[Work, mental disorders and burnout: concepts and developments in diagnostics, prevention and therapy].

The term burnout is associated with an intensive debate on psychological stress in the modern working environment and the potential risks for mental health imposed by working conditions. However, this important discourse on how to design working conditions is hindered by a lack of differentiation of several distinct entities: prevention of mental work strain on the one hand and treatment care for persons affected by burnout syndrome accompanied by a manifest psychiatric disorder on the other. In view of these rather different work fields several shortcomings need to be pointed out: in Germany psychosocial risk assessment and prevention of mental work strain are insufficiently carried out on a company level. Means of interventions for people with pure burnout syndrome are numerous but the evaluation in terms of efficiency and long-term effects cannot be considered satisfactory in view of the existing studies. Therapy for patients with an existing psychiatric disorder and burnout should incorporate and focus on the working context as well, for example with a corresponding facultative module. For these groups an all-encompassing stepped-care model should be developed by involving all relevant players on the company level, the political level and the healthcare system.