title: Joint effect of chronic medical illness and burnout on depressive symptoms among employed adults.
abstract: OBJECTIVE
  Chronic medical illnesses (CMIs) are prevalent in nearly half the working population and are associated with a two-fold risk for developing depression. Burnout is a chronic affective state comprised of symptoms of emotional exhaustion, physical fatigue, and cognitive weariness. It is an outcome of depletion of energetic resources resulting from prolonged exposure to work and life stresses. Building upon the Conservation of Resources theory (Hobfoll, 1989), this prospective study was designed to test the hypothesis that CMI interacts with burnout to facilitate the development of depressive symptoms.
  
  
  METHODS
  Participants were 4,861 employed men and women, aged 19 to 67 years, who came for routine health examinations and were followed for 18 months on average. Forty-seven percent reported having one or more diagnosed CMIs.
  
  
  RESULTS
  Burnout was found to predict an increase in depressive symptoms in apparently healthy individuals. Furthermore, the coexistence of burnout in employees with a CMI accelerates the process of developing depressive symptoms within a relatively short period. Burnout was also found to be associated with intensification of preexisting depressive symptoms in employees suffering from different chronic medical conditions (other than cancer), independent of medical comorbidities and other potent confounding variables.
  
  
  CONCLUSIONS
  Among employees, coexistence of burnout and at least one CMI predicts an increase in depressive symptoms with time. Health care professionals should be made aware of such at-risk employees and follow and manage them closely.
authors.affiliation: Department of Psychology.
authors.forename: Galit
authors.initials: G
authors.lastname: Armon
authors.affiliation: Academic College of Tel-Aviv-Yaffo.
authors.forename: Samuel
authors.initials: S
authors.lastname: Melamed
authors.affiliation: Faculty of Management, Tel-Aviv University.
authors.forename: Sharon
authors.initials: S
authors.lastname: Toker
authors.affiliation: Tel-Aviv Sourasky Medical Center.
authors.forename: Shlomo
authors.initials: S
authors.lastname: Berliner
authors.affiliation: Tel-Aviv Sourasky Medical Center.
authors.forename: Itzhak
authors.initials: I
authors.lastname: Shapira
mesh_terms: D000328:Adult; D000368:Aged; D002055:Burnout, Professional / Q000453:epidemiology / Q000523:psychology*; D002908:Chronic Disease / Q000453:epidemiology / Q000523:psychology*; D015897:Comorbidity; D003863:Depression / Q000453:epidemiology*; D004651:Employment / Q000523:psychology* / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011446:Prospective Studies; D012306:Risk; D013315:Stress, Psychological / Q000523:psychology