Burnout is substantially associated with paranoid ideation; emotional exhaustion correlated as strongly with paranoid ideation as it correlated with depersonalization

Burnout, depression and paranoid ideation: a cluster-analytic study. R Bianchi, L Janin
Occupational Medicine, Volume 69, Issue 1, Feb 7 2019, Pages 35–38, https://doi.org/10.1093/occmed/kqy150. Correction: https://doi.org/10.1093/occmed/kqy177

Abstract
Background: A link between burnout and paranoid ideation has long been suspected. However, systematic research on the association has been scarce.

Aims: We investigated the relationship between burnout and paranoid ideation. Because burnout overlaps with depression, depression was also examined.

Methods: A total of 218 Swiss schoolteachers participated in the study (58% female; mean age: 47). Burnout symptoms were assessed with the emotional exhaustion (EE) and depersonalization (DP) subscales of the Maslach Burnout Inventory-Educators Survey, depressive symptoms with the PHQ-9 and paranoid ideation with the Green et al. Paranoid Thought Scales.

Results: Burnout, depression and their subdimensions showed raw correlations ranging from 0.42 to 0.55 with paranoid ideation. Burnout, depression and paranoid thoughts were found to cluster together. Lower levels of burnout and depression coexisted with lower levels of paranoid ideation and higher levels of burnout and depression coexisted with higher levels of paranoid ideation. When corrected for measurement error, the correlations of EE with depression and DP were 0.96 and 0.57, respectively. A principal component analysis confirmed that EE was indistinguishable from depression.

Conclusions: Burnout is substantially associated with paranoid ideation. Interestingly, EE correlated as strongly with paranoid ideation as it correlated with DP. Moreover, if burnout is a syndrome of EE and DP that excludes depression, then the EE-depression correlation should not be close to 1 and EE should not correlate more strongly with depression than with DP. These basic requirements for construct distinctiveness and syndromal unity were not satisfied.

Keywords: Dysphoria, exhaustion, health, mood, paranoia, personality, suicidal ideation, work stress