Management of patients with occupational burnout in Switzerland: some insights on the heterogeneity in current practices

We aimed to describe the characteristics and current practices of Swiss health professionals who manage patients with occupational burnout (POB), namely the general practitioners (GP), psychiatrist-psychotherapists (PP), occupational physicians (OP) and psychologists. Among 3216 respondents, 2951 reported to consult POB, and 1130 (713 physicians and 410 psychologists) to treat them. The study showed that POB management constitutes 5 to 25% of health care professionals consultations, with an inequal distribution of POBs across professionals specialties and specializations, but also across geographic regions. The profile of POB consulted also differs across professionals. Work psychologists see more often POB at early burnout stage, GPs have most patients with moderate burnout, while PPs report the largest proportion of patients with severe burnout. The treatment practices depend on burnout severity. Psychiatrists and physicians with double specialty (GP-OPs and GP-PPs) treat patients with more severe burnout than GPs. Psychologists treating patients with severe burnout collaborate with other health professionals and contact the POBs employer and/or health insurance. Treatment practices and burnout severity are not associated with the proportion of relapsed patients and patients who return to work. Yet, the former is associated with professionals age, sex, and specialty. Physicians with waiting time >3 months have a higher proportion of relapsed patients. GPs prescribe most often sick leaves, while PPs are the most frequent prescribers of pharmacological treatment. PPs collaborate significantly more often than GPs with pharmacologists and contact POBs employer and health insurance. Among psychologists, work psychologists differ from other psychologists by a more frequent POB (psycho)education and coaching, namely on how to negotiate with employer and family, as well as on physical exercise. They also more often contact POBs employer. Besides profession and specialization, we observed important regional variation in treatment modalities chosen by both physicians and psychologists.