{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,29]],"date-time":"2026-08-29T18:48:23Z","timestamp":1788029303318,"version":"build-2784847793"},"reference-count":61,"publisher":"MDPI AG","issue":"1","license":[{"start":{"date-parts":[[2022,1,15]],"date-time":"2022-01-15T00:00:00Z","timestamp":1642204800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Behavioral Sciences"],"abstract":"<jats:p>Burnout in healthcare workers (HCWs) is defined as a state of emotional, physical, and mental exhaustion that results from unmanaged, excessive, and long-term workplace stressors. This study aims to assess the prevalence of burnout and the levels of anxiety and depression among HCWs who primarily work with children who have autism spectrum disorder (ASD). A quantitative cross-sectional survey was conducted utilizing the Arabic version of the Maslach Burnout Inventory (MBI), Areas of Worklife Survey (AWS), Patient Health Questionnaire for Generalized Anxiety Disorder (GAD-7), and Patient Health Questionnaire for Depression (PHQ-9). Among the 381 participants working in autism centers, the majority were young Saudi females (326) working full-time as specialists in the private sector with less than five years of experience. The HCWs\u2019 overall mean scores on the three Maslach Burnout Inventory (MBI) subscales: emotional exhaustion (EE), depersonalization (DP), and personal accomplishment (PA) were 62%, 23.7%, and 76.5%, respectively. A total of 51.4% of HCWs reported moderate to high anxiety levels on GAD-7, and 47.8% showed moderate to very high levels of depression on PHQ-9. The mean perceived EE converged significantly but negatively on their overall mean perceived satisfaction with AWS (p-value &lt; 0.001), demonstrating that greater emotional fatigue predicts less satisfaction with their work. The PA scores correlated significantly and positively with their overall mean satisfaction with their AWS score (p-value &lt; 0.001). Considering sociodemographic variables, HCWs aged between 20\u201329 years have significantly lower mean PA scores than HCWs aged thirty and older (p = 0.007). Also, male HCWs perceived significantly higher work-related DP than females. More research is required to determine the nature of variables that contribute to burnout, depression, and anxiety in HCWs helping children with ASD.<\/jats:p>","DOI":"10.3390\/bs12010015","type":"journal-article","created":{"date-parts":[[2022,1,16]],"date-time":"2022-01-16T20:44:00Z","timestamp":1642365840000},"page":"15","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Burnout, Depression, and Anxiety Levels among Healthcare Workers Serving Children with Autism Spectrum Disorder"],"prefix":"10.3390","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7049-0960","authenticated-orcid":false,"given":"Shuliweeh","family":"Alenezi","sequence":"first","affiliation":[{"name":"Department of Psychiatry, College of Medicine, King Saud University, Riyadh 11451, Saudi Arabia"},{"name":"Department of Psychiatry, King Saud University Medical City, King Saud University, Riyadh 11362, Saudi Arabia"},{"name":"SABIC Psychological Health Research and Applications Chair (SPHRAC), Department of Psychiatry, College of Medicine, King Saud University, Riyadh 12372, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4490-3220","authenticated-orcid":false,"given":"Ahmad","family":"Almadani","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, College of Medicine, King Saud University, Riyadh 11451, Saudi Arabia"},{"name":"Department of Psychiatry, King Saud University Medical City, King Saud University, Riyadh 11362, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maram","family":"Al Tuwariqi","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, College of Medicine, King Saud University, Riyadh 11451, Saudi Arabia"},{"name":"Department of Psychiatry, King Saud University Medical City, King Saud University, Riyadh 11362, Saudi Arabia"},{"name":"SABIC Psychological Health Research and Applications Chair (SPHRAC), Department of Psychiatry, College of Medicine, King Saud University, Riyadh 12372, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fahad","family":"Alzahrani","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, College of Medicine, King Saud University, Riyadh 11451, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Meshari","family":"Alshabri","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, College of Medicine, King Saud University, Riyadh 11451, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohammed","family":"Khoja","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, College of Medicine, King Saud University, Riyadh 11451, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Khalid","family":"Al Dakheel","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, College of Medicine, King Saud University, Riyadh 11451, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Khalil","family":"Alghalayini","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, College of Medicine, King Saud University, Riyadh 11451, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Norah","family":"Alkadi","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, College of Medicine, King Saud University, Riyadh 11451, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shahad","family":"Aljebreen","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, College of Medicine, King Saud University, Riyadh 11451, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Razan","family":"Alzahrani","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, College of Medicine, King Saud University, Riyadh 11451, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,1,15]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"159","DOI":"10.1111\/j.1540-4560.1974.tb00706.x","article-title":"Staff Burn-Out","volume":"30","author":"Freudenberger","year":"1974","journal-title":"J. Soc. Issues"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1131","DOI":"10.1001\/jama.2018.12777","article-title":"Prevalence of Burnout Among Physicians: A Systematic Review","volume":"320","author":"Rotenstein","year":"2018","journal-title":"JAMA"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"99","DOI":"10.1002\/job.4030020205","article-title":"The measurement of experienced burnout","volume":"2","author":"Maslach","year":"1981","journal-title":"J. Organ. Behav."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"1043","DOI":"10.1001\/jamasurg.2020.3351","article-title":"Evaluating the Association of Multiple Burnout Definitions and Thresholds with Prevalence and Outcomes","volume":"155","author":"Hewitt","year":"2020","journal-title":"JAMA Surg."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"334","DOI":"10.7326\/0003-4819-149-5-200809020-00008","article-title":"Burnout and Suicidal Ideation among U.S. Medical Students","volume":"149","author":"Dyrbye","year":"2008","journal-title":"Ann. Intern. Med."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"54","DOI":"10.1001\/archsurg.2010.292","article-title":"Special Report: Suicidal Ideation among American Surgeons","volume":"146","author":"Shanafelt","year":"2011","journal-title":"Arch. Surg."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"168","DOI":"10.1001\/archsurg.2011.1481","article-title":"Prevalence of Alcohol Use Disorders Among American Surgeons","volume":"147","author":"Oreskovich","year":"2012","journal-title":"Arch. Surg."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"29","DOI":"10.1097\/01.HMR.0000304493.87898.72","article-title":"Linking physician burnout and patient outcomes: Exploring the Dyadic Relationship between Physicians and Patients","volume":"33","author":"Halbesleben","year":"2008","journal-title":"Health Care Manag. Rev."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"555","DOI":"10.7326\/M19-1152","article-title":"Evidence Relating Health Care Provider Burnout and Quality of Care: A Systematic Review and Meta-Analysis","volume":"171","author":"Tawfik","year":"2019","journal-title":"Ann. Intern. Med."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"94","DOI":"10.1097\/ACM.0b013e3181c46aad","article-title":"Burnout and Serious Thoughts of Dropping Out of Medical School: A Multi-Institutional Study","volume":"85","author":"Dyrbye","year":"2010","journal-title":"Acad. Med."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"187","DOI":"10.1177\/088840649001300309","article-title":"The Effects of Special Education Category and Type of Training on Job Burnout in Special Education Teachers","volume":"13","author":"Banks","year":"1990","journal-title":"Teach. Educ. Spec. Educ. J. Teach. Educ. Div. Counc. Except. Child."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"71","DOI":"10.1177\/088840640202500108","article-title":"Burnout Among Special Education Teachers in Self-Contained Cross-Categorical Classrooms","volume":"25","author":"Nichols","year":"2002","journal-title":"Teach. Educ. Spec. Educ. J. Teach. Educ. Div. Counc. Except. Child."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"148","DOI":"10.1352\/0047-6765(2002)040<0148:CSATIO>2.0.CO;2","article-title":"Coping Strategies and the Impact of Challenging Behaviors on Special Educators\u2019 Burnout","volume":"40","author":"Hastings","year":"2002","journal-title":"Ment. Retard."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"261","DOI":"10.1177\/001440298204900312","article-title":"Factors in Burnout among Teachers of Exceptional Children","volume":"49","author":"Zabel","year":"1982","journal-title":"Except. Child."},{"key":"ref_15","doi-asserted-by":"crossref","unstructured":"Masanotti, G.M., Paolucci, S., Abbafati, E., Serratore, C., and Caricato, M. (2020). Sense of Coherence in Nurses: A Systematic Review. Int. J. Environ. Res. Public Health, 17.","DOI":"10.3390\/ijerph17061861"},{"key":"ref_16","doi-asserted-by":"crossref","unstructured":"G\u00f3mez-Salgado, J., Dom\u00ednguez-Salas, S., Romero-Mart\u00edn, M., Ortega-Moreno, M., Garc\u00eda-Iglesias, J.J., and Ruiz-Frutos, C. (2020). Sense of Coherence and Psychological Distress Among Healthcare Workers During the COVID-19 Pandemic in Spain. Sustainability, 12.","DOI":"10.3390\/su12176855"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1002\/smi.2673","article-title":"How Effective are Mindfulness-Based Interventions for Reducing Stress Among Healthcare Professionals? A Systematic Review and Meta-Analysis","volume":"33","author":"Burton","year":"2017","journal-title":"Stress Health"},{"key":"ref_18","unstructured":"World Health Organization (WHO) (2017). Depression and Other Common Mental Disorders: Global Health Estimates."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"2373","DOI":"10.1001\/jama.2015.15845","article-title":"Prevalence of Depression and Depressive Symptoms Among Resident Physicians a Systematic Review and Meta-Analysis","volume":"314","author":"Mata","year":"2015","journal-title":"JAMA J. Am. Med. Assoc."},{"key":"ref_20","doi-asserted-by":"crossref","unstructured":"Maharaj, S., Lees, T., and Lal, S. (2019). Prevalence and Risk Factors of Depression, Anxiety, and Stress in a Cohort of Australian Nurses. Int. J. Environ. Res. Public Health, 16.","DOI":"10.3390\/ijerph16010061"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"182","DOI":"10.1213\/ANE.0b013e3182917da9","article-title":"The Prevalence of Burnout and Depression and Their Association with Adherence to Safety and Practice Standards: A Survey of United States Anesthesiology Trainees","volume":"117","author":"Chang","year":"2013","journal-title":"Anesth. Analg."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"126","DOI":"10.1097\/JOM.0000000000001198","article-title":"A National Study Links Nurses\u2019 Physical and Mental Health to Medical Errors and Perceived Worksite Wellness","volume":"60","author":"Melnyk","year":"2018","journal-title":"J. Occup. Environ. Med."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"284","DOI":"10.3389\/fpsyg.2019.00284","article-title":"The Relationship Between Burnout, Depression, and Anxiety: A Systematic Review and Meta-Analysis","volume":"10","author":"Koutsimani","year":"2019","journal-title":"Front. Psychol."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"227","DOI":"10.1037\/1072-5245.14.3.227","article-title":"Comparing two burnout interventions: Perceived job control mediates decreases in burnout","volume":"14","author":"Kinnunen","year":"2007","journal-title":"Int. J. Stress Manag."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"867","DOI":"10.1016\/j.biopsych.2006.04.029","article-title":"Neuroendocrine, Cognitive and Structural Imaging Characteristics of Women on Longterm Sickleave with Job Stress\u2013Induced Depression","volume":"60","author":"Rydmark","year":"2006","journal-title":"Biol. Psychiatry"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"782","DOI":"10.1177\/1359105313481079","article-title":"Comparative symptomatology of burnout and depression","volume":"18","author":"Bianchi","year":"2013","journal-title":"J. Health Psychol."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"396","DOI":"10.1097\/JOM.0b013e31816c0043","article-title":"Diagnosis and Referral of Workplace Depression","volume":"50","author":"Kahn","year":"2008","journal-title":"J. Occup. Environ. Med."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"307","DOI":"10.1037\/a0037906","article-title":"Is burnout a depressive disorder? A reexamination with special focus on atypical depression","volume":"21","author":"Bianchi","year":"2014","journal-title":"Int. J. Stress Manag."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"185","DOI":"10.1007\/978-3-319-57379-3_17","article-title":"Anxiety and Depression in Staff of Mental Units: The Role of Burnout","volume":"Volume 987","author":"Vlamos","year":"2017","journal-title":"Advances in Experimental Medicine and Biology"},{"key":"ref_30","first-page":"58","article-title":"Depression and anxiety among parents and caregivers of autistic spectral disorder children","volume":"18","author":"Almansour","year":"2013","journal-title":"Neurosciences"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"2277","DOI":"10.3389\/fpsyg.2017.02277","article-title":"Relationship between Psychological Capital and Psychological Well-Being of Direct Support Staff of Specialist Autism Services. The Mediator Role of Burnout","volume":"8","author":"Ayala","year":"2017","journal-title":"Front. Psychol."},{"key":"ref_32","doi-asserted-by":"crossref","unstructured":"Adib, N.A.N., Ibrahim, M.I., Ab Rahman, A., Bakar, R.S., Yahaya, N.A., Hussin, S., and Mansor, W.N.A.W. (2019). Perceived Stress among Caregivers of Children with Autism Spectrum Disorder: A State-Wide Study. Int. J. Environ. Res. Public Health, 16.","DOI":"10.3390\/ijerph16081468"},{"key":"ref_33","first-page":"22","article-title":"The association between psychological capital, mental health and burnout among specialists working in autism centers in Pakistan","volume":"10","author":"Rafaq","year":"2020","journal-title":"J. Environ. Occup. Health"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"207","DOI":"10.1007\/s40489-014-0021-x","article-title":"Coping in Parents and Caregivers of Children with Autism Spectrum Disorders (ASD): A Review","volume":"1","author":"Lai","year":"2014","journal-title":"Rev. J. Autism Dev. Disord."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"295","DOI":"10.4103\/0256-4947.65261","article-title":"Autism spectrum disorders","volume":"30","author":"Faras","year":"2010","journal-title":"Ann. Saudi Med."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"223","DOI":"10.17712\/nsj.2016.3.20150597","article-title":"The availability of services for children with autism spectrum disorder in a Saudi population","volume":"21","author":"Babatin","year":"2016","journal-title":"Neurosciences"},{"key":"ref_37","doi-asserted-by":"crossref","unstructured":"American Psychiatric Association (2013). Diagnostic and Statistical Manual of Mental Disorders, American Psychiatric Association. [5th ed.].","DOI":"10.1176\/appi.books.9780890425596"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"413","DOI":"10.1007\/s40489-019-00171-0","article-title":"Predictors of Burnout, Job Satisfaction, and Turnover in Behavior Technicians Working with Individuals with Autism Spectrum Disorder","volume":"6","author":"Novack","year":"2019","journal-title":"Rev. J. Autism Dev. Disord."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"189","DOI":"10.15537\/smj.2020.2.24841","article-title":"Burnout and imposter syndrome among Saudi young adults: The Strings in the Puppet Show of Psychological Morbidity","volume":"41","author":"Alrayyes","year":"2020","journal-title":"Saudi Med. J."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"103616","DOI":"10.1016\/j.ridd.2020.103616","article-title":"Burnout in providers serving individuals with ASD: The impact of the workplace","volume":"100","author":"Bottini","year":"2020","journal-title":"Res. Dev. Disabil."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"160","DOI":"10.1002\/aur.239","article-title":"Global Prevalence of Autism and Other Pervasive Developmental Disorders","volume":"5","author":"Elsabbagh","year":"2012","journal-title":"Autism Res."},{"key":"ref_42","first-page":"291","article-title":"Systemic review of the epidemiology of autism in Arab Gulf countries","volume":"19","author":"Salhia","year":"2014","journal-title":"Neurosciences"},{"key":"ref_43","unstructured":"IBM Corporation (2012). Released IBM SPSS Statistics for Windows, Version 21, IBM Corporation."},{"key":"ref_44","unstructured":"(2021, July 07). FACTOR Standalone Factor Analysis Program (Release 10.9.01). Available online: https:\/\/psico.fcep.urv.cat\/utilitats\/factor\/Download.html."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"592","DOI":"10.1177\/1362361316664868","article-title":"Services for children with autism in the Kingdom of Saudi Arabia","volume":"21","author":"Aldhalaan","year":"2017","journal-title":"Autism"},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"268","DOI":"10.1111\/j.1365-2788.2003.00523.x","article-title":"Burnout in direct care staff in intellectual disability services: A factor analytic study of the Maslach Burnout Inventory","volume":"48","author":"Hastings","year":"2004","journal-title":"J. Intellect. Disabil. Res."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"255","DOI":"10.1177\/1534765612471144","article-title":"Compassion satisfaction, compassion fatigue, work life conditions, and burnout among frontline mental health care professionals","volume":"19","author":"Ray","year":"2013","journal-title":"Traumatology"},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"60","DOI":"10.1016\/j.burn.2015.05.001","article-title":"Areas of worklife as predictors of occupational health\u2014A validation study in two German samples","volume":"2","author":"Brom","year":"2015","journal-title":"Burn. Res."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"1943","DOI":"10.2147\/NDT.S107103","article-title":"Stress, anxiety, and depression among parents of children with autism spectrum disorder in Oman: A case-control study","volume":"12","year":"2016","journal-title":"Neuropsychiatr. Dis. Treat."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"388","DOI":"10.1080\/09638237.2017.1417570","article-title":"Social capital and burnout among mental healthcare providers","volume":"27","author":"Eliacin","year":"2018","journal-title":"J. Ment. Health"},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"370","DOI":"10.1080\/20473869.2020.1827211","article-title":"Using mindfulness to improve quality of life in caregivers of individuals with intellectual disabilities and autism spectrum disorder","volume":"66","author":"Singh","year":"2020","journal-title":"Int. J. Dev. Disabil."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"500","DOI":"10.1111\/j.1365-2788.2011.01406.x","article-title":"Stress, depression, workplace and social supports and burnout in intellectual disability support staff","volume":"55","author":"Mutkins","year":"2011","journal-title":"J. Intellect. Disabil. Res."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"172","DOI":"10.1111\/j.1365-2788.2005.00732.x","article-title":"The impact of behaviour problems on caregiver stress in young people with autism spectrum disorders","volume":"50","author":"Lecavalier","year":"2006","journal-title":"J. Intellect. Disabil. Res."},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"311","DOI":"10.1007\/s10597-018-0343-8","article-title":"An Examination of the Relations Between Symptom Distributions in Children Diagnosed with Autism and Caregiver Burden, Anxiety and Depression Levels","volume":"55","author":"Baykal","year":"2019","journal-title":"Community Ment. Health J."},{"key":"ref_55","unstructured":"Nevill, R.E.A., and Havercamp, S. (2018). Retention, Resilience, and Burnout of Staff Caregivers for Aggressive Adults with DD. Abstracts International: Section B: The Sciences and Engineering. [Ph.D. Thesis, The Ohio State University]."},{"key":"ref_56","first-page":"7","article-title":"Occupational Satisfaction, Strain, and Intention to Quit among Direct Care Providers Assisting Individuals with Developmental Disabilities","volume":"17","author":"McKillop","year":"2011","journal-title":"J. Dev. Disabil."},{"key":"ref_57","doi-asserted-by":"crossref","unstructured":"Scherer, N., Verhey, I., and Kuper, H. (2019). Depression and anxiety in parents of children with intellectual and developmental disabilities: A systematic review and meta-analysis. PLoS ONE, 14.","DOI":"10.1371\/journal.pone.0219888"},{"key":"ref_58","doi-asserted-by":"crossref","unstructured":"Li, Z., Dai, J., Wu, N., Jia, Y., Gao, J., and Fu, H. (2019). Effect of Long Working Hours on Depression and Mental Well-Being among Employees in Shanghai: The Role of Having Leisure Hobbies. Int. J. Environ. Res. Public Health, 16.","DOI":"10.3390\/ijerph16244980"},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"311","DOI":"10.1016\/j.cgh.2017.06.043","article-title":"Physician Burnout: The Hidden Health Care Crisis","volume":"16","author":"Lacy","year":"2018","journal-title":"Clin. Gastroenterol. Hepatol."},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"873","DOI":"10.1016\/S0191-8869(00)00079-9","article-title":"Burnout and depression are not identical twins: Is decline of superiority a distinguishing feature?","volume":"30","author":"Brenninkmeyer","year":"2001","journal-title":"Personal. Individ. Differ."},{"key":"ref_61","doi-asserted-by":"crossref","unstructured":"Adam, S., Mohos, A., Kalabay, L., and Torzsa, P. (2018). Potential correlates of burnout among general practitioners and residents in Hungary: The significant role of gender, age, dependant care and experience. BMC Fam. Pract., 19.","DOI":"10.1186\/s12875-018-0886-3"}],"container-title":["Behavioral Sciences"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2076-328X\/12\/1\/15\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,13]],"date-time":"2025-10-13T13:27:28Z","timestamp":1760362048000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2076-328X\/12\/1\/15"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,1,15]]},"references-count":61,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2022,1]]}},"alternative-id":["bs12010015"],"URL":"https:\/\/doi.org\/10.3390\/bs12010015","relation":{},"ISSN":["2076-328X"],"issn-type":[{"value":"2076-328X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,1,15]]}}}