The clinical utility of the Maslach Burnout Inventory in a clinical population

This replication study examines the use of the Maslach Burnout Inventory (MBI-GS), a self-report questionnaire on burnout, as a clinical diagnostic instrument for measuring clinical burnout. The MBI and Mini International Neuropsychiatric Interview (MINI), a semistructured interview based on classifications in the Diagnostic and Statistical Manual of Mental Disorders (4th ed.; DSM-IV; American Psychiatric Association, 1994), were administered to 419 outpatients at a Dutch multicenter institution specializing in the treatment of work-related psychological problems. MBI scores indicative of the presence of burnout were compared to the primary DSM-IV diagnosis as established by the MINI. The DSM-IV diagnosis "undifferentiated somatoform disorder" was used as a proxy measure for clinical burnout. The results showed that the psychometric properties of the MBI were good. The factorial validity of the MBI could be confirmed. Several decision rules or cutoff points were assessed to determine the discriminant validity of the MBI. None of these cutoff points proved to be sufficiently discriminable, however. Receiver operating characteristic analyses revealed that the MBI showed the highest sum of sensitivity (78%) and specificity (48%) with a cutoff point of 3.50 on the Exhaustion subscale, with a kappa agreement of .25 with the structured diagnostic interview. The practical implication is that the MBI should not be used by itself as a diagnostic tool in a patient population, because of a resultant high probability of overdiagnosing burnout.