Work Addiction, Obsessive-Compulsive Personality Disorder, Burn-Out, and Global Burden of Disease: Implications from the ICD-11

Abstract

Occupational stress and high workload are being increasingly recognized as significant contributors to the diseases and disorders constituting major components of the global burden of disease. A more detailed definition of burn-out was recently included by the World Health Organization (WHO) in the eleventh revision of the International Classification of Diseases (ICD-11) which reflects a growing acknowledgment of the role of professional work in mental health. One of the symptoms of obsessive-compulsive personality disorder/anankastic personality disorder (OCPD/APD) is an undue preoccupation with productivity to the exclusion of pleasure and interpersonal relationships. This compulsive overworking is closely related to the concept of work addiction, and OCPD/APD was suggested to be its major risk factor. OCPD/APD is the most prevalent personality disorder and one that appears to produce the highest direct and indirect medical costs. At the same time, it is vastly understudied. In recent years, it has been repeatedly emphasized that it requires consistent conceptualization and clarification of its overlapping with similar conditions. Even though the limited existing studies suggest its strong relationship with burn-out and depression among employed individuals, there has been no systematic effort to investigate its role in the consequences of occupational stress and high workload. This paper identifies several substantial gaps in the current understanding of the relationships between work addiction, OCPD/APD, burn-out, and the global burden of disease within the context of the WHO’s plan of developing evidence-based guidelines on mental wellbeing in the workplace.

The majority of professionally active women diagnosed with eating disorders may be at risk of work addiction: an overlooked comorbidity

“…Taking all this into account, it is surprising that there is no systematic investigation on their comorbidity. Moreover, there is a vast discrepancy in the number of high-quality scientific papers on WA (and anankastia/OCPD) in comparison to EDs (see Figure 1; for an overview of the relationship of compulsive overworking with other mental disorders and health, including its neglect in scientific literature and policies, see Atroszko, Demetrovics, & Griffiths, 2020).…”

“…While there are still not enough data to conclude that SA is an early form of work addiction, the available studies strongly suggest that it is likely, and the data on prevalence are consistent with that hypothesis. Based on I) these data and II) a review of studies, which also used different cut-offs, suggesting prevalence rates of work addiction of about 8-10%, as well as III) prevalence of OCPD, which is the most prevalent personality disorder in the general population and is hypothesized to be the main risk factor for WA (see Atroszko et al, 2020), it can be expected that this problematic behavior is generally significantly more prevalent than most other addictions and disorders, including behavioral addictions, and its prevalence substantially varies between countries. These differences in prevalence rates may be closely related to cultural factors and their interaction with socioeconomic conditions of particular countries, for example, an interaction of work ethic, consumer values, and economic pressures (see Atroszko et al, , 2020.…”

“…For example, the interaction of individual predispositions and environmental factors can be observed in the fact that both EDs and WA/SA are common among musicians, arguably due to their perfectionism, depression, anxiety, stress, peer pressure and social isolation (Kapsetaki & Easmon, 2019;Lawendowski et al, 2019;Niemeier & Larsen, 2020). A recent paper emphasized the need for systematic studies on compulsive overworking, burnout, and the global burden of disease, among other things, because currently we do not know to what extent burnout is a cause, effect or part of the clinical manifestation of other disorders (Atroszko et al, 2020).…”

“…Moreover, co-occurrence of disorders plays an important role as findings indicate that comorbidity is related to worse health outcomes, to more complex clinical management, and increased health care costs (Valderas et al, 2009;Vall & Wade, 2015). Similarly to many other disorders, both EDs and WA co-occur with mood disorders, especially major depressive disorder, and anxiety disorders (see Atroszko et al, , 2020Blinder, Cumella, & Sanathara, 2006;Braun, Sunday, & Halmi, 1994;Herzog, Keller, Sacks, Yeh, & Lavori, 1992), though anxiety and mood disorders may co-occur more often with BN than AN (Hudson et al, 2007). There is significant comorbidity of EDs with personality disorders (PD) (Farstad, McGeown, & von Ranson, 2016;Martinussen et al, 2017).…”

Is the Polythetic Approach Efficient in Identifying Potentially Addicted to Work Individuals? Comparison of the Polythetic Approach With the Item Response Theory Framework

“…Unfortunately, as far as we are aware the latent trait levels at which work addiction or symptoms of work addiction start causing significant impairment in functioning for individuals have not been determined and reported in the extant literature. However, previous studies consistently showed that work addiction was positively associated with impaired functioning of individuals (for meta-analysis, see Clark, Michel, Zhdanova, Pui, & Baltes, 2016; for narrative reviews, see Griffiths et al, 2018;Atroszko, Demetrovics, & Griffiths, 2020) and various mental disorders (Andreassen et al, 2016a;Atroszko et al, 2020). Additionally, Lane and Sher (2015) showed that in the case of alcohol use disorder the latent trait level of 1.5 could be a quite effective cut-off point for differentiating between disordered and not disordered individuals.…”