The expansion., of the term "burn-out" is a source of confusion because of the imprecise confines of that reality. The symptomatology of burn-out includes several dimensions: emotional exhaustion, depersonalization, reduction of personal accomplishment. Medical nosographies do not mention burn-out. It can be similar either to. an adaptative disorder, a post-traumatic stress disorder or a depressive disorder. It can also designate the picture resulting from an emotional turmoil at a lower clinical level than the one required for a characterized condition. This is confirmed by a few biological data that show a dysregulation of the hypothalamic pituitary adrenal axis, of the immune system or of the plasma levels of neurotrophic factors (such as BDNF). The measurement scale developed by Christina Maslach (MBI) cannot be considered as a diagnosis tool: in non-clinical population it divides each dimension (emotional exhaustion, depersonalization, reduction of self-accomplishment) in three tertiles (low, moderate and high levels). The etiological factors of burn-out are those of psychosocial risks (work demands; emotional demands; lack of autonomy, lack of social support and of recognition, conflicts values, and job insecurity) and those related to the individual personality. The prevention of burn-out depends on the implication of the management at its highest level. It has to take into account the risk factors inherent to the subject himself: neuroticism, psychopathological history. The occupational physician (and the health department of the company) in agreement with his ethics, must contribute in defining the actions promoting good health in the company. Health Ministry has to set up campaigns to inform the global population and to cooperate with Labour Ministry.
