BackgroundPostgraduate medical trainees experience high rates of burnout, but evidence regarding psychiatric trainees is missing. We aim to determine burnout rates among psychiatric trainees, and identify individual, educational and work-related factors associated with severe burnout. MethodsIn an online survey psychiatric trainees from 22 countries were asked to complete the Maslach Burnout Inventory (MBI-GS) and provide information on individual, educational and work-related parameters. Linear mixed models were used to predict the MBI-GS scores, and a generalized linear mixed model to predict severe burnout. ResultsThis is the largest study on burnout and training conditions among psychiatric trainees to date. Complete data were obtained from 1980 out of 7625 approached trainees (26%; range 17.8 -65.6%). Participants were 31.9 (SD 5.3) years old with 2.8 (SD 1.9) years of training. Severe burnout was found in 726 (36.7%) trainees. The risk was higher for trainees who were younger (p<0.001), without children (p=0.010), and had not opted for psychiatry as a first career choice (p=0.043). After adjustment for sociodemographic characteristics, years in training and country differences in burnout, severe burnout remained associated with long working hours (p<0.001), lack of supervision (p<0.001), and not having regular time to rest (p=0.001). Main findings were replicated in a sensitivity analysis with countries with response rate above 50%. Conclusions 4Besides previously described risk factors such as working hours and younger age, this is the first evidence of negative influence of lack of supervision and not opting for psychiatry as a first career choice on trainees' burnout.

Background Conflict-related sexual violence (CRSV) was committed on a large scale against women across Bosnia and Herzegovina (BiH) during the 1990’s war, and research has shown both negative and positive psychosocial outcomes following such acts of interpersonal violence. We aim to determine the capacity for posttraumatic growth (PTG) among a population of women who experienced CRSV, and to what extent it is impacted by factors such as coping and optimism. Methods This study sought to examine the relationship between PTG (posttraumatic growth inventory), symptoms of posttraumatic stress disorder (PTSD; Harvard Trauma Questionnaire) and dispositional factors such as coping (COPE) and optimism (Life-Orientation Test-Revised) in a sample of n = 104 women. We first conducted bivariate correlations and then hierarchical linear regression analyses, and hypothesized that approach coping strategies and optimism will act to enhance PTG. Results Findings showed that the average total score for PTG in this study was 58.94 (SD = 23.01), and current PTSD symptomatology above a threshold of > 2.5 was detected in 92.3% ( n = 96) participants (mean score 3.18, SD = .45). Bivariate correlations showed that higher levels of PTG were associated with greater optimism, greater approach coping strategies positive reinterpretation and planning, and lower avoidance strategies behavioural disengagement and substance use. When entered into a regression model, only positive reinterpretation and behavioural disengagement remained, the R -square of the total set of predictors was 0.16, thus explaining 16% of PTG total score. Conclusion Two types of coping (namely capacity of both greater positive reinterpretation and lower behavioural disengagement) most strongly predicted growth after trauma in this sample of CRSV survivors from BiH. These dimensions of coping confirm the role of coping strategies in the development of PTG. Further research would be useful in corroborating these findings in other post-conflict settings, and delving further into the possibility of a dual mechanism of growth and distress after CRSV. Electronic supplementary material The online version of this article (10.1186/s13031-019-0201-5) contains supplementary material, which is available to authorized users.

The Tuzla Workshop showed that the active participation of affected groups in adequate coping with the past is required for post-conflict reconstruction, trauma healing and peacebuilding in the long run.