title: What makes psychiatry such a stressful profession? A qualitative study.
abstract: OBJECTIVE
  We aimed to elucidate causative and protective factors associated with burnout in New Zealand psychiatrists, to identify signs and symptoms of the burnout syndrome, and to identify any difference in the perspectives of psychiatrists who scored high versus low on the emotional exhaustion (EE) subscale of the Maslach Burnout Inventory (MBI).
  
  
  METHODS
  Twelve participants were randomly selected, six from each group of psychiatrists (high versus low EE). A face-to-face interview based on a semi-structured questionnaire was carried out with each participant. The interviews were recorded and transcribed verbatim. The transcriptions were manually analysed by two independent reviewers using a grounded theory approach for qualitative analysis.
  
  
  RESULTS
  Major features of burnout were changes in appearance, behaviour and mood. Causes of burnout identified were external, internal and interpersonal factors, and changing work environment. Protective factors associated with burnout included supportive relationships, extracurricular activities, variety in one's work, a positive attitude towards one's work and high job satisfaction.
  
  
  CONCLUSIONS
  A preliminary profile of the burnout syndrome was established and has a potential role in the prevention of burnout in psychiatrists. Causative factors associated with burnout were identified and supported previous findings. Novel factors protective against burnout were suggested and require further investigation. No differences were apparent between the two subgroups of psychiatrists (high versus low EE).
authors.affiliation: Christchurch School of Medicine and Health Science, University of Otago, Christchurch, New Zealand.
authors.forename: Jesse
authors.initials: J
authors.lastname: Fischer
authors.forename: Shailesh
authors.initials: S
authors.lastname: Kumar
authors.forename: Simon
authors.initials: S
authors.lastname: Hatcher
mesh_terms: D002055:Burnout, Professional; D006801:Humans; D007407:Interviews as Topic; D007588:Job Satisfaction; D009520:New Zealand; D010361:Patients; D011570:Psychiatry / Q000706:statistics & numerical data*