High-quality controlled studies on burnout syndrome are lacking. A standardized and internationally accepted diagnostic instrument with a validated rating scale should be developed. There is also a need for epidemiological and health-economic studies on the prevalence, incidence, and cost of burnout. The etiology and pathogenesis of burnout should be studied with special regard to the possible role of neurobiological factors. Treatments for it should be studied systematically so that their effects can be judged at a high level of evidence. In view of the current lack of knowledge about what is called "burnout," the term should not be used as a medical diagnosis or as a basis for decisions regarding disability or other socioeconomic matters.

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Burnout is widely known as a work-related syndrome that is associated by serious individual and social consequences. The aim of the HTA report "Differential diagnostic of the burnout syndrome" published by DIMDI in 2010 was to determine how burnout can be diagnosed and distinguished from other disorders. Based on a systematic literature review of 36 databases, 852 studies published between 2004 and 2009 were identified. After considering inclusion and exclusion criteria, 25 medical and one ethical study remained. The study evidence is predominantly low. Self-assessment tools are mainly used. The analysis showed that no standardized, common valid procedure exists to obtain a burnout diagnosis. Overall the problem is to measure a phenomenon that is not exactly defined. It is primarily important to distinguish burnout from depression, alexithymia, feeling unwell, and the concept of prolonged exhaustion. Beside the need for a valid definition, further research is needed, particularly high-quality, long-term studies, to broaden the understanding of the syndrome. Furthermore, a standardized, internationally accepted and valid procedure for diagnosing burnout is necessary.

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