Experts urge rethink of burn-out diagnosis in the Netherlands

Psychiatrists and occupational health experts are calling for a review of how the Netherlands diagnoses and treats burn-out, after Sweden announced it would drop the term following updated guidelines from the World Health Organization (WHO), the Volkskrant reported on Monday.

The Netherlands and Sweden were the only two countries that still recognize burn-out as a formal diagnosis. While symptoms such as exhaustion, concentration problems and sleep issues are real, critics argue the label lacks scientific precision and may delay access to more targeted treatment.

Psychiatrist Christiaan Vinkers, professor of stress and resilience at Amsterdam UMC teaching hospital, told the paper many patients now labeled with burn-out could be more effectively helped if diagnosed with conditions such as depression or anxiety.

“Burnout is poorly defined and creates a separate treatment market outside psychiatry,” he said. National statistics agency CBS dropped the term in 2023 and the WHO's guidelines now define burnout as an “occupational phenomenon rather than a medical condition”.

However, occupational health and family doctors say the current approach works well. They use structured criteria to assess symptoms and suggest tailored interventions such as sleep routines, exercise or therapy.

The Hague family doctor Richard Starmans told the paper the diagnosis is meaningful to patients and gives direction to care. While he agrees that treatments are often based on experience rather than hard evidence, he stressed that most patients recover within six months.

Vinkers is now leading a new study on early detection of stress symptoms, aiming to bring together GPs, psychiatrists, occupational doctors and psychologists to design better coordinated care. “We need to break down silos and understand what this kind of stress really involves,” he said.

Dutch research institute TNO said in 2023 that one in four employees aged 18 to 34 reported burnout complaints.