Utmattningssyndrom or exhaustion disorder (ED) is the reason given for around one in six mental illness-related sick leaves that last for more than two weeks, according to the Swedish Social Insurance Agency.
It's a diagnosis unique to Sweden, but from 2028 it will be scrapped when the International Classification of Diseases is updated from ICD-10 to ICD-11, reports Psykologtidningen, a magazine for psychologists. The World Health Organization (WHO) has said ahead of the new ICD-11 that it doesn't want countries to create their own national classifications, so the decision follows their guidance.
"Sweden is the only country which has had the specific diagnosis of exhaustion disorder with these specific criteria," Elin Lindsäter, associate professor at Karolinska Institute, told the TT newswire.
"In other countries, they have found other ways of trying to identify this clinically."
The removal of the diagnosis does not mean that tens of thousands of people currently on sick leave with ED will be sent back to work.
"I think everyone from the highest levels of politics down to the floor know that there are people who are suffering greatly who cannot function at work or in their everyday lives, and who need to be on sick leave," Lindsäter said.
A number of those people meet the criteria for depression, she added, as well as other stress-related illnesses.
"Exhaustion disorder has been used quite casually as a diagnosis within healthcare, so my hope now is that a more thorough assessment will be made."
She hopes that this could result in treatments becoming more accurate to the needs of individual patients.
"I think it could be for the better, not least for people with very complex problems."
Magdalena Fresk, head of the classification and terminology department at the National Board of Health and Welfare, told the TT newswire that the board is currently working on the Swedish translation of WHOs most recent International Classification of Diseases, which is expected to continue throughout 2025.
ICD-10, the current classification, is becoming outdated, and the new ICD-11 will be a "long-awaited, medically updated version", Fresk said.
"There are changes in classification and we know that exhaustion disorder will not be included as its own category. We're aware of that and will be looking at that in particular," she said.
"There are a number of issues which we know we're going to have to work on to make sure that there are no problems for patients, as well as making sure that things work as well as possible in the future."
In Sweden, the diagnosis of exhaustion disorder (ED) was developed around 20 years ago and has been gradually implemented in clinical practice. Symptoms include tiredness which is not improved after rest, fatigue, difficulty sleeping, anxiety, difficulty concentrating, heart palpitations and sensitivity to sound.
There is an overlap with burnout, but ED includes not only work-related stressors but also those that happen in private life.
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