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Qi X, Deng H, Zhang H, Shao F, Cai W, Liu Y. Over-commitment positively predicts hair cortisol concentrations only in nurses with high need for recovery. Int Arch Occup Environ Health 2024:10.1007/s00420-024-02091-x. [PMID: 39060504 DOI: 10.1007/s00420-024-02091-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2024] [Accepted: 07/05/2024] [Indexed: 07/28/2024]
Abstract
PURPOSE In the contemporary workplace, enduring fatigue has become a standard for employees. This investigation assesses whether such working conditions exacerbate the depletion of employees' personal resources. The need for recovery serves as an indicator of the necessity to mitigate post-work fatigue. A high need for recovery signifies that employees must commence a new workday while already fatigued. METHODS This research recruited two cohorts of nurses, categorized by a high need for recovery and a low need for recovery, to examine the correlation between work effort and hair cortisol concentrations in each group. RESULTS Hair cortisol concentrations serve as a biological marker of cumulative cortisol secretion over a specific time frame, reflecting overall personal resource expenditure during this interval. Findings revealed a notable positive correlation between intrinsic work effort (over-commitment) and hair cortisol levels exclusively among nurses with a high need for recovery. CONCLUSION These outcomes imply that active effort amidst fatigue may lead to excessive strain. This insight enriches the classic 'effort-recovery' model by illustrating how an employee' s personal volition can influence the accumulation of fatigue.
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Affiliation(s)
- Xingliang Qi
- College of Pro-school Education, Nanjing Xiaozhuang University, Nanjing, 211171, China
| | - Huihua Deng
- Key Laboratory of Child Development and Learning Science (Southeast University), Ministry of Education, Nanjing, 210096, China
- Institute of Child Development and Education, Southeast University, Nanjing, 210096, China
| | - Hong Zhang
- Faculty of Teacher Development, Shaanxi Normal University, Xi'an Shaanxi, 710062, China
| | - Feng Shao
- College of Pro-school Education, Nanjing Xiaozhuang University, Nanjing, 211171, China
| | - Wenjing Cai
- College of Pro-school Education, Nanjing Xiaozhuang University, Nanjing, 211171, China
| | - Yapeng Liu
- College of Pro-school Education, Nanjing Xiaozhuang University, Nanjing, 211171, China.
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2
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Bärtl C, Henze GI, Peter HL, Giglberger M, Bohmann P, Speicher N, Konzok J, Kreuzpointner L, Waller L, Walter H, Wüst S, Kudielka BM. Neural and cortisol responses to acute psychosocial stress in work-related burnout: The Regensburg Burnout Project. Psychoneuroendocrinology 2024; 161:106926. [PMID: 38118266 DOI: 10.1016/j.psyneuen.2023.106926] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Revised: 11/22/2023] [Accepted: 12/10/2023] [Indexed: 12/22/2023]
Abstract
BACKGROUND While several attempts have been made to elucidate the pathophysiology of burnout, neural stress responses have not yet been investigated. Therefore, the aim of this study was to examine salivary cortisol and - for the first time - neural responses to acute psychosocial stress within a strictly specified sample consisting of individuals suffering from burnout (BO group) and a healthy comparison group (HC group). METHODS After a multi-stage recruitment procedure based on burnout symptomatology and pathogenesis, 55 individuals suffering from burnout (25 women) and 61 individuals serving as HC group (31 women) out of an initial sample of 1022 volunteers were exposed to acute psychosocial stress during functional magnetic resonance imaging (fMRI) applying ScanSTRESS. RESULTS No differences were found between the BO and the HC group with respect to cortisol and mean neural stress responses. However, an exploratory comparison of neural stress responses of the first and second run of ScanSTRESS (exposure-time effect) revealed group-specific response patterns in one cluster peaking in the left dorsal anterior cingulate cortex (dACC). While the neural activation of the HC group was higher in the first compared to the second run of ScanSTRESS (i.e., decreasing activation), this pattern was reversed in the BO group (i.e., increasing activation). CONCLUSIONS Our analysis mainly did not provide evidence for altered acute cortisol and mean neural stress responses in burnout. However, the BO group was characterized by a limited capacity to show decreasing activation over stress exposure-time and exhibited instead increasing activation. Importantly, this group difference manifested in the left dACC which is both involved in neural stress processing and affected in individuals suffering from burnout. Given the present results, it seems promising to further examining temporal dynamics of neural stress responses in (sub-) clinical conditions such as burnout.
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Affiliation(s)
- Christoph Bärtl
- Institute of Psychology, University of Regensburg, Regensburg, Germany.
| | - Gina-Isabelle Henze
- Institute of Psychology, University of Regensburg, Regensburg, Germany; Division of Mind and Brain Research, Department of Psychiatry and Psychotherapy, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Hannah L Peter
- Institute of Psychology, University of Regensburg, Regensburg, Germany
| | - Marina Giglberger
- Institute of Psychology, University of Regensburg, Regensburg, Germany
| | - Patricia Bohmann
- Institute of Psychology, University of Regensburg, Regensburg, Germany; Department of Epidemiology and Preventive Medicine, University of Regensburg, Regensburg, Germany
| | - Nina Speicher
- Institute of Psychology, University of Regensburg, Regensburg, Germany
| | - Julian Konzok
- Institute of Psychology, University of Regensburg, Regensburg, Germany; Department of Epidemiology and Preventive Medicine, University of Regensburg, Regensburg, Germany
| | | | - Lea Waller
- Division of Mind and Brain Research, Department of Psychiatry and Psychotherapy, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Henrik Walter
- Division of Mind and Brain Research, Department of Psychiatry and Psychotherapy, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Stefan Wüst
- Institute of Psychology, University of Regensburg, Regensburg, Germany
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Kaltenegger HC, Marques MD, Becker L, Rohleder N, Nowak D, Wright BJ, Weigl M. Prospective associations of technostress at work, burnout symptoms, hair cortisol, and chronic low-grade inflammation. Brain Behav Immun 2024; 117:320-329. [PMID: 38307447 DOI: 10.1016/j.bbi.2024.01.222] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Revised: 01/23/2024] [Accepted: 01/25/2024] [Indexed: 02/04/2024] Open
Abstract
BACKGROUND Working conditions in the age of digitalization harbor risks for chronic stress and burnout. However, real-world investigations into biological effects of technostress, that is stress in the context of digital technology use, are sparse. This study prospectively assessed associations between technostress, general work stress, burnout symptoms, hair cortisol, and chronic low-grade inflammation. METHODS Hospital employees (N = 238, 182 females, Mage = 28.5 years) participated in a prospective cohort study with two follow-ups six months apart (T2, T3). Participants answered standardized questionnaires on general job strain (job demand-control ratio), technostressors (work interruptions, multitasking, information overload), burnout symptoms (exhaustion, mental distance), and relevant confounders. Moreover, they provided capillary blood samples for C-reactive protein (CRP) and hair strands for hair cortisol concentration (HCC) analysis. Structural equation modelling was performed. RESULTS The factorial structure of survey measures was confirmed. Burnout symptoms (MT2 = 2.17, MT3 = 2.33) and HCC (MT2 = 4.79, MT3 = 9.56; pg/mg) increased over time, CRP did not (MT2 = 1.15, MT3 = 1.21; mg/L). Adjusted path models showed that technostress was negatively associated with HCC (β = -0.16, p =.003), but not with burnout and CRP. General work stress in contrast, was not significantly associated with burnout, HCC or CRP. Furthermore, there were reciprocal effects of CRP on HCC (β = 0.28, p =.001) and of HCC on CRP (β = -0.10, p ≤.001). Associations were robust in additional analyses including further confounders. CONCLUSION This is the first study on prospective effects of technostress on employees' endocrine and inflammatory systems. Results suggest differential effects of technostress on the hypothalamic-pituitary-adrenocortical axis activity. Given its key role for long-term health, the findings have important implications for occupational health and safety in digitalized work environments.
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Affiliation(s)
- Helena C Kaltenegger
- Institute and Clinic for Occupational, Social and Environmental Medicine, University Hospital, LMU Munich, Munich, Germany.
| | - Mathew D Marques
- School of Psychology and Public Health, La Trobe University, Melbourne, VIC, Australia
| | - Linda Becker
- Institute of Psychology, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany; Humanwissenschaftliche Fakultät, Vinzenz Pallotti University gGmbH, Vallendar, Germany
| | - Nicolas Rohleder
- Institute of Psychology, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Dennis Nowak
- Institute and Clinic for Occupational, Social and Environmental Medicine, University Hospital, LMU Munich, Munich, Germany
| | - Bradley J Wright
- School of Psychology and Public Health, La Trobe University, Melbourne, VIC, Australia
| | - Matthias Weigl
- Institute and Clinic for Occupational, Social and Environmental Medicine, University Hospital, LMU Munich, Munich, Germany; Institute for Patient Safety, University Hospital Bonn, Bonn, Germany
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Falco A, Girardi D, Elfering A, Peric T, Pividori I, Dal Corso L. Is Smart Working Beneficial for Workers' Wellbeing? A Longitudinal Investigation of Smart Working, Workload, and Hair Cortisol/Dehydroepiandrosterone Sulfate during the COVID-19 Pandemic. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:6220. [PMID: 37444069 PMCID: PMC10341102 DOI: 10.3390/ijerph20136220] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Revised: 05/23/2023] [Accepted: 06/21/2023] [Indexed: 07/15/2023]
Abstract
Building on the job demands-resources (JD-R) and allostatic load (AL) models, in the present study we examined the role of smart working (SW) in the longitudinal association between workload/job autonomy (JA) and a possible biomarker of work-related stress (WRS) in the hair-namely, the cortisol-dehydroepiandrosterone sulfate (DHEA(S)) ratio-during the COVID-19 pandemic. Overall, 124 workers completed a self-report questionnaire (i.e., psychological data) at Time 1 (T1) and provided a strand of hair (i.e., biological data) three months later (Time 2, T2). Results from moderated multiple regression analysis showed that SW at T1 was negatively associated with the hair cortisol/DHEA(S) ratio at T2. Additionally, the interaction between workload and SW was significant, with workload at T1 being positively associated with the hair cortisol/DHEA(S) ratio at T2 among smart workers. Overall, this study indicates that SW is a double-edged sword, with both positive and negative consequences on employee wellbeing. Furthermore, our findings suggest that the hair cortisol/DHEA(S) ratio is a promising biomarker of WRS. Practical implications that organizations and practitioners can adopt to prevent WRS and promote organizational wellbeing are discussed.
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Affiliation(s)
- Alessandra Falco
- FISPPA Section of Applied Psychology, University of Padua, 35131 Padua, Italy
| | - Damiano Girardi
- FISPPA Section of Applied Psychology, University of Padua, 35131 Padua, Italy
| | - Achim Elfering
- Institute of Psychology, University of Bern, 3012 Bern, Switzerland
| | - Tanja Peric
- Department of Agricultural, Environmental and Animal Sciences, University of Udine, 33100 Udine, Italy
| | - Isabella Pividori
- Department of Agricultural, Environmental and Animal Sciences, University of Udine, 33100 Udine, Italy
| | - Laura Dal Corso
- FISPPA Section of Applied Psychology, University of Padua, 35131 Padua, Italy
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5
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Rahnfeld M, Wendsche J, Wegge J. Job demands and resources as drivers of exhaustion and leaving intentions: a prospective analysis with geriatric nurses. BMC Geriatr 2023; 23:167. [PMID: 36959574 PMCID: PMC10037764 DOI: 10.1186/s12877-023-03829-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Accepted: 02/16/2023] [Indexed: 03/25/2023] Open
Abstract
BACKGROUND Nurses show a high prevalence of exhaustion and increased leaving intentions. With this study, we integrate established research about turnover intention with recent burnout literature and present a theoretical model that combines both. The aim of this study was to examine job demands (time pressure, social conflicts) and resources (job control, supervisor support, task identity, person-organisation fit) as drivers and health and age as moderators for the relationships between exhaustion and nurses' organisational and professional leaving intentions. METHODS We analysed data from a standardised paper-pencil questionnaire survey with a prospective, two-wave (12 months apart) study design. In total, 584 nurses participated at Time 1 (t1). The final sample at Time 2 (t2) was n = 222 nurses (38%; age: M = 41.1 years, SD = 11.0; 88% females). RESULTS We identified time pressure as job demand and job control, task identity, and person-organisation fit as resources that drive the relationships of exhaustion (mean between both times of measures) and organisational and professional leaving intentions. The relationships to organisational leaving intentions decreased with nurses' age and the relationships to professional leaving intentions increased for nurses who had poorer self-rated health. We found indirect effects of exhaustion for relationships between job demands and nurses' leaving intentions. Relationships to exhaustion remained significant after adjusting for depressive mood. CONCLUSION Insights from this study can be used both by employers and employees. Redesigning work might be a promising approach to improve nurses' well-being and retention in this profession. Geriatric care facilities should include the concept of person-organisation fit into their personnel selection process.
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Affiliation(s)
- Marlen Rahnfeld
- Faculty of Psychology, TU Dresden, Zellescher Weg 17, D-01069, Dresden, Germany
| | - Johannes Wendsche
- Federal Institute for Occupational Safety and Health, Fabricestraße 8, D-01099, Dresden, Germany
| | - Jürgen Wegge
- Faculty of Psychology, TU Dresden, Zellescher Weg 17, D-01069, Dresden, Germany.
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6
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Bärtl C, Kreuzpointner L, Wüst S, Kudielka BM. Investigation of cross-sectional and longitudinal associations between work-related burnout and hair cortisol: The Regensburg Burnout Project. Psychoneuroendocrinology 2023; 149:106026. [PMID: 36657345 DOI: 10.1016/j.psyneuen.2023.106026] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Revised: 01/10/2023] [Accepted: 01/12/2023] [Indexed: 01/15/2023]
Abstract
BACKGROUND Burnout is characterized by feelings of exhaustion, depersonalization as well as reduced personal accomplishment and is linked to various negative health effects. Previous studies on biological correlates of burnout have focused on the hypothalamic-pituitary-adrenal (HPA) axis. However, especially studies on hair cortisol concentrations (HCC) were often based on cross-sectional data and yielded inconsistent results, probably due to the heterogeneity of the selected samples. Accordingly, the aim of the present study was to investigate cross-sectional as well as longitudinal associations between burnout and HCC within a sample consisting of a strictly specified group of individuals suffering from burnout (BO group) and a healthy comparison group (HC group). METHODS After a multi-stage recruitment procedure based on burnout symptoms and pathogenesis, eligible subjects (out of an initial sample of 1022 volunteers) were assigned either to a BO (n = 55) or HC group (n = 59), as described in detail in Bärtl et al. (2022). Burnout symptoms as well as HCC (1 cm hair samples) were measured repeatedly at two sampling time points t1 (n = 114) and t2 (n = 100) with an interval of M = 7.20 months (SD = 1.16) between assessments. RESULTS In the total study sample, no cross-sectional associations between burnout and HCC were found either at t1 or at t2. When the analysis was restricted to the BO group, HCC was positively related to burnout symptomatology at t1 but not t2. In the longitudinal analysis, burnout symptoms at t1 were significant negative predictors of HCC at t2. However, the change in HCC from t1 to t2 was not associated with the change in burnout symptoms. CONCLUSIONS In the present study, we investigated the association between HCC and burnout in a strictly defined sample of subjects suffering from burnout and healthy controls. Our findings mainly do not support our hypotheses. At least, the positive association between HCC and burnout symptoms only within the BO group supports the idea that HPA axis alterations in burnout might only become apparent once a certain threshold of burnout symptomatology has been exceeded, while the longitudinal data provide some empirical evidence for the potential long-term development of hypocortisolism in burnout. However, respective results remain relatively inconclusive.
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Affiliation(s)
- Christoph Bärtl
- Institute of Psychology, University of Regensburg, Regensburg, Germany.
| | | | - Stefan Wüst
- Institute of Psychology, University of Regensburg, Regensburg, Germany
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7
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Ren SY, Sun ZL, Yang J. The use of biochemical indexes in hair for clinical studies of psychiatric diseases: What can we learn about mental disease from hair? J Psychiatr Res 2023; 158:305-313. [PMID: 36628872 DOI: 10.1016/j.jpsychires.2023.01.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2022] [Revised: 12/25/2022] [Accepted: 01/03/2023] [Indexed: 01/06/2023]
Abstract
Analysis of hair samples provides unique advantages, including non-invasive sampling, sample stability, and the possibility of additional optimization of high sensitivity detection methods. Hair sample analysis is often used in psychiatric disease research to evaluate previous periods of stress encountered by patients. Glucocorticoid analysis is the most frequently tested indicator of stress. Furthermore, the hypothalamus-pituitary-gonad axis and endocannabinoid system also are involved in the occurrence and development of mental disorders. The endocannabinoid and sex hormone levels in patients experiencing mental illness are considerably different from levels observed in healthy individuals. Nevertheless, due to the different methods used to assess the degree of disease and the range of analytical methods involved in clinical research, the trends in changes for these biomarkers are not uniform. The correlations between changes in biomarker concentrations and illness severity also are not clear. The observed alterations suggest these biochemical substances in hair have potential as biomarkers for diagnosis or predictive treatment. However, the variable results obtained thus far could hamper further development of hair samples for clinical assessment in psychiatric disorders. This article summarizes the published reports documenting the changes in the content of relevant substances in hair in individuals experiencing mental illness and the degree of correlation. In the discussion section, we proposed several issues that should be considered in future studies of hair samples obtained from patients with mental disorders to promote the use of hair sample assessment as an aid in diagnosis or predictive treatment.
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Affiliation(s)
- Si-Yu Ren
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China; Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Zuo-Li Sun
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China; Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Jian Yang
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China; Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China.
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8
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Olivé V, Navinés R, Macías L, López JA, Ariz J, Quesada S, Barroso S, Filella X, Langohr K, Martin-Santos R. Psychosocial and biological predictors of resident physician burnout. Gen Hosp Psychiatry 2022; 78:68-71. [PMID: 35901627 DOI: 10.1016/j.genhosppsych.2022.07.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Revised: 07/15/2022] [Accepted: 07/18/2022] [Indexed: 11/30/2022]
Abstract
BACKGROUND A high proportion of health professionals in training suffer from work-related stress and may develop a burnout syndrome. OBJECTIVES To study the incidence of burnout after the first year of residency in a teaching hospital and to identify baseline psychological, psychosocial work conditions, and biological risk factors. METHODOLOGY We assessed the following in a prospective cohort of residents at baseline (first month residence) and after 1 year: background factors (socio-demographics, psychiatric history), perceived stress score (Perceived Stress Scale), Maslach Burnout Inventory score, and psychosocial factors (Job Content Questionnaire). Blood samples were obtained to study serum cortisol, IL-6, and TNF-α concentrations. The cumulative incidence was modelled by multivariate log-binomial regression analysis. RESULTS We included 71 participants with a female majority (64.8%), age 26.4 (2.65) years, psychiatric history in 20%, and burnout in 13%. Among those without burnout initially (N = 59), it had developed by 1 year in 22% of residents. Increased job demand (RR = 1.259, 95%CI = 1.019-1.556, p = 0.033) and decreased cortisol levels (RR = 0.877, 95%CI = 0.778-0.989, p = 0.032) predicted burnout after 1 year of residency among medical trainees. CONCLUSION Burnout syndrome develops in 22% of residents by 1 year of training and can be predicted by increased work demands and decreased cortisol levels.
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Affiliation(s)
- V Olivé
- Department of Medicine, Psychiatry Functional Unit, Institute of Neuroscience, University of Barcelona (UB), Barcelona, Spain.; Department of Occupational Health and Prevention, Hospital Clinic, Barcelona, Spain.
| | - R Navinés
- Department of Psychiatry and Psychology, Hospital Clinic, UB, Institut d' Investigació, Biomèdica August Pi i Sunyer (IDIBAPS), CIBERSAM, Barcelona, Spain.
| | - L Macías
- Department of Biochemistry and Molecular Genetics, Center of Biomedic Diagnosis (CDB), Hospital Clinic, UB, IDIBAPS, Barcelona, Spain.
| | - J A López
- Department of Occupational Health and Prevention, Hospital Clinic, Barcelona, Spain.
| | - J Ariz
- Department of Occupational Health and Prevention, Hospital Clinic, Barcelona, Spain.
| | - S Quesada
- Department of Occupational Health and Prevention, Hospital Clinic, Barcelona, Spain.
| | - S Barroso
- Department of Occupational Health and Prevention, Hospital Clinic, Barcelona, Spain.
| | - X Filella
- Department of Biochemistry and Molecular Genetics, Center of Biomedic Diagnosis (CDB), Hospital Clinic, UB, IDIBAPS, Barcelona, Spain.
| | - K Langohr
- Department of Statistics and Operations Research, Universitat Politècnica de Catalunya/Barcelonatech (UPC), Barcelona, Spain.
| | - R Martin-Santos
- Department of Medicine, Psychiatry Functional Unit, Institute of Neuroscience, University of Barcelona (UB), Barcelona, Spain.; Department of Psychiatry and Psychology, Hospital Clinic, UB, Institut d' Investigació, Biomèdica August Pi i Sunyer (IDIBAPS), CIBERSAM, Barcelona, Spain.
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9
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Out of Sight, Out of Mind? A Longitudinal Investigation of Smart Working and Burnout in the Context of the Job Demands–Resources Model during the COVID-19 Pandemic. SUSTAINABILITY 2022. [DOI: 10.3390/su14127121] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
The academic interest in smart working, a form of flexible work characterized by the use of technology to conduct one’s work, has dramatically increased over recent years, especially during the COVID-19 pandemic. Building on the job demands–resources (JD-R) model, in this study we investigate whether smart working affects the longitudinal association between perceived work characteristics, such as workload and social support (SS), and workers’ health and well-being, in terms of exhaustion. Overall, 185 workers completed a self-report questionnaire at two time points (four-month time-lag) during the COVID-19 outbreak. The results from moderated multiple regression analysis partially support our predictions. The longitudinal association between workload and exhaustion was positive—although marginally significant—for smart workers, but nonsignificant for in-person workers. Contrarily, the longitudinal association between SS and exhaustion was negative for in-person workers, but nonsignificant for smart workers. Overall, this study suggests that, to support employees’ health and productivity, work characteristics—both physical and psychosocial—should fit the new way of working as well as remote workers’ specific needs and expectations. Hence, to promote sustainable work, interventions should be aimed at helping smart workers to manage their workload effectively, as well as reducing professional and social isolation.
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10
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Marcil MJ, Cyr S, Marin MF, Rosa C, Tardif JC, Guay S, Guertin MC, Genest C, Forest J, Lavoie P, Labrosse M, Vadeboncoeur A, Selcer S, Ducharme S, Brouillette J. Hair cortisol change at COVID-19 pandemic onset predicts burnout among health personnel. Psychoneuroendocrinology 2022; 138:105645. [PMID: 35134663 PMCID: PMC8697418 DOI: 10.1016/j.psyneuen.2021.105645] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Revised: 11/23/2021] [Accepted: 12/21/2021] [Indexed: 12/05/2022]
Abstract
BACKGROUND The COVID-19 pandemic has put chronic pressure on worldwide healthcare systems. While the literature regarding the prevalence of psychological distress and associated risk factors among healthcare workers facing COVID-19 has exploded, biological variables have been mostly overlooked. METHODS 467 healthcare workers from Quebec, Canada, answered an electronic survey covering various risk factors and mental health outcomes three months after the onset of the COVID-19 pandemic. Of them, 372 (80%) provided a hair sample, providing a history of cortisol secretion for the three months preceding and following the pandemic's start. We used multivariable regression models and a receiver operating characteristic curve to study hair cortisol as a predictor of burnout and psychological health, together with individual, occupational, social, and organizational factors. RESULTS As expected, hair cortisol levels increased after the start of the pandemic, with a median relative change of 29% (IQR = 3-59%, p < 0.0001). There was a significant association between burnout status and change in cortisol, with participants in the second quarter of change having lower odds of burnout. No association was found between cortisol change and post-traumatic stress disorder, anxiety, and depression symptoms. Adding cortisol to individual-occupational-socio-organizational factors noticeably enhanced our burnout logistic regression model's predictability. CONCLUSION Change in hair cortisol levels predicted burnout at three months in health personnel at the onset of the COVID-19 pandemic. This non-invasive biological marker of the stress response could be used in further clinical or research initiatives to screen high-risk individuals to prevent and control burnout in health personnel facing an important stressor.
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Affiliation(s)
- Marie-Joëlle Marcil
- Research Centre, Montreal Heart Institute, 5000 Bélanger Street, Montréal, H1T 1C8 Québec, Canada,Department of Psychiatry and Addiction, Université de Montréal, Roger-Gaudry Pavilion, Faculty of Medicine, P.O. Box 6128, Downtown Branch, Montréal, H3C 3J7 Québec, Canada
| | - Samuel Cyr
- Research Centre, Montreal Heart Institute, 5000 Bélanger Street, Montréal, H1T 1C8 Québec, Canada,Faculty of Pharmacy, Université de Montréal, P.O. Box 6128, Downtown Branch, Montréal, H3C 3J7 Québec, Canada
| | - Marie-France Marin
- Department of Psychiatry and Addiction, Université de Montréal, Roger-Gaudry Pavilion, Faculty of Medicine, P.O. Box 6128, Downtown Branch, Montréal, H3C 3J7 Québec, Canada,Department of Psychology, UQAM, 100 Sherbrooke Street West, Montréal, H2X 3P2 Québec, Canada,Research Centre, Institut universitaire en santé mentale de Montréal, 7331 Hochelaga Street, Montréal, H1N 3V2 Québec, Canada
| | - Camille Rosa
- Montreal Health Innovations Coordinating Centre, 5000 Bélanger Street, Montréal, H1T 1C8 Québec, Canada
| | - Jean-Claude Tardif
- Research Centre, Montreal Heart Institute, 5000 Bélanger Street, Montréal, H1T 1C8 Québec, Canada,Faculty of Medicine, Université de Montréal, P.O. Box 6128, Downtown Branch, Montréal, H3C 3J7 Québec, Canada
| | - Stéphane Guay
- Department of Psychiatry and Addiction, Université de Montréal, Roger-Gaudry Pavilion, Faculty of Medicine, P.O. Box 6128, Downtown Branch, Montréal, H3C 3J7 Québec, Canada,Centre d’étude sur le Trauma, Research Centre, Institut universitaire en santé mentale de Montréal, 7331 Hochelaga Street, Montréal, H1N 3V2 Québec, Canada
| | - Marie-Claude Guertin
- Montreal Health Innovations Coordinating Centre, 5000 Bélanger Street, Montréal, H1T 1C8 Québec, Canada
| | - Christine Genest
- Centre d’étude sur le Trauma, Research Centre, Institut universitaire en santé mentale de Montréal, 7331 Hochelaga Street, Montréal, H1N 3V2 Québec, Canada,Faculty of Nursing, Université de Montréal, Marguerite-d'Youville Pavilion, P.O. Box 6128, Downtown Branch, Montréal, H3C 3J7 Québec, Canada
| | - Jacques Forest
- Department of Organization and Human Resources, ESG UQAM, P.O. Box 8888, Downtown Branch, Montréal, H3C 3P8 Québec, Canada
| | - Patrick Lavoie
- Research Centre, Montreal Heart Institute, 5000 Bélanger Street, Montréal, H1T 1C8 Québec, Canada,Faculty of Nursing, Université de Montréal, Marguerite-d'Youville Pavilion, P.O. Box 6128, Downtown Branch, Montréal, H3C 3J7 Québec, Canada
| | - Mélanie Labrosse
- Faculty of Medicine, Université de Montréal, P.O. Box 6128, Downtown Branch, Montréal, H3C 3J7 Québec, Canada,Division of Emergency Medicine, Department of Pediatrics, Centre Hospitalier Universitaire Sainte-Justine, 3175 Côte-Sainte-Catherine Road, Montréal, H3T 1C5 Québec, Canada
| | - Alain Vadeboncoeur
- Research Centre, Montreal Heart Institute, 5000 Bélanger Street, Montréal, H1T 1C8 Québec, Canada,Faculty of Medicine, Université de Montréal, P.O. Box 6128, Downtown Branch, Montréal, H3C 3J7 Québec, Canada
| | - Shaun Selcer
- Research Centre, Montreal Heart Institute, 5000 Bélanger Street, Montréal, H1T 1C8 Québec, Canada,Faculty of Medicine, Université de Montréal, P.O. Box 6128, Downtown Branch, Montréal, H3C 3J7 Québec, Canada
| | - Simon Ducharme
- Department of Psychiatry, Douglas Mental Health University Institute, McGill University, 6875 LaSalle Boulevard, Verdun, H4H 1R3 Québec, Canada,McConnell Brain Imaging Centre, Montreal Neurological Institute, McGill University, 3801 University St, Montréal, H3A 2B4 Québec, Canada
| | - Judith Brouillette
- Research Centre, Montreal Heart Institute, 5000 Bélanger Street, Montréal, H1T 1C8 Québec, Canada; Department of Psychiatry and Addiction, Université de Montréal, Roger-Gaudry Pavilion, Faculty of Medicine, P.O. Box 6128, Downtown Branch, Montréal, H3C 3J7 Québec, Canada.
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Hair-based biomarkers in women with major depressive disorder: Glucocorticoids, endocannabinoids, N-acylethanolamines, and testosterone. COMPREHENSIVE PSYCHONEUROENDOCRINOLOGY 2021; 7:100068. [PMID: 35757050 PMCID: PMC9216461 DOI: 10.1016/j.cpnec.2021.100068] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Accepted: 06/14/2021] [Indexed: 11/24/2022] Open
Abstract
Background Stress-related alterations in the regulation of several endocrine systems, including the hypothalamus-pituitary-adrenal (HPA) and -gonadal (HPG) axes and the endocannabinoid system are proposed to be involved in the etiology of major depressive disorder (MDD). Therefore, this study examines whether altered concentrations of glucocorticoids, testosterone, endocannabinoids, and related N-acylethanolamines accumulated in hair are present in MDD. Methods Female participants (range: 19–59, Mdn = 30.5 years) were recruited, including n = 21 with a current MDD episode and n = 27 nondepressed controls without any current mental disorder. Weight-standardized samples of 3 cm hair segments were analyzed which equals to three months of retrospectively assessed biomarkers in hair. Concentrations of cortisol, cortisone, testosterone, endocannabinoids (i.e., anandamide [AEA], 2-arachidonylglycerol [2-AG]), and selected N-acylethanolamines (i.e., stearoylethanolamide [SEA], oleoylethanolamide [OEA], palmitoylethanolamide [PEA]) were measured using mass spectrometry. Results Female MDD patients exhibited lower cortisol and cortisone levels in hair than nondepressed controls, whereas the hair concentrations of endocannabinoids, N-acylethanolamines, and testosterone did not differ between the groups. Conclusions Our results add to the heterogeneous body of findings on alterations in hair-stored glucocorticoids and endocannabinoids in MDD. As in previous studies, there was no evidence of altered testosterone concentrations in the hair of MDD patients. Larger and longitudinal studies are needed to comprehensively explore the overall picture of endocrine alterations in MDD. Analysis of hair-based markers of endocrine alterations in female MDD outpatients. Lower hair cortisol and cortisone concentrations in mild to moderately severe MDD. No differences in endocannabinoid, N-acylethanolamine, and testosterone hair levels. Testosterone and cortisone levels were linked to higher stress/trauma exposure.
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Ostinelli G, Scovronec A, Iceta S, Ouellette AS, Lemieux S, Biertho L, Bégin C, Michaud A, Tchernof A. Deciphering the Association Between Hypothalamus-Pituitary-Adrenal Axis Activity and Obesity: A Meta-Analysis. Obesity (Silver Spring) 2021; 29:846-858. [PMID: 33783120 DOI: 10.1002/oby.23125] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2020] [Revised: 12/17/2020] [Accepted: 12/31/2020] [Indexed: 12/29/2022]
Abstract
OBJECTIVE Both the cortisol awakening response (CAR; corresponding to the state measurement) and hair cortisol concentration (HCC; corresponding to the trait measurement) are considered reliable markers of hypothalamus-pituitary-adrenal axis activity. Because cortisol has long been associated with adiposity, this systematic review and meta-analysis aims to summarize and compare the literature around CAR and HCC and their association with obesity or fat distribution indices. METHODS The PubMed, Web of Science (Web of Science Core Collection and Medline), EBSCO Information Services, Embase, and PsycNET databases were searched, and full-text articles investigating the association between CAR or HCC and markers of adiposity in humans were included. Meta-analyses were then performed to compare studies associating CAR or HCC with BMI (a marker of general adiposity) and waist circumference (a marker of fat distribution). RESULTS The results of this review highlight inconsistencies in cortisol sampling and CAR computation, which makes comparisons between studies difficult. It was found that adiposity indices are not associated with CAR but that they correlate significantly and positively with HCC. The subgroup analysis hinted to possible age differences in the magnitude of the association between HCC and BMI. CONCLUSIONS Trait rather than state measurement of the hypothalamus-pituitary-adrenal axis activity is associated with increased general and abdominal adiposity in humans.
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Affiliation(s)
- Giada Ostinelli
- Québec Heart and Lung Institute Research Center, Québec City, Québec, Canada
- School of Nutrition, Université Laval, Québec City, Québec, Canada
| | - Anaïs Scovronec
- Québec Heart and Lung Institute Research Center, Québec City, Québec, Canada
- School of Nutrition, Université Laval, Québec City, Québec, Canada
| | - Sylvain Iceta
- Québec Heart and Lung Institute Research Center, Québec City, Québec, Canada
- School of Nutrition, Université Laval, Québec City, Québec, Canada
| | | | - Simone Lemieux
- School of Nutrition, Université Laval, Québec City, Québec, Canada
| | - Laurent Biertho
- Québec Heart and Lung Institute Research Center, Québec City, Québec, Canada
| | - Catherine Bégin
- School of Psychology, Université Laval, Québec City, Québec, Canada
| | - Andréanne Michaud
- Québec Heart and Lung Institute Research Center, Québec City, Québec, Canada
- School of Nutrition, Université Laval, Québec City, Québec, Canada
| | - André Tchernof
- Québec Heart and Lung Institute Research Center, Québec City, Québec, Canada
- School of Nutrition, Université Laval, Québec City, Québec, Canada
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