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Publications

Journal Article Ahead of print

PubMed: 41867012 DOI: 10.1192/bjp.2026.10582

Risk and protective factors against burnout increase during psychiatry training: evidence from a longitudinal multicentre controlled study.

Br J Psychiatry

Authors: Giovanni Castellini, Livio Tarchi, Emanuele Cassioli, Valdo Ricca, Giovanni Abbate-Daga, Andrea Aguglia, Umberto Albert, Anna Rita Atti, Stefano Barlati, Giuseppe Blasi, Claudia Carmassi, Giuseppe CarrĂ , Pasquale De Fazio, Chiara De Panfilis, Bianca Della Rocca, Giorgio Di Lorenzo, Matteo Di Vincenzo, Silvia Ferrari, Carla Gramaglia, Mario Luciano, Giovanni Martinotti, Marco Menchetti, Giulia Menculini, Maria Giulia Nanni, Alessandra Nivoli, Federica Pinna, Maurizio Pompili, Gianluca Rosso, Maria Salvina Signorelli, Fabio Sambataro, Gaia Sampogna, Gabriele Sani, Gianluca Serafini, Sarah Tosato, Antonio Ventriglio, Caterina ViganĂ², Umberto Volpe, Andrea Fiorillo

Affiliations

  • Psychiatry Unit, Department of Health Sciences, https://ror.org/04jr1s763University of Florence, Florence, Italy.
  • Department of Neuroscience, University of Turin, Turin, Italy.
  • Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, Section of Psychiatry, University of Genoa, Genoa, Italy.
  • IRCCS General Hospital, Genoa, Italy.
  • Department of Medicine, Surgery and Health Sciences, University of Trieste, Trieste, Italy.
  • Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy.
  • Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy.
  • Department of Mental Health and Addiction Services, ASST Brescia Hospital, Brescia, Italy.
  • Department of Translational Biomedicine and Neuroscience, University of Bari Aldo Moro, Bari, Italy.
  • Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy.
  • Department of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy.
  • Department of Health Sciences, University Magna Graecia of Catanzaro, Catanzaro, Italy.
  • Unit of Neuroscience, Department of Medicine and Surgery, University of Parma, Parma, Italy.
  • Department of Psychiatry, University of Campania 'L Vanvitelli', Naples, Italy.
  • Department of Systems Medicine, Tor Vergata University of Rome, Rome, Italy.
  • Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy.
  • Department of Translational Medicine, University of Eastern Piedmont, Novara, Italy.
  • Psychiatry Division, Novara Hospital, Novara, Italy.
  • Department of Neurosciences, Imaging and Clinical Sciences, 'G. D'Annunzio' University, Chieti, Italy.
  • Department of Psychiatry, University of Perugia, Perugia, Italy.
  • Department of Neuroscience and Rehabilitation, Institute of Psychiatry, University of Ferrara, Ferrara, Italy.
  • Department of Medicine, Surgery and Pharmacy, University of Sassari, Sassari, Italy.
  • Section of Psychiatry, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy.
  • Department of Neurosciences, Mental Health, and Sensory Organs, Faculty of Medicine and Psychology, Sapienza University of Rome, Rome, Italy.
  • Psychiatry Unit, Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy.
  • Department of Neuroscience (DNS), University of Padova, Padua, Italy.
  • Department of Neuroscience, Section of Psychiatry, Catholic University of the Sacred Heart, Rome, Italy.
  • Section of Psychiatry, Department of Neuroscience, Biomedicine and Movement, University of Verona, Verona, Italy.
  • Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy.
  • Department of Biomedical and Clinical Sciences, University of Milan, Milan, Italy.
  • Unit of Clinical Psychiatry, Department of Neurosciences/DIMSC, School of Medicine and Surgery, Polytechnic University of Marche, Ancona, Italy.

Abstract

BACKGROUND

Mentalising skills may be conceptualised as composed by both personal and interpersonal competencies, in turn shaped by early adverse experiences and coping strategies. Although cross-sectional observations described a role for mentalising skills in burnout development, large-scale longitudinal studies on the topic remain limited, especially in relation to psychiatry training.

AIMS

The primary aim was to investigate protective and risk factors for higher burnout scores across time. Secondary aims included testing whether psychiatry exhibited different burnout scores across time in comparison to other medical residents.

METHOD

A cohort of 1803 medical residents (1131 psychiatry residents) was assessed for mentalising skills, conceptualised as composed of emotional regulation (Difficulties in Emotion Regulation Scale), interpersonal competencies (Interpersonal Competence Questionnaire), coping strategies (Coping Orientation to Problems Experienced) and burnout dimensions (Maslach Burnout Inventory). One-year follow-up was available for 520 psychiatry residents (73.03% response rate) and 234 other medical residents (35.94% response rate). Longitudinal mixed models and bivariate latent change models were employed.

RESULTS

Across all residents, greater levels of burnout were associated with higher scores in insecure attachment, emotional dysregulation and maladaptive coping, as well as lower scores in interpersonal skills. Attending at least one supervision per month was associated with lower burnout scores across time. According to a bivariate latent change model, emotional regulation improvements through years were associated with lower burnout scores across time. In psychiatry residents, lower burnout scores across time were observed as compared to other medical residents. Psychiatry residents benefited from a higher protective effect of interpersonal competencies (group by moderator by time interaction) and coping strategies against burnout.

CONCLUSIONS

Mentalising skills may mitigate burnout development. Training in psychiatry emerged as a potential mitigating factor against burnout increases. Structured supervisions may foster professional development and emotional resilience.

MeSH

Emotions, Education, Professional, Protective Factors, Burnout, Psychological, Psychiatry, Emotional Regulation