · Cited by 29
Hunter, R., Willis, K. F., & Smallwood, N. (2022) · Internal Medicine Journal · doi:10.1111/imj.15720 · Cited by 30
Cakirpaloglu, S. D., Cakirpaloglu, P., Skopal, O., Kvapilová, B., Schovankova, T., Vévodová, Š., Greaves, P. J., & Steven, A. (2024) · Frontiers in Psychology · doi:10.3389/fpsyg.2024.1415996 · Cited by 38
“Our findings align with those of various studies (Imo, 2017; Molina-Praena et al., 2018).”
BackgroundResultInfluentialSharma, D., Mathur, S., Solanki, R., & Goyal, M. K. (2020) · Indian Journal of Medical Specialities · doi:10.4103/injms.injms_77_20 · Cited by 42
Nørøxe, K. B., Pedersen, A. F., Carlsen, A. H., Bro, F., & Vedsted, P. (2019) · BMJ Quality & Safety · doi:10.1136/bmjqs-2018-009039 · Cited by 29
Krishnan, A., Odejimi, O., Bertram, I., Chukowry, P. S., & Tadros, G. (2022) · BMC Psychology · doi:10.1186/s40359-022-00868-8 · Cited by 27
“Background Burnout and psychiatric morbidity has been identified to be prevalent and worryingly high amongst doctors in the United Kingdom (UK) [1].”
BackgroundFalade, J., Oyebanji, A. H., Babatola, A. O., Falade, O. O., & Ojo, T. O. (2020) · Pan African Medical Journal · doi:10.11604/pamj.2020.37.53.24994 · Cited by 28
“Other public medical institutions in Ni prevalences [29, 30].”
BackgroundDawson, J., McCarthy, I., Taylor, C., Hildenbrand, K., Leamy, M. C., Reynolds, E., & Maben, J. (2021) · BMC Health Services Research · doi:10.1186/s12913-021-06413-4 · Cited by 24
Golder, S., Jefferson, L., McHugh, E., Essex, H. N., Heathcote, C., Avila, A. C., Dale, V., Feltz-Cornelis, C. M. V. D., & Bloor, K. E. (2021) · medRxiv · doi:10.1101/2021.10.19.21265194 · Cited by 24
Meditation and mental health apps: relaxation, yoga, and meditation apps
Gál, É. (2023) · Elsevier eBooks · doi:10.1016/b978-0-323-99271-8.00013-9 · Cited by 23
Eldercare’s Turnover Intention and Human Resource Approach: A Systematic Review
Jurij, R., Ismail, I. R., Alavi, ., & Alavi, R. (2023) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph20053932 · Cited by 23
“The job burnout element constituting physical and emotional exhaustion leads to negative implications that could affect other colleagues, induce an undesirable working environment, and incite workers to resign [62,64].”
BackgroundPopa-Velea, O., Diaconescu, L. V., Gheorghe, I.-R., Olariu, O., Panaitiu, I., Cerniţanu, M., Goma, L., Nicov, I., & Spinei, L. (2019) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph16132382 · Cited by 23
“5% [2,3], depending on the type of measurement, timing, country and specialty [4–8].”
BackgroundMargiotta, F., Crudden, G., Byrne, D., & Doherty, A. M. (2018) · Irish Journal of Medical Science (1971 -) · doi:10.1007/s11845-018-1886-y · Cited by 24
Spányik, A., Simon, D., Rigó, A., Griffiths, M. D., & Demetrovics, Z. (2022) · PLoS ONE · doi:10.1371/journal.pone.0270156 · Cited by 28
Hvidt, E. A., Pedersen, L. B., Lykkegaard, J., Pedersen, K. M., & Andersen, M. K. K. (2019) · Health An Interdisciplinary Journal for the Social Study of Health Illness and Medicine · doi:10.1177/1363459319857461 · Cited by 22
Impact of COVID-19 on the mental health of surgeons and coping strategiesPreprint
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Son, H. S., Kim, K., Cho, I., Lee, J., Choi, J. M., Kil, K., Kim, J.-H., Hong, Y., Ahn, M. H., & Chung, S. (2022) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2021.735016 · Cited by 20
“Work-Related Stress and Anxiety and Organizational Commitment of Healthcare Workers in the COVID-19 Pandemic The healthcare workers are among the most important people during major public health issues, they have made great contributions to epidemic prevention work and have experienced negative psychological adjustmen…”
BackgroundApplying self‐determination theory to stem medical schools' clinical teacher sustainability crisis
Hirsh, D. A., Crampton, P. E. S., & Osman, N. Y. (2023) · Medical Education · doi:10.1111/medu.15181 · Cited by 25
“15 These crises affect our diverse faculty differently: Groups typically underrepresented in medicine have lower rates of matriculation 16 and higher rates of attrition 17 across the medical education continuum.”
BackgroundBurnout y malestar psicológico en los residentes de Medicina Familiar y Comunitaria
Ovejas-López, A., Izquierdo, F., Rodríguez-Barragán, M., Rodríguez-Benítez, J., Garcia-Batanero, M., Alonso-Martínez, M., & Alonso-Masanas, C. (2020) · Atención Primaria · doi:10.1016/j.aprim.2020.02.014 · Cited by 20
Andah, E., Essang, B., Friend, C., Greenley, S. L., Harvey, K., Spears, M., & Reeve, J. L. (2021) · BJGP Open · doi:10.3399/bjgpo.2021.0005 · Cited by 19
Increased risk of health professionals to feel traumatized during the COVID-19 pandemic
Pinto, A. L. D. C. B., Serpa, A. L. D. O., de Paula, J. J., Costa, D. S., Robis, K. P., Díaz, A. P., Joaquim, R. M., da Silva, A. G., de Miranda, D. M., & Malloy‐Diniz, L. F. (2021) · Scientific Reports · doi:10.1038/s41598-021-97783-6 · Cited by 22
Whitehead, I. O., Moffatt, S. M., Jagger, C., & Hanratty, B. (2022) · PLoS ONE · doi:10.1371/journal.pone.0276739 · Cited by 19
“There is a dearth of data from UK GPs using the ‘gold standard’ measure of burnout, as shortened versions of the MBI or self-rating have been more commonly used [35].”
BackgroundGriffin, L., & Riley, R. A. (2022) · BMJ Open · doi:10.1136/bmjopen-2021-055804 · Cited by 22
Performance anxiety among surgeons
Hotton, M., Miller, R., & Chan, J. (2018) · Bulletin of The Royal College of Surgeons of England · doi:10.1308/rcsbull.2019.20 · Cited by 19
Burnout among Croatian physicians: a cross-sectional national survey
Japec, V. P., Vučemilo, L., Kust, D., Babacanli, A., Dodig, D., Štefančić, V., Vučur, K., Brechelmacher, A., Katavić, M., Luetić, K., et al. (2019) · Croatian Medical Journal · doi:10.3325/cmj.2019.60.255 · Cited by 19
“This finding could be concordant to the research that showed front-line care specialties such as emergency, family, and internal medicine to be at the highest risk (22,27).”
Burnout and resilience at work among health professionals serving in tertiary hospitals, in Ethiopia
Gelaw, Y. M., Kashtan, H., & Adini, B. B. (2023) · Frontiers in Public Health · doi:10.3389/fpubh.2023.1118450 · Cited by 20
“Similarly, a study in the United Kingdom (UK) reported a high prevalence of burnout among participants with high work overload (10).”
BackgroundJanes, G., Harrison, R., Johnson, J., Simms‐Ellis, R., Mills, T., & Lawton, R. (2021) · Journal of Evaluation in Clinical Practice · doi:10.1111/jep.13555 · Cited by 18
Kirykowicz, K., Jaworski, B. K., Owen, J. E., Kirschbaum, C., Seedat, S., & van den Heuvel, L. L. (2023) · Psychiatry Research · doi:10.1016/j.psychres.2023.115493 · Cited by 19
“…(HCWs) globally (Shanafelt et al., 2015; Bridgeman et al., 2018; O ’ Connor et al., 2018) and can lead to serious consequences such as poor patient care and medical errors, as well as personal consequences, including substance abuse, broken relationships and suicide (Imo, 2017; de Hert, 2020).”
BackgroundDaniels, J., Ingram, J. C., Pease, A. S., Wainwright, E. M., Beckett, K., Iyadurai, L., Harris, S., Donnelly, O., Roberts, T., & Carlton, E. W. (2021) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph18189675 · Cited by 17
“Doctors are likely to benefit from specialist services and interventions tailored to their needs due to the well-documented barriers they perceive to accessing psychological support [25] and the high rates of burnout and distress already prevalent in this group [26].”
BackgroundSocial prescribing for stress related disorders and brain health
Fixsen, A. M., & Polley, M. J. (2019) · International review of neurobiology · doi:10.1016/bs.irn.2019.11.005 · Cited by 18
Lagunes-Córdoba, E., Shale, S., Evans, R. C., & Tracy, D. K. (2021) · BMJ Leader · doi:10.1136/leader-2020-000395 · Cited by 15
Impact of intrawork rest breaks on doctors’ performance and well-being: systematic review
O’Neill, A., Baldwin, D. S., Cortese, S., & Sinclair, J. (2022) · BMJ Open · doi:10.1136/bmjopen-2022-062469 · Cited by 18
Tailoring EHRs for Specific Working Environments Improves Work Well-Being of Physicians
Vainiomäki, S., Heponiemi, T., Vänskä, J., & Hyppönen, H. (2020) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph17134715 · Cited by 14
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Atroszko, P. A. (2022) · Studies in neuroscience, psychology and behavioral economics · doi:10.1007/978-3-031-04772-5_9 · Cited by 14
Healthcare workers’ perceptions of strategies supportive of their mental health
Maple, J., Willis, K. F., Lewis, S. C., Putland, M., Baldwin, P. A., Bismark, M., Harrex, W., Johnson, D. F., Karimi, L., & Smallwood, N. (2024) · Journal of Medicine Surgery and Public Health · doi:10.1016/j.glmedi.2024.100049 · Cited by 14
Pascoe, A., Johnson, D., Putland, M., Willis, K., & Smallwood, N. (2022) · Journal of Occupational and Environmental Medicine · doi:10.1097/jom.0000000000002505 · Cited by 12
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Need for recovery and physician well-being in emergency departments: national survey findings
Cottey, L., Roberts, T., Graham, B., Horner, D. E., Latour, J. M., Enki, D. G., Lyttle, M. D., & Stevens, K. N. (2021) · European Journal of Emergency Medicine · doi:10.1097/mej.0000000000000850 · Cited by 12
“[5,29] The response to this question likely represents the personal impact of what is reported more broadly in EDs, with high workloads, concerns about crowding and patient care delivery frequently highlighted.”
Hirayama, Y., Khan, S., Gill, C., Thoburn, M., Hancox, J., & Muzaffar, J. (2024) · Future Healthcare Journal · doi:10.1016/j.fhj.2024.100195 · Cited by 12
Does reverse mentoring work in the NHS: a feasibility study of clinicians in practice
Raju, S. A., Ching, H., Jalal, M., Lau, M. S. Y., Rej, A., Tai, F. W. D., Tun, G. S. Z., Hopper, A. D., McAlindon, M. E., Sidhu, R., et al. (2022) · BMJ Open · doi:10.1136/bmjopen-2022-062361 · Cited by 11
Workplace support for newly qualified doctors and secondary school teachers: A comparative analysis
Foster‐Collins, H., Mattick, K. L., & Baumfield, V. M. (2023) · British Educational Research Journal · doi:10.1002/berj.3879 · Cited by 10
Wang, Y., Wu, L., Liu, C., Li, K., Wang, M., Feng, T., Wang, Q., Chao, W., Ren, L., & Liu, X. (2024) · BMC Nursing · doi:10.1186/s12912-024-01751-0 · Cited by 14
Metadata
- Authors
- Imo, U. O.
- Affiliations
- Royal Oldham Hospital (GB)
- Corresponding author
- Imo, Udemezue O.
- Venue
- BJPsych Bulletin
- Publisher
- Royal College of Psychiatrists
- Published
- 2017-08
- Volume
- 41
- Issue
- 4
- Pages
- 197-204
- ISSN
- 2056-4694 (ISSN-L)
- 2056-4708
- PMC
- PMC5537573
- OpenAlex
- W2583895290
- Cited by
- 268
- References
- 57
- Citations by year
- 2026: 10 · 2025: 22 · 2024: 29 · 2023: 35 · 2022: 43 · 2021: 51 · 2020: 41 · 2019: 23 · 2018: 12 · 2017: 2
- FWCI
- 3.76
- Type
- journal article
- Language
- en
- Open access
- diamond
- doi.org
- Locations
- BJPsych Bulletin (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Health Professions › General Health Professions › Healthcare professionals’ stress and burnout
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Occupational Health and Burnout
- Social Sciences › Psychology › Social Psychology › Stress and Burnout Research
- Keywords
- burnout, psychiatric morbidity, physicians, emotional exhaustion, depersonalization, personal accomplishment, job satisfaction, workload, neuroticism, general practitioners, consultants, prevalence, associated factors, occupational stress
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