Differentiating Job Burnout from Depression: Evidence of the Mediating Role of Stress in Ecuadorian Healthcare Professionals

Abstract

This study explored how psychological stress influences the relationship between job burnout and depression in Ecuadorian healthcare professionals, a debated topic given the frequent coexistence of both phenomena in chronic stress contexts. To this end, a cross-sectional design was conducted with 437 physicians and nurses who completed the PHQ-9 for depressive symptoms, the Perceived Stress Scale (PSS-10), and the Spanish version of the Maslach Burnout Inventory (MBI-HSS). Analytical methods included confirmatory factor analysis and structural equation modeling to evaluate the mediating role of stress, alongside testing for gender measurement invariance. Results supported the factor structures of the stress and depression scales, although only the personal accomplishment subscale of the MBI-HSS demonstrated solid psychometric properties. The analysis revealed that psychological stress partially mediated the association between reduced personal accomplishment and depressive symptoms, suggesting that burnout could be understood as a workplace manifestation of depression, with stress acting as a transdiagnostic mechanism. Furthermore, measurement invariance across gender was established, revealing distinct symptom patterns between men and women, where cognitive-affective symptoms were more prominent in men, whereas somatic symptoms and motor activity were more frequent in women. It is concluded that interventions aimed at improving the mental health of healthcare professionals must address both individual symptoms and systemic occupational stressors.