Context: The World Health Organization has for the first time recognised “burn-out” in its International Classification of Diseases (ICD), which is widely used as a benchmark for diagnosis and health insurers.

Significance:

The decision could help put to rest decades of debate among experts over how to define burnout, and whether it should be considered a medical condition.

What is burn- out?

In the latest update of its catalogue of diseases and injuries around the world, WHO defines burn-out as “a syndrome conceptualised as resulting from chronic workplace stress that has not been successfully managed.”

The syndrome is characterised by three dimensions: “1) feelings of energy depletion or exhaustion; 2) increased mental distance from one’s job, or feelings of negativism or cynicism related to one’s job; and 3) reduced professional efficacy.”

Background:

The updated ICD list, dubbed ICD-11, was drafted last year following recommendations from health experts around the world. The ICD-11, which is to take effect in January 2022, contains several other additions, including classification of “compulsive sexual behaviour” as a mental disorder, although it stops short of lumping the condition together with addictive behaviours.

What is ICD?

The ICD is the global health information standard for mortality and morbidity statistics. The first international classification edition, known as the International List of Causes of Death, was adopted by the International Statistical Institute in 1893. WHO was entrusted with the ICD at its creation in 1948. The ICD is revised periodically and is currently in its 10th revision.

• ICD is increasingly used in clinical care and research to define diseases and study disease patterns, as well as manage health care, monitor outcomes and allocate resources. ICD has been translated into 43 languages.
• More than 100 countries use the system to report mortality data, a primary indicator of health status. This system helps to monitor death and disease rates worldwide and measure progress towards the Millennium Development Goals.
• About 70% of the world’s health expenditures (USD $ 3.5 billion) are allocated using ICD for reimbursement and resource allocation.

Highlights of ICD- 11:

• ICD-11 identifies health trends and statistics worldwide, and contains around 55,000 unique codes for injuries, diseases and causes of death.
• ICD-11, which has been over a decade in the making, provides significant improvements on previous versions.
• Also for the first time, it is completely electronic and has a much more user-friendly format. And there has been unprecedented involvement of health care workers who have joined collaborative meetings and submitted proposals.
• The new ICD-11 also reflects progress in medicine and advances in scientific understanding. For example, the codes relating to antimicrobial resistance are more closely in line with the Global Antimicrobial Resistance Surveillance System (GLASS).
• ICD-11 is also able to better capture data regarding safety in health care, which means that unnecessary events that may harm health – such as unsafe workflows in hospitals can be identified and reduced.
• The new ICD also includes new chapters- one on traditional medicine and another new chapter on sexual health.
• Gaming disorder has been added to the section on addictive disorders.

ICD purpose and uses:

• The ICD is the foundation for the identification of health trends and statistics globally. It is the international standard for defining and reporting diseases and health conditions. It allows the world to compare and share health information using a common language.
• The ICD defines the universe of diseases, disorders, injuries and other related health conditions. These entities are listed in a comprehensive way so that everything is covered. It organizes information into standard groupings of diseases, which allows for:
• Easy storage, retrieval and analysis of health information for evidenced-based decision-making;
• Sharing and comparing health information between hospitals, regions, settings and countries; and
• Data comparisons in the same location across different time periods.