Health professionals have new recommendations to identify and treat burnout, then allow the return to work.
Burn-out: “subject to debate and controversy”. In his news recommendations, the High Authority of Health (HAS) warns that it is tackling a heated question. But it is a question of going “beyond” these debates to promote the management of a very real evil, which would affect three million people in France.
In fact, “burnout syndrome can have serious consequences on people’s lives and requires medical treatment,” underlines the HAS. But this syndrome, by its various and transverse manifestations, can be difficult to spot. It is “sometimes wrongly diagnosed or confused with other mental disorders” and thus inadequately treated.
Spot the signs
Hence the need for recommendations in order to help treating physicians and occupational physicians to diagnose burnout, deal with it in an appropriate manner and support the return to work.
Initially, it is a question of “identifying the manifestations of burn-out”, even though they may differ from one individual to another, settle gradually and resemble those linked to other disorders. psychic or physical.
“These main symptoms are both emotional (anxiety, sadness, hypersensitivity, absence of emotion, etc.), cognitive (memory, attention, concentration disorders, etc.), behavioral or interpersonal. (social isolation, aggressive or violent behavior, decrease in empathy, addictive behavior …), motivational (disengagement, professional questioning, devaluation …) than physical (sleep disorders, musculoskeletal disorders, gastrointestinal intestinal …) ”, notes the HAS.
Analyze working conditions
The doctor should therefore identify all these manifestations before ruling out the hypothesis of a physical illness. Then, it “will be necessary to judge their severity and to evaluate in priority the suicidal risk”, recommends the HAS.
Health professionals are also invited to analyze working conditions and individual factors in order to establish the correct diagnosis. As the identifiable symptoms are not specific to burn-out, the doctor must thoroughly examine the working conditions of his patient (intensity and organization of work, emotional demands, autonomy and room for maneuver, relationships at work, conflicts of values , job insecurity).
He is also asked to take an interest in the patient’s experience, his personal and family history (in particular depressive history), the events that have occurred in his personal life, the support he has in his entourage, and the relationship he has with work.
“The comparison of these different analyzes will make it possible to establish or not the diagnosis of burn-out. This will make it possible to differentiate it from other mental disorders (depression, anxiety disorders, post-traumatic stress) or to establish that they coexist with it. The help of a psychiatrist may be requested at this stage ”.
Customize support
The HAS insists on the need to personalize care, by trying not to systematically resort to antidepressants. “The management of burn-out must be individualized according to the manifestations observed, any associated pathologies identified, the history of the patient and his work”.
This care is based on a work stoppage, “the duration of which is adapted to the evolution of the disorder and to the socio-professional context”, the combination of psychotherapeutic or psycho-corporal interventions (cognitive-behavioral therapies, relaxation, mindfulness mediation ,…), Possible drug treatment, in particular with antidepressants, “but only if the burn-out is associated with anxiety or depressive disorders”.
Prepare for return to work
Finally, we must anticipate and prepare for the return to work. “The analysis of the job and working conditions will allow the implementation of possible individual and / or collective prevention actions”.
Before returning to work, HAS recommends organizing one or more pre-return visits with the occupational physician. At the end of the pre-resumption visit, the occupational physician may recommend “adjustments or adaptations of the workstation, or even measures aimed at facilitating the redeployment of the employee or his professional reorientation”.
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