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Hansson C, Hadžibajramović E, Svensson PA, Jonsdottir IH. Increased plasma levels of neuro-related proteins in patients with stress-related exhaustion: A longitudinal study. Psychoneuroendocrinology 2024; 167:107091. [PMID: 38964018 DOI: 10.1016/j.psyneuen.2024.107091] [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: 12/22/2023] [Revised: 05/29/2024] [Accepted: 05/30/2024] [Indexed: 07/06/2024]
Abstract
Exhaustion disorder (ED) is a stress-related disorder characterized by physical and mental symptoms of exhaustion. Recent data suggest that pathophysiological processes in the central nervous system are involved in the biological mechanisms underlying ED. The aims of this study were to investigate if plasma levels of neuro-related proteins differ between patients with ED and healthy controls, and, if so, to investigate if these differences persist over time. Using the Olink Neuro Exploratory panel, we quantified the plasma levels of 92 neuro-related proteins in 163 ED patients at the time of diagnosis (baseline), 149 patients at long-term follow-up (7-12 years later, median follow-up time 9 years and 5 months), and 100 healthy controls. We found that the plasma levels of 40 proteins were significantly higher in the ED group at baseline compared with the control group. Out of these, the plasma levels of 36 proteins were significantly lower in the ED group at follow-up compared with the same group at baseline and the plasma levels of four proteins did not significantly differ between the groups. At follow-up, the plasma levels of two proteins were significantly lower in the ED group compared with the control group. These data support the hypothesis that pathophysiological processes in the central nervous system are involved in the biological mechanisms underlying ED.
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Affiliation(s)
- Caroline Hansson
- The Institute of Stress Medicine, Region Västra Götaland, Gothenburg, Sweden; Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
| | - Emina Hadžibajramović
- The Institute of Stress Medicine, Region Västra Götaland, Gothenburg, Sweden; School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Per-Arne Svensson
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Ingibjörg H Jonsdottir
- The Institute of Stress Medicine, Region Västra Götaland, Gothenburg, Sweden; School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
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Kramuschke M, Renner A, Kersting A. [Burnout : Symptoms, diagnostics and treatment approaches]. DER NERVENARZT 2024; 95:484-493. [PMID: 38625570 DOI: 10.1007/s00115-024-01649-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 03/15/2024] [Indexed: 04/17/2024]
Abstract
Burnout syndrome is characterized by the triad of symptoms exhaustion, mental distance from work activities and a feeling of ineffectiveness. The syndrome is not an independent mental disorder but can be coded in the 10th Revision of the International Statistical Classification of Diseases and Related Health Problems (ICD-10) as a problem related to difficulties in coping with life (Z73) and in ICD-11 as a qualifying diagnosis (QD85). This article discusses the prevalence and comorbidities of burnout syndrome, taking the methodological difficulties in conceptualizing and operationalizing the construct into account. In addition, it provides an overview of available measurement instruments and their validation. Furthermore, it discusses work-related and individual factors in the development of burnout syndrome as well as analysis of the effectiveness of treatment options.
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Affiliation(s)
- M Kramuschke
- Klinik und Poliklinik für Psychosomatische Medizin und Psychotherapie, Universitätsklinikum Leipzig, Semmelweisstr. 10, 04103, Leipzig, Deutschland.
| | - A Renner
- Klinik und Poliklinik für Psychosomatische Medizin und Psychotherapie, Universitätsklinikum Leipzig, Semmelweisstr. 10, 04103, Leipzig, Deutschland
| | - A Kersting
- Klinik und Poliklinik für Psychosomatische Medizin und Psychotherapie, Universitätsklinikum Leipzig, Semmelweisstr. 10, 04103, Leipzig, Deutschland
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3
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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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Tossici G, Zurloni V, Nitri A. Stress and sport performance: a PNEI multidisciplinary approach. Front Psychol 2024; 15:1358771. [PMID: 38495423 PMCID: PMC10940545 DOI: 10.3389/fpsyg.2024.1358771] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Accepted: 02/07/2024] [Indexed: 03/19/2024] Open
Abstract
Stress control is essential for avoiding a state of anxiety in sport competitions, as this state may have negative effects on other psychological variables of athletes, decreasing their self-confidence and harming their attentional control. In the present contribution a distress intervention model developed from a PNEI perspective will be sketched out. Our theoretical-methodological proposal consists of the definition of an integrated protocol of psycho-biological assessment and intervention on the allostatic load and on the levels of distress/eustress detectable in the sport environment, in relation to the person's health/well-being condition and the impact of this condition on the quality of sport performance. This paradigm has the potential to explore both the psychological dimension of stress management and the psycho-educational and psycho-physical dimension, according to a truly integrated approach to the athlete's health and psychophysical well-being. Its multidisciplinary nature requires close cooperation between different professional figures, such as the mental coach, psychologist, nutritionist, osteopath, and physiotherapist, as well as biologists, physicians and kinesiologists, both in planning and in implementation and monitoring at all stages. The potential impact of the model on sport performance will be deeply discussed.
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Affiliation(s)
- Giulia Tossici
- “Riccardo Massa” Department of Human Sciences for Education, University of Milano-Bicocca, Milan, Italy
| | - Valentino Zurloni
- “Riccardo Massa” Department of Human Sciences for Education, University of Milano-Bicocca, Milan, Italy
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Spanakis M, Fragkiadaki P, Renieri E, Vakonaki E, Fragkiadoulaki I, Alegakis A, Kiriakakis M, Panagiotou N, Ntoumou E, Gratsias I, Zoubaneas E, Morozova GD, Ovchinnikova MA, Tsitsimpikou C, Tsarouhas K, Drakoulis N, Skalny AV, Tsatsakis A. Advancing athletic assessment by integrating conventional methods with cutting-edge biomedical technologies for comprehensive performance, wellness, and longevity insights. Front Sports Act Living 2024; 5:1327792. [PMID: 38260814 PMCID: PMC10801261 DOI: 10.3389/fspor.2023.1327792] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Accepted: 12/19/2023] [Indexed: 01/24/2024] Open
Abstract
In modern athlete assessment, the integration of conventional biochemical and ergophysiologic monitoring with innovative methods like telomere analysis, genotyping/phenotypic profiling, and metabolomics has the potential to offer a comprehensive understanding of athletes' performance and potential longevity. Telomeres provide insights into cellular functioning, aging, and adaptation and elucidate the effects of training on cellular health. Genotype/phenotype analysis explores genetic variations associated with athletic performance, injury predisposition, and recovery needs, enabling personalization of training plans and interventions. Metabolomics especially focusing on low-molecular weight metabolites, reveal metabolic pathways and responses to exercise. Biochemical tests assess key biomarkers related to energy metabolism, inflammation, and recovery. Essential elements depict the micronutrient status of the individual, which is critical for optimal performance. Echocardiography provides detailed monitoring of cardiac structure and function, while burnout testing evaluates psychological stress, fatigue, and readiness for optimal performance. By integrating this scientific testing battery, a multidimensional understanding of athlete health status can be achieved, leading to personalized interventions in training, nutrition, supplementation, injury prevention, and mental wellness support. This scientifically rigorous approach hereby presented holds significant potential for improving athletic performance and longevity through evidence-based, individualized interventions, contributing to advances in the field of sports performance optimization.
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Affiliation(s)
- Marios Spanakis
- Department of Forensic Sciences and Toxicology, School of Medicine, University of Crete, Heraklion, Greece
- Computational Bio-Medicine Laboratory, Institute of Computer Science, Foundation for Research and Technology – Hellas, Heraklion, Greece
- LifePlus Diagnostic & Consulting Health Services, Science Technology Park of Crete, Heraklion, Greece
| | - Persefoni Fragkiadaki
- Department of Forensic Sciences and Toxicology, School of Medicine, University of Crete, Heraklion, Greece
- LifePlus Diagnostic & Consulting Health Services, Science Technology Park of Crete, Heraklion, Greece
| | - Elisavet Renieri
- Department of Forensic Sciences and Toxicology, School of Medicine, University of Crete, Heraklion, Greece
- LifePlus Diagnostic & Consulting Health Services, Science Technology Park of Crete, Heraklion, Greece
| | - Elena Vakonaki
- Department of Forensic Sciences and Toxicology, School of Medicine, University of Crete, Heraklion, Greece
- LifePlus Diagnostic & Consulting Health Services, Science Technology Park of Crete, Heraklion, Greece
| | - Irene Fragkiadoulaki
- Department of Forensic Sciences and Toxicology, School of Medicine, University of Crete, Heraklion, Greece
- LifePlus Diagnostic & Consulting Health Services, Science Technology Park of Crete, Heraklion, Greece
| | - Athanasios Alegakis
- Department of Forensic Sciences and Toxicology, School of Medicine, University of Crete, Heraklion, Greece
- LifePlus Diagnostic & Consulting Health Services, Science Technology Park of Crete, Heraklion, Greece
| | - Mixalis Kiriakakis
- Department of Forensic Sciences and Toxicology, School of Medicine, University of Crete, Heraklion, Greece
- LifePlus Diagnostic & Consulting Health Services, Science Technology Park of Crete, Heraklion, Greece
| | | | | | - Ioannis Gratsias
- Check Up Medicus Biopathology & Ultrasound Diagnostic Center – Polyclinic, Athens, Greece
| | | | - Galina Dmitrievna Morozova
- Bioelementology and Human Ecology Center, I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
| | - Marina Alekseevna Ovchinnikova
- Department of Sport Medicine and Medical Rehabilitation, I.M. Sechenov First Moscow State Medical University (Sechenov Univercity), Moscow, Russia
| | | | | | - Nikolaos Drakoulis
- Research Group of Clinical Pharmacology and Pharmacogenomics, Faculty of Pharmacy, School of Health Sciences, National and Kapodistrian University of Athens, Athens, Greece
| | - Anatoly Viktorovich Skalny
- Bioelementology and Human Ecology Center, I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
- Medical Elementology Department, Peoples Friendship University of Russia, Moscow, Russia
| | - Aristides Tsatsakis
- Department of Forensic Sciences and Toxicology, School of Medicine, University of Crete, Heraklion, Greece
- Computational Bio-Medicine Laboratory, Institute of Computer Science, Foundation for Research and Technology – Hellas, Heraklion, Greece
- LifePlus Diagnostic & Consulting Health Services, Science Technology Park of Crete, Heraklion, Greece
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Yamaguchi S, Fujita T, Kato S, Yoshimitsu Y, Ito YM, Yano R. Utility of salivary cortisol profile as a predictive biomarker in nurses' turnover risk: a preliminary study. J Physiol Anthropol 2024; 43:1. [PMID: 38167248 PMCID: PMC10759393 DOI: 10.1186/s40101-023-00349-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2023] [Accepted: 11/28/2023] [Indexed: 01/05/2024] Open
Abstract
BACKGROUND Predicting nurse turnover risk is crucial due to the global nursing shortage; however, existing predictors, such as fatigue and burnout, lack objectivity. Salivary cortisol is a non-invasive marker of stress and fatigue, but its utility in predicting nurse turnover risk is unknown. We examined whether salivary cortisol profiles across three different day shifts in a month are predictors of the extent of nurses' reluctance to stay in their current jobs. METHODS This preliminary longitudinal study followed forty female nurses who engaged in shift work at a university hospital for 3 months. Data at enrollment were collected including demographics, working conditions, chronic fatigue (the Japanese version of the Occupational Fatigue/Exhaustion Recovery Scale), and burnout (Japanese Burnout scale). Salivary cortisol was measured before the three different day shifts (after awakening) during the first month, and the means of these measurements were used as the cortisol profile. The extent of reluctance to stay was assessed using the numerical rating scale at 3 months. RESULTS Among the forty female nurses (mean [SD] age, 28.3 [5.1]), all completed follow-up and were included in the analysis. The cortisol profile was associated with the extent of reluctance to stay (P = 0.017), and this association was significant despite adjustments for chronic fatigue and burnout (P = 0.005). A multiple regression model with chronic fatigue, burnout, and job tenure explained 41.5% of the variation in reluctance to stay. When the cortisol profile was added to this model, the association of the cortisol profile was significant (P = 0.006) with an R2 of 0.529 (ΔR2 = 0.114). CONCLUSIONS This preliminary study conducted in an actual clinical setting indicated the potential of the salivary cortisol profile across three different day shifts in a month to predict nurses' reluctance to stay in their current jobs. The combination of subjective indicators and the cortisol profile would be useful in predicting nurses' turnover risk.
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Affiliation(s)
- Shinya Yamaguchi
- Department of Nursing, Teine Keijinkai Hospital, Sapporo, Japan
- Graduate School of Health Sciences, Hokkaido University, Sapporo, Japan
| | | | | | | | - Yoichi M Ito
- Data Science Center, Promotion Unit, Institute of Health Science Innovation for Medical Care, Hokkaido University Hospital, Sapporo, Japan
| | - Rika Yano
- Faculty of Health Sciences, Hokkaido University, Sapporo, Japan.
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von Känel R, Princip M, Holzgang SA, Sivakumar S, Pazhenkottil AP, Gomez Vieito D, Zuccarella-Hackl C. Sympathetic nervous system responses to acute psychosocial stress in male physicians with clinical burnout. Biol Psychol 2023; 183:108687. [PMID: 37716520 DOI: 10.1016/j.biopsycho.2023.108687] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2023] [Revised: 08/31/2023] [Accepted: 09/11/2023] [Indexed: 09/18/2023]
Abstract
BACKGROUND Occupational burnout has been associated with an increased risk of cardiovascular disease, with sympathetic nervous system (SNS) dysfunction as one explanation. This study examined the effects of burnout on responses of SNS activity measures to acute psychosocial stress in male physicians, a population at risk for burnout. METHODS Study participants were 60 male physicians, 30 with clinical burnout, assessed with the Maslach Burnout Inventory, and 30 without burnout (controls). All participants underwent the 15-min Trier Social Stress Test. Heart rate, blood pressure, salivary alpha-amylase, and plasma levels of epinephrine (EPI) and norepinephrine were assessed pre-stress, immediately post-stress, and 15 min and 45 min post-stress. RESULTS Physicians with burnout and controls differed in EPI changes over time, controlling for age, job stress and anxiety symptoms (F (3,147) = 5.18, p = .002 for 'Time by Group' interaction; η2p = .096). Burnout was associated with a smaller increase in EPI from pre-stress to immediately post-stress (r(54) = -.40, p = .004). The emotional exhaustion dimension of burnout was a significant driver of this effect. The area under the curve with respect to increase in EPI was also smaller in the burnout group (F (1,49) = 6.06, p = .017, η2p = .110). Group differences were not significant for the other SNS activity measures. CONCLUSIONS Burnout may be linked to dysfunction of the sympathoadrenal medullary (SAM) system, when exposed to acute psychosocial stress. In keeping with the allostatic load concept, an insufficient SAM stress response in burnout could potentially contribute to cardiovascular disease.
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Affiliation(s)
- Roland von Känel
- Department of Consultation-Liaison Psychiatry and Psychosomatic Medicine, University Hospital Zurich, University of Zurich, Zurich, Switzerland.
| | - Mary Princip
- Department of Consultation-Liaison Psychiatry and Psychosomatic Medicine, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Sarah A Holzgang
- Department of Consultation-Liaison Psychiatry and Psychosomatic Medicine, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Sinthujan Sivakumar
- Department of Consultation-Liaison Psychiatry and Psychosomatic Medicine, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Aju P Pazhenkottil
- Department of Consultation-Liaison Psychiatry and Psychosomatic Medicine, University Hospital Zurich, University of Zurich, Zurich, Switzerland; Department of Cardiology, University Hospital Zurich, University of Zurich, Zurich, Switzerland; Cardiac Imaging, Department of Nuclear Medicine, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Diego Gomez Vieito
- Department of Consultation-Liaison Psychiatry and Psychosomatic Medicine, University Hospital Zurich, University of Zurich, Zurich, Switzerland; Institute of Molecular Cancer Research, University of Zurich, Zurich, Switzerland
| | - Claudia Zuccarella-Hackl
- Department of Consultation-Liaison Psychiatry and Psychosomatic Medicine, University Hospital Zurich, University of Zurich, Zurich, Switzerland
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Vieira LMSMDA, Mininel VA, Sato TDO. Sleep Quality as a Mediator of Burnout, Stress and Multisite Musculoskeletal Pain in Healthcare Workers: A Longitudinal Study. Healthcare (Basel) 2023; 11:2476. [PMID: 37761673 PMCID: PMC10531134 DOI: 10.3390/healthcare11182476] [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: 07/25/2023] [Revised: 09/01/2023] [Accepted: 09/04/2023] [Indexed: 09/29/2023] Open
Abstract
This study aimed to verify whether sleep quality is a mediator of the relationship between burnout, stress and multisite pain in healthcare workers in a longitudinal study with 12 months of follow-up during the COVID-19 pandemic. Online questionnaires were used for data collection. The sociodemographic questionnaire contained personal and occupational data. The short version of the Copenhagen Psychosocial Questionnaire (COPSOQ II-Br) was used to assess burnout and stress. The Pittsburgh Sleep Quality Index (PSQI-Br) assessed sleep quality over one month. The Nordic Musculoskeletal Questionnaire (NMQ) aimed to identify the presence of multisite musculoskeletal pain in the last 12 months and the last 7 days. Mediation analysis was used to verify whether the effect of the predictor variables (burnout and stress) on the dependent variable (number of pain sites in the last 12 months and 7 days) was due to an intervening variable (sleep quality). Stress and burnout were associated with multisite pain in healthcare workers in the last 12 months and the last 7 days. Sleep quality was a significant mediator of this association in the last 12 months, indicating that some of the association between burnout, stress and multisite pain can be explained by poor sleep quality. Thus, a comprehensive approach to long-term multisite pain should consider psychosocial aspects such as burnout, stress and sleep quality.
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Affiliation(s)
| | - Vivian Aline Mininel
- Nursing Department, Universidade Federal de São Carlos, São Carlos 13565-905, Brazil;
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Colin C, Prince V, Bensoussan JL, Picot MC. Music therapy for health workers to reduce stress, mental workload and anxiety: a systematic review. J Public Health (Oxf) 2023; 45:e532-e541. [PMID: 37147921 DOI: 10.1093/pubmed/fdad059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Revised: 04/05/2023] [Indexed: 05/07/2023] Open
Abstract
BACKGROUND The physical and mental exhaustion of health care workers urgently needs to be addressed as a public health priority. Benefits of music on stress parameters have been extensively reported. METHODS We carried out a systematic review to examine the efficacy of music interventions on stress parameters by selecting studies conducted in genuine care stress conditions. To approach the potential benefit of music therapy (MT) versus music medicine (MM), we followed international music-based intervention guidelines. RESULTS Five outcomes were considered in our studies: stress, anxiety, mental workload, burnout risk and psychosomatic symptoms. Corresponding measures, including psychological, physiological questionnaires or stress biological parameters, showed significant results for the majority of them in music groups. Implications of music types, designs and limitations are discussed. Only one study compared MM and MT with an advantage for customized playlists over time. CONCLUSIONS In spite of heterogeneity, music interventions seem to significantly decrease stress parameters. The individual, customized supports with MT may be a crucial condition for this specific professional category. The impact of MT versus MM, the number of music sessions and the effect over time need to be explored.
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Affiliation(s)
- Catherine Colin
- Department of Radiology, Centre Hospitalier inter-communal du Bassin de Thau, BP 475 Bd Camille Blanc, Sète 34 207, France
- Music Therapy Department, Paul Valery Montpellier 3 University, Route de Mende, Montpellier 34090, France
| | - Violaine Prince
- Montpellier Laboratory of Computer Science, Robotics and Microelectronics (LIRMM), Montpellier University, 161, Ada Street, Montpellier Cedex 5, 34392, France
| | - Jean-Luc Bensoussan
- Music Therapy Department, Paul Valery Montpellier 3 University, Route de Mende, Montpellier 34090, France
| | - Marie-Christine Picot
- Department of Medical Information, INSERM, Centre d'Investigation Clinique 1411, CHU Montpellier, Montpellier University, Montpellier Cedex 5, 34 295, France
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Renaud C, Lacroix A. Neuroticism, perfectionism, and emotion suppression in burnout: Implications for cognitive functioning. APPLIED NEUROPSYCHOLOGY. ADULT 2023:1-10. [PMID: 37572420 DOI: 10.1080/23279095.2023.2244623] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/14/2023]
Abstract
This study aimed to investigate the relationship between burnout and cognitive functions, particularly memory, attention, and executive functions, which have been found to be negatively affected in most studies. However, the results are not consistent across studies, and there is often a discrepancy between self-reported cognitive function and objective assessment. Two possible explanations for this discrepancy are the heterogeneous profiles of individuals in burnout and their personality traits. The study administered neuropsychological tests and questionnaires to 29 participants with clinical burnout to assess their cognitive functions and the impact of perfectionism, neuroticism, and emotion suppression on subjective and objective cognitive scores. The main findings showed little or no deterioration in memory or executive functions, despite patients reporting severely impaired executive function. The study found that neuroticism and perfectionism were related to poorer self-reported executive function, while emotion suppression was related to better self-reported executive function. No relationship was found between personality traits and neuropsychological test scores, indicating a discrepancy between self-perception and objective evaluation.
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Affiliation(s)
- Charlie Renaud
- Laboratoire de Psychologie, Cognition, Comportement, Communication (LP3C), University of Rennes 2, Rennes, Bretagne, France
| | - Agnes Lacroix
- Laboratoire de Psychologie, Cognition, Comportement, Communication (LP3C), University of Rennes 2, Rennes, Bretagne, France
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Kottler J, Gingell MJ, Khosla S, Kordzikowski M, Raszewski R, Chestek D, Maki K. Exploring physical and biological manifestations of burnout and post-traumatic stress disorder symptoms in healthcare workers: a scoping review protocol. BMJ Open 2023; 13:e074887. [PMID: 37479518 PMCID: PMC10364163 DOI: 10.1136/bmjopen-2023-074887] [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] [Indexed: 07/23/2023] Open
Abstract
INTRODUCTION The COVID-19 pandemic has strained the mental and physical well-being of healthcare workers (HCW). Increased work-related stress and limited resources have increased symptoms of anxiety, depression, insomnia and post-traumatic stress disorder (PTSD) in this population. Stress-related disorders have been strongly associated with long-term consequences, including cardiometabolic disorders, endocrine disorders and premature mortality. This scoping review aims to explore available literature on burnout, PTSD, and other mental health-associated symptoms in HCW to synthesise relationships with physiological and biological biomarkers that may be associated with increased risk of disease, creating an opportunity to summarise current biomarker knowledge and identify gaps in this literature. METHODS AND ANALYSIS This scoping review uses the Arksey and O'Malley six-step scoping review methodology framework. The research team will select appropriate primary sources using a search strategy developed in collaboration with a health sciences librarian. Three reviewers will initially screen the title and abstracts obtained from the literature searches, and two reviewers will conduct independent reviews of full-text studies for inclusion. The research team will be reviewing literature focusing on which burnout and/or PTSD-associated physiological and biological biomarkers have been studied, the methodologies used to study them and the correlations between the biomarkers and HCW experiencing burnout/PTSD. Data extraction forms will be completed by two reviewers for included studies and will guide literature synthesis and analysis to determine common themes. ETHICS AND DISSEMINATION This review does not require ethical approval. We expect results from this scoping review to identify gaps in the literature and encourage future research regarding improving biological and physiological biomarker research in HCW. Preliminary results and general themes will be communicated back to stakeholders. Results will be disseminated through peer-reviewed publications, policy briefs and conferences as well as presented to stakeholders to an effort to invest in HCW mental and physical health.
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Affiliation(s)
- Janey Kottler
- Department of Emergency Medicine, University of Illinois Hospital & Health Sciences System, Chicago, Illinois, USA
| | - Monica J Gingell
- Department of Population Health Nursing Science, College of Nursing, University of Illinois Chicago, Chicago, Illinois, USA
| | - Shaveta Khosla
- Department of Emergency Medicine, University of Illinois Hospital & Health Sciences System, Chicago, Illinois, USA
| | - Mitchell Kordzikowski
- Department of Population Health Nursing Science, College of Nursing, University of Illinois Chicago, Chicago, Illinois, USA
| | - Rebecca Raszewski
- Library of the Health Sciences Chicago, University of Illinois at Chicago, Chicago, Illinois, USA
| | - David Chestek
- Department of Emergency Medicine, University of Illinois Hospital & Health Sciences System, Chicago, Illinois, USA
| | - Katherine Maki
- Translational Biobehavioral and Health Disparities Branch, National Institutes of Health Clinical Center, Bethesda, Maryland, USA
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Steffey MA, Griffon DJ, Risselada M, Buote NJ, Scharf VF, Zamprogno H, Winter AL. A narrative review of the physiology and health effects of burnout associated with veterinarian-pertinent occupational stressors. Front Vet Sci 2023; 10:1184525. [PMID: 37465277 PMCID: PMC10351608 DOI: 10.3389/fvets.2023.1184525] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2023] [Accepted: 06/19/2023] [Indexed: 07/20/2023] Open
Abstract
Chronic workplace stress and burnout are serious problems in veterinary medicine. Although not classified as a medical condition, burnout can affect sleep patterns and contributes to chronic low grade systemic inflammation, autonomic imbalance, hormonal imbalances and immunodeficiencies, thereby increasing the risks of physical and psychological ill health in affected individuals. Cultural misconceptions in the profession often lead to perceptions of burnout as a personal failure, ideas that healthcare professionals are somehow at lower risk for suffering, and beliefs that affected individuals can or should somehow heal themselves. However, these concepts are antiquated, harmful and incorrect, preventing the design of appropriate solutions for this serious and growing challenge to the veterinary profession. Veterinarians must first correctly identify the nature of the problem and understand its causes and impacts before rational solutions can be implemented. In this first part of two companion reviews, burnout will be defined, pathophysiology discussed, and healthcare and veterinary-relevant occupational stressors that lead to burnout identified.
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Affiliation(s)
- Michele A. Steffey
- Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California, Davis, Davis, CA, United States
| | - Dominique J. Griffon
- Western University of Health Sciences, College of Veterinary Medicine, Pomona, CA, United States
| | - Marije Risselada
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Purdue University, West-Lafayette, IN, United States
| | - Nicole J. Buote
- Department of Clinical Sciences, Cornell University College of Veterinary Medicine, Ithaca, NY, United States
| | - Valery F. Scharf
- Department of Clinical Sciences, North Carolina State University College of Veterinary Medicine, Raleigh, NC, United States
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Kottler J, Gingell MJ, Khosla S, Kordzikowski M, Raszewski R, Chestek D, Maki KA. Exploring Physical and Biological Manifestations of Burnout and Post-Traumatic Stress Disorder Symptoms in Healthcare Workers: A Scoping Review Protocol. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2023:2023.04.16.23288657. [PMID: 37205368 PMCID: PMC10187352 DOI: 10.1101/2023.04.16.23288657] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
Abstract
Introduction The COVID-19 pandemic has strained the mental and physical well-being of healthcare workers (HCW). Increased work-related stress and limited resources has increased symptoms of anxiety, depression, insomnia, and post-traumatic stress disorder (PTSD) in this population. Stress-related disorders have been strongly associated with long-term consequences including cardiometabolic disorders, endocrine disorders and premature mortality. This scoping review aims to explore available literature on burnout, PTSD, and other mental health-associated symptoms in HCW to synthesize relationships with physiological and biological biomarkers that may be associated with increased risk of disease, creating an opportunity to summarize current biomarker knowledge and identify gaps in this literature. Methods and Analysis This scoping review uses the Arksey and O'Malley six-step scoping review methodology framework. The research team will select appropriate primary sources using a search strategy developed in collaboration with a health sciences librarian. Three reviewers will initially screen the title and abstracts obtained from the literature searches, and two reviewers will conduct independent reviews of full-text studies for inclusion. The research team will be reviewing literature focusing on which burnout and/or PTSD-associated physiological and biological biomarkers have been studied, the methodologies used to study them and the correlations between the biomarkers and HCW experiencing burnout/PTSD. Data extraction forms will be completed by two reviewers for included studies and will guide literature synthesis and analysis to determine common themes. Ethics and Dissemination This review does not require ethical approval. We expect results from this scoping review to identify gaps in the literature and encourage future research regarding improving biologic and physiologic biomarker research in HCW. Preliminary results and general themes will be communicated back to stakeholders. Results will be disseminated through peer-reviewed publications, policy briefs, and conferences, as well as presented to stakeholders to an effort to invest in HCW mental and physical health. Strengths and Limitations of This Study This will be the first scoping review to assess the current understanding of the biologic and physiological impact of burnout on healthcare workers. The target population is restricted to healthcare workers; however, identified research gaps may be used to guide future studies in other high-burnout occupations and industries.This scoping review will be guided by the Arksey and O'Malley six-step methodological framework and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Review checklist.Both peer reviewed manuscript and pre-prints/abstracts will be evaluated, but studies that have not been peer reviewed will be notated in the summary table. Conference abstracts are excluded.Preliminary and final themes and results identified by this scoping review will be communicated to stakeholders, including hospital staff and HCW, to ensure agreement with our interpretation and to convey knowledge gained with our population of interest.This review will advance the field's current understanding of mechanisms connecting the burnout and pathogenic stress to biologic and physiologic outcomes in healthcare workers and provide researchers with gaps in the literature to inform opportunities for future research.
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Bianchi R, Verkuilen J, Sowden JF, Schonfeld IS. Towards a new approach to job-related distress: A three-sample study of the Occupational Depression Inventory. Stress Health 2023; 39:137-153. [PMID: 35700982 PMCID: PMC10084211 DOI: 10.1002/smi.3177] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Revised: 05/25/2022] [Accepted: 06/07/2022] [Indexed: 02/05/2023]
Abstract
The Occupational Depression Inventory (ODI) was recently developed to assess depressive symptoms that individuals specifically attribute to their work. One purpose of the ODI is to respond to limitations of current assessments of job-related distress, most notably, assessments relying on the burnout construct. In this study, we conducted a thorough examination of the psychometric and structural properties of the ODI using exploratory structural equation modelling bifactor analysis and Mokken scale analysis. The study involved three samples of employed individuals, recruited in France (N = 3454), Switzerland (N = 1971), and Australia (N = 1485). Results were consistent across the three samples. The ODI exhibited essential unidimensionality and excellent total-score reliability-as indexed by McDonald's omega, Cronbach's alpha, Guttman's lambda-2, and the Molenaar-Sijtsma statistic. We found evidence for measurement invariance across sexes, age groups, and samples. Mokken scale analysis revealed that the ODI's scalability was strong. No monotonicity violation was detected. Invariant item ordering showed sufficient accuracy. In all three samples, suicidal ideation was the least commonly endorsed item-thus acting as a sentinel item-and fatigue/loss of energy was the most commonly endorsed item. The ODI exhibits excellent psychometric and structural properties, suggesting that occupational health specialists can effectively employ the instrument.
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Affiliation(s)
- Renzo Bianchi
- University of Neuchâtel, Neuchâtel, Switzerland.,Norwegian University of Science and Technology (NTNU), Trondheim, Norway
| | - Jay Verkuilen
- City University of New York, New York City, New York, USA
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15
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Chen Y, Juvinao-Quintero D, Velez JC, Muñoz S, Castillo J, Gelaye B. Personal and Work-Related Burnout Is Associated with Elevated Diastolic Blood Pressure and Diastolic Hypertension among Working Adults in Chile. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:1899. [PMID: 36767266 PMCID: PMC9915288 DOI: 10.3390/ijerph20031899] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Revised: 01/15/2023] [Accepted: 01/18/2023] [Indexed: 06/18/2023]
Abstract
We aimed at investigating the association of personal and work-related burnout with blood pressure and hypertension among working adults in Chile. We conducted a cross-sectional study among 1872 working adults attending the Hospital del Trabajador in Santiago, Chile, between September 2015 and February 2018. The Copenhagen Burnout Inventory was used to assess personal and work-related burnout. Blood pressure was measured by medical practitioners. Multivariable linear and logistic regressions were used to estimate the association of burnout status with systolic blood pressure (SBP), diastolic blood pressure (DBP), and hypertension. After adjusting for confounders, participants with both types of burnout had a 1.66 (95% confidence interval [CI]: 0.02-3.30) mmHg higher mean DBP than those without burnout. The odds of isolated diastolic hypertension among the participants with only personal burnout and both types of burnout were 2.00-fold (odds ratio [OR] = 2.00; 95% CI: 1.21-3.31) and 2.08-fold (OR = 2.08; 95% CI: 1.15-3.78) higher than those without burnout. The odds of combined systolic/diastolic hypertension among the participants with only work-related burnout increased by 59% (OR = 1.59; 95% CI: 1.01-2.50) compared with those without burnout. Both work-related and personal burnouts were associated with increased DBP and odds of diastolic hypertension among working adults in Chile.
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Affiliation(s)
- Yinxian Chen
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA
| | - Diana Juvinao-Quintero
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA
| | - Juan Carlos Velez
- Departamento de Rehabilitación, Hospital del Trabajador, Asociación Chilena de Seguridad, Santiago 8320000, Chile
| | - Sebastian Muñoz
- Departamento de Rehabilitación, Hospital del Trabajador, Asociación Chilena de Seguridad, Santiago 8320000, Chile
| | - Jessica Castillo
- Departamento de Rehabilitación, Hospital del Trabajador, Asociación Chilena de Seguridad, Santiago 8320000, Chile
| | - Bizu Gelaye
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA
- Department of Psychiatry, Harvard Medical School, Boston, MA 02115, USA
- The Chester M. Pierce, MD Division of Global Psychiatry, Massachusetts General Hospital, Boston, MA 02114, USA
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Dutheil F, Parreira LM, Pereira B, Baldet M, Marson F, Chabaud C, Blot M, Baker JS, Zak M, Vallet G, Magnon V, Clinchamps M, Altun S. SOphrology Intervention to Improve WELL-Being in Hospital Staff (SO-WELL): Protocol for a Randomized Controlled Trial Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:1185. [PMID: 36673939 PMCID: PMC9859524 DOI: 10.3390/ijerph20021185] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Revised: 12/23/2022] [Accepted: 12/27/2022] [Indexed: 06/17/2023]
Abstract
INTRODUCTION Stress at work and psychosocial risks are a major public health problem. Sophrology and neurolinguistic programming (NLP) have demonstrated benefits in terms of mental, physical and social health, both in the general population and in patients, and both in and out of hospital settings. However, these approaches have never been provided at the hospital for the benefit of health professionals at risk of suffering at work. In general, we aim to demonstrate the effectiveness of a hospital sophrology/NLP intervention for health care professionals at risk of stress-related disorders. The secondary objectives are to study (i) within-group, and (ii) between-group): (1) effects on mental, physical, and social health; (2) persistence of effect; (3) relationships between job perception and mental, physical, and social health; (4) intervention success factors (personality and job perception, attendance and practice, other); (5) effects on other stress biomarkers (other measures of autonomic nervous system activity, DHEAS, cortisol, etc.). METHODS Our study will be a randomized controlled prospective study (research involving the human person of type 2). The study will be proposed to any health-care workers (HCW) or any non-HCW (NHCW) from a healthcare institution (such as CHU of Clermont-Ferrand, other hospitals, clinics, retirement homes). Participants will benefit from NLP and sophrology interventions at the hospital. For both groups: (i) heart rate variability, skin conductance and saliva biomarkers will be assessed once a week during the intervention period (6 to 8 sophrology sessions) and once by month for the rest of the time; (ii) the short questionnaire will be collected once a week during the whole protocol (1-2 min); (iii) the long questionnaire will be assessed only 5 times: at baseline (M0), month 1 (M1), month 3 (M3), month 5 (M5) and end of the protocol (M7). ETHICS AND DISSEMINATION The protocol, information and consent form had received the favorable opinion from the Ethics Committee. Notification of the approval of the Ethics Committee was sent to the study sponsor and the competent authority (ANSM). The study is registered in ClinicalTrials.gov under the identification number NCT05425511 after the French Ethics Committee's approval. The results will be reported according to the CONSORT guidelines. STRENGTHS AND LIMITATIONS OF THIS STUDY The psychological questionnaires in this study are self-assessed. It is also possible that responses suffer from variation. For the study, participants need to attend 6 to 8 sophrology sessions and one visit per month for 7 months, which might seem demanding. Therefore, to make sure that participants will complete the protocol, two persons will be fully in charge of the participants' follow-up.
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Affiliation(s)
- Frédéric Dutheil
- Physiological and Psychosocial Stress, CNRS UMR 6024, LaPSCo, University Clermont Auvergne, WittyFit, 63000 Clermont-Ferrand, France
- Preventive and Occupational Medicine, University Hospital of Clermont-Ferrand (CHU), 63000 Clermont-Ferrand, France
| | - Lénise M. Parreira
- Preventive and Occupational Medicine, University Hospital of Clermont-Ferrand (CHU), 63000 Clermont-Ferrand, France
| | - Bruno Pereira
- The Clinical Research and Innovation Direction, CHU Clermont-Ferrand, 63000 Clermont-Ferrand, France
| | - Maryse Baldet
- Pole REUNIRRH, University Hospital of Clermont-Ferrand (CHU), 63000 Clermont-Ferrand, France
| | - Frédérique Marson
- Pole MobEx (Mobility–Exercise), University Hospital of Clermont-Ferrand (CHU), 63000 Clermont-Ferrand, France
| | - Christine Chabaud
- Sophrologist (Caycedo Method)–Trained in Neurolinguistic Programming (NLP), University Hospital of Clermont-Ferrand (CHU), 63000 Clermont-Ferrand, France
| | - Magali Blot
- Sophrologist (Caycedo Method)–Trained in Neurolinguistic Programming (NLP), University Hospital of Clermont-Ferrand (CHU), 63000 Clermont-Ferrand, France
| | - Julien S. Baker
- Centre for Health and Exercise Science Research, Department of Sport, Physical Education and Health, Hong Kong Baptist University, Kowloon Tong, Hong Kong
| | - Marek Zak
- Faculty of Medicine and Health Sciences, Institute of Physiotherapy, The Jan Kochanowski University, 25-369 Kielce, Poland
| | - Guillaume Vallet
- Department of Psychology, CNRS UMR 6024, LaPSCo, University Clermont Auvergne, 63000 Clermont-Ferrand, France
| | - Valentin Magnon
- Department of Psychology, CNRS UMR 6024, LaPSCo, University Clermont Auvergne, 63000 Clermont-Ferrand, France
| | - Maëlys Clinchamps
- Physiological and Psychosocial Stress, CNRS UMR 6024, LaPSCo, University Clermont Auvergne, WittyFit, 63000 Clermont-Ferrand, France
- Preventive and Occupational Medicine, University Hospital of Clermont-Ferrand (CHU), 63000 Clermont-Ferrand, France
| | - Senem Altun
- Physiological and Psychosocial Stress, CNRS UMR 6024, LaPSCo, University Clermont Auvergne, WittyFit, 63000 Clermont-Ferrand, France
- Preventive and Occupational Medicine, University Hospital of Clermont-Ferrand (CHU), 63000 Clermont-Ferrand, France
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Castillo-Navarrete JL, Guzmán-Castillo A, Bustos C, Rojas R. Peripheral brain-derived neurotrophic factor (BDNF) and salivary cortisol levels in college students with different levels of academic stress. Study protocol. PLoS One 2023; 18:e0282007. [PMID: 36812175 PMCID: PMC9946253 DOI: 10.1371/journal.pone.0282007] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Accepted: 02/05/2023] [Indexed: 02/24/2023] Open
Abstract
INTRODUCTION Brain-derived neurotrophic factor (BDNF) is essential for brain physiological processes influencing memory and learning. BDNF levels can be affected by many factors, including stress. Stress increase serum and salivary cortisol levels. Academic stress is of the chronic type. BDNF levels can be measure from serum, plasma or platelets, and there is still no standard methodology, which is relevant to ensure reproducibility and comparability between studies. HYPOTHESIS (i) BDNF concentrations in serum show greater variability than in plasma. (ii) In college students with academic stress, peripheral BDNF decreases and salivary cortisol increases. GENERAL OBJECTIVE To standardize plasma and serum collection for BDNF levels and to determine whether academic stress affects peripheral BDNF and salivary cortisol levels. DESIGN Quantitative research, with a non-experimental cross-sectional descriptive design. PARTICIPANTS Student volunteers. Under convenience sampling, 20 individuals will be included for standardization of plasma and serum collection and between 70 and 80 individuals to determine the effect of academic stress on BDNF and salivary cortisol. PERIPHERAL BLOOD AND SALIVARY CORTISOL SAMPLING, MEASUREMENTS 12 mL of peripheral blood (with and without anticoagulant) will be drawn per participant, separated from plasma or serum and cryopreserved at -80°C. Additionally, they will be instructed in the collection of 1 mL of saliva samples, which will be centrifuged. Val66Met polymorphism will be performed by allele-specific PCR, while BDNF and salivary cortisol levels will be determined by ELISA. STATISTICAL ANALYSIS (i) descriptive analysis of the variables, through measures of central tendency and dispersion, and the categorical variables through their frequency and percentage. (ii) Then a bivariate analysis will be performed comparing groups using each variable separately. EXPECTED RESULTS We expect to (i) determine the analytical factors that allow a better reproducibility in the measurement of peripheral BDNF, and (ii) the effect of academic stress on BDNF and salivary cortisol levels.
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Affiliation(s)
- Juan-Luis Castillo-Navarrete
- Departamento de Tecnología Médica, Facultad de Medicina, Universidad de Concepción, Concepción, Chile
- Programa de Neurociencia, Psiquiatría y Salud Mental, NEPSAM (http://nepsam.udec.cl), Universidad de Concepción, Concepción, Chile
- * E-mail: (JLCN); (AGC)
| | - Alejandra Guzmán-Castillo
- Programa de Neurociencia, Psiquiatría y Salud Mental, NEPSAM (http://nepsam.udec.cl), Universidad de Concepción, Concepción, Chile
- Programme in Mental Health, Facultad de Medicina, Universidad de Concepción, Concepción, Chile
- Departamento de Ciencias Básicas y Morfología, Facultad de Medicina, Universidad Católica de la Santísima Concepción, Concepción, Chile
- * E-mail: (JLCN); (AGC)
| | - Claudio Bustos
- Programa de Neurociencia, Psiquiatría y Salud Mental, NEPSAM (http://nepsam.udec.cl), Universidad de Concepción, Concepción, Chile
- Departamento de Psicología, Facultad de Ciencias Sociales, Universidad de Concepción, Concepción, Chile
| | - Romina Rojas
- Programa de Neurociencia, Psiquiatría y Salud Mental, NEPSAM (http://nepsam.udec.cl), Universidad de Concepción, Concepción, Chile
- Departamento de Farmacología, Facultad de Ciencias Biológicas, Universidad de Concepción, Concepción, Chile
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Occupational Burnout Is Linked with Inefficient Executive Functioning, Elevated Average Heart Rate, and Decreased Physical Activity in Daily Life - Initial Evidence from Teaching Professionals. Brain Sci 2022; 12:brainsci12121723. [PMID: 36552182 PMCID: PMC9775632 DOI: 10.3390/brainsci12121723] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2022] [Revised: 12/03/2022] [Accepted: 12/12/2022] [Indexed: 12/23/2022] Open
Abstract
Burnout is becoming a global pandemic jeopardizing brain health, with a huge impact on quality of life, available workforce, and the economy. Knowledge of the impact of burnout on cognition, physiology, and physical activity (PA) in daily life allows for an improved understanding of the health consequences and everyday ramifications of burnout. Twenty-eight volunteers participated in a three-day recording of daily physiology and PA, including heart rate (HR) and daily steps, with a wearable device. They filled in questionnaires screening for burnout (BBI-15), depression (BDI), and executive functions (EFs) in daily life (BRIEF-A). The subjects with burnout had more challenges in EFs, higher average HRs and lower numbers of steps in daily life than those without it. The BBI-15 scores correlated positively with the BDI scores and BRIEF-A indices and negatively with the awake HR variability (HRV) and daily steps. The metacognition index correlated negatively with the HRV. In conclusion, burnout is linked with compromised EFs along with alterations in cardiac physiology and PA in daily life. Such alterations may be easily detected with wearable devices, opening possibilities for novel biomarkers of burnout and other neuropsychiatric disorders. We suggest that physical activity and heart and brain health are intimately intertwined and that burnout interacts with each of them bidirectionally.
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McQueen SA, Hammond Mobilio M, Moulton CA. Pulling our lens backwards to move forward: an integrated approach to physician distress. MEDICAL HUMANITIES 2022; 48:404-410. [PMID: 34417324 DOI: 10.1136/medhum-2020-012100] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 05/13/2021] [Indexed: 06/13/2023]
Abstract
The medical community has recently acknowledged physician stress as a leading issue for individual wellness and healthcare system functioning. Unprecedented levels of stress contribute to physician burnout, leaves of absence and early retirement. Although recommendations have been made, we continue to struggle with addressing stress. One challenge is a lack of a shared definition for what we mean by 'stress', which is a complex and idiosyncratic phenomenon that may be examined from a myriad of angles. As such, research on stress has traditionally taken a reductionist approach, parsing out one aspect to investigate, such as stress physiology. In the medical domain, we have traditionally underappreciated other dimensions of stress, including emotion and the role of the environmental and sociocultural context in which providers are embedded. Taking a complementary, holistic approach to stress and focusing on the composite, subjective individual experience may provide a deeper understanding of the phenomenon and help to illuminate paths towards wellness. In this review article, we first examine contributions from unidimensional approaches to stress, and then outline a complementary, integrated approach. We describe how complex phenomena have been tackled in other domains and discuss how holistic theory and the humanities may help in studying and addressing physician stress, with the ultimate goal of improving physician well-being and consequently patient care.
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Affiliation(s)
| | - Melanie Hammond Mobilio
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada
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20
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Shoman Y, Rousson V, Bianchi R, Guseva Canu I. Holistic Assessment of Factors Associated with Exhaustion, the Main Symptom of Burnout: A Meta-Analysis of Longitudinal Studies. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph192013037. [PMID: 36293607 PMCID: PMC9602979 DOI: 10.3390/ijerph192013037] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Revised: 10/04/2022] [Accepted: 10/07/2022] [Indexed: 05/05/2023]
Abstract
BACKGROUND This meta-analysis summarized longitudinal findings pertaining to exhaustion's predictors. In so doing, our aim was ultimately to identify target factors for the prevention of burnout. METHODS We searched for studies that (a) examined predictors of exhaustion longitudinally and (b) reported correlation coefficients as an effect estimate. We conducted our literature search in three databases: MEDLINE, PsycINFO, and Embase. We focused on studies published between January 1990 and November 2020. Predictors were grouped into families, subfamilies, and subgroups. A meta-analysis of z-transformed correlation coefficients (rho) was performed. The results were scrutinized in relation to studies' follow-up length. RESULTS We included 65 studies assessing 242 predictors of different types captured across different occupations. Our findings highlighted mostly weak associations (rho < 0.30). For six predictors-Job control, Job resources, Interactions at work, Communication and leadership, Job attitudes, and Work-family interface-longer length of follow-up involved weaker associations with exhaustion. The quality of the evidence available was generally low. CONCLUSIONS The evidence available does not point to clear target factors for preventing burnout. The decrease in associations as the follow-up length increases may suggest a relatively short latency period, followed by recovery. Higher-quality cohorts should be conducted to better understand the etiology and course of burnout.
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Affiliation(s)
- Yara Shoman
- Center of Primary Care and Public Health (Unisanté), University of Lausanne, 1066 Epalinges-Lausanne, Switzerland
- Correspondence: ; Tel.: +41-(21)-3147413
| | - Valentin Rousson
- Center of Primary Care and Public Health (Unisanté), University of Lausanne, 1066 Epalinges-Lausanne, Switzerland
| | - Renzo Bianchi
- Department of Psychology, Norwegian University of Science and Technology (NTNU), 7491 Trondheim, Norway
| | - Irina Guseva Canu
- Center of Primary Care and Public Health (Unisanté), University of Lausanne, 1066 Epalinges-Lausanne, Switzerland
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21
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Higher allostatic load in work-related burnout: The Regensburg Burnout Project. Psychoneuroendocrinology 2022; 143:105853. [PMID: 35792379 DOI: 10.1016/j.psyneuen.2022.105853] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Revised: 06/24/2022] [Accepted: 06/24/2022] [Indexed: 11/21/2022]
Abstract
BACKGROUND Burnout and chronic work stress have been linked to various negative health outcomes. While the mechanisms underlying this interplay are still unclear, the allostatic load (AL) model was suggested to demonstrate a possible biological pathway. However, previous studies provided divergent results regarding the association between burnout and AL, probably also due to the heterogeneity of selected samples. Therefore, the aim of the present study was to examine differences in AL between a conceptually strictly specified group of individuals suffering from burnout (BO group) and a healthy comparison group (HC group). METHODS After a multi-stage recruitment procedure with strict inclusion criteria based on burnout symptomatology and pathogenesis, the BO group (n = 56) was compared to the HC group (n = 65) regarding an index of AL. The AL-index included 14 parameters: high-sensitivity c-reactive protein (hsCRP), tumor necrosis factor-alpha (TNF-α), interleukin 6 (IL-6), fibrinogen, d-dimer, plasminogen activator inhibitor 1 (PAI-1), glycosylated hemoglobin (HbA1c), high-density lipoprotein (HDL) cholesterol, total cholesterol to HDL cholesterol ratio (TC/HDL), dehydroepiandrosterone-sulphate (DHEA-S), systolic blood pressure (SBP), diastolic blood pressure (DBP), waist-hip ratio (WHR), and body fat percentage. RESULTS The BO group showed significantly higher AL-scores in comparison to the HC group. This effect remained significant after adjusting for sex, age, and smoking status. Additionally, burnout symptoms (assessed with the Maslach Burnout Inventory; MBI), MBI-subscales emotional exhaustion and depersonalization as well as chronic work stress (assessed with the effort-reward imbalance questionnaire) were significantly associated with higher AL-scores. CONCLUSIONS Consistent with our hypothesis, we detected higher AL-scores in the BO compared to the HC group, indicating a greater cumulative physiological burden in individuals suffering from burnout. Given the high heterogeneity in individuals experiencing burnout symptoms, future studies may focus on well-specified subgroups, when examining the association between burnout and psychophysiological dysregulations.
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22
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Zadro S, Stapleton P. Does Reiki Benefit Mental Health Symptoms Above Placebo? Front Psychol 2022; 13:897312. [PMID: 35911042 PMCID: PMC9326483 DOI: 10.3389/fpsyg.2022.897312] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Accepted: 05/20/2022] [Indexed: 12/05/2022] Open
Abstract
Background Reiki is an energy healing technique or biofield therapy in which an attuned therapist places their hands on or near the client's body and sends energy to the client to activate the body's ability to heal itself and restore balance. It was developed in Japan at the end of the 19th century by Mikao Usui of Kyoto. Given the enormous international socioeconomic burden of mental health, inexpensive, safe, and evidenced-based treatments would be welcomed. Reiki is safe, inexpensive, and preliminary research suggests it may assist in treating a wide variety of illnesses. Given that Reiki is a biofield therapy, growing in use, and not yet accepted by the dominant biomedical paradigm, it is important to establish its effectiveness over placebo. This study aimed to examine Reiki's effectiveness over placebo in treating symptoms of mental health and to explore parameters for its effectiveness. Method A systematic review of randomized placebo-controlled trials (RPCTs) examining Reiki's effectiveness in treating symptoms of mental health in adults was conducted through a systematic search of PubMed, PsycINFO, MEDLINE, CINAHL, Web of Science, Scopus, Embase, and ProQuest. Fourteen studies met the inclusion criteria, and risk of bias was assessed using Cochrane's Revised ROB 2 assessment tool. This was followed by a grading of recommendations, assessment, development and evaluations (GRADE) assessment. Results The evidence to date suggests that Reiki consistently demonstrates a greater therapeutic effect over placebo for some symptoms of mental health. The GRADE level of evidence is high for clinically relevant levels of stress and depression, moderate to high for clinically relevant levels of anxiety, low to moderate for normal levels of stress, and low to moderate for burnout, and low for normal levels of depression and anxiety. Conclusion The results suggest that, Reiki may be more effective in treating some areas of mental health, than placebo, particularly if symptoms are clinically relevant. To date, there are a small number of studies in each area, therefore findings are inconclusive and, more RCTs controlling for placebo in Reiki research are needed. Most included studies were also assessed as having a risk of bias of some concern. Incorporating Reiki as a complementary treatment to mainstream psychotherapy for depression, stress, and anxiety may be appropriate. Systematic Review Registration [https://www.crd.york.ac.uk/], identifier [CRD42020194311].
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Affiliation(s)
- Sonia Zadro
- School of Psychology, Bond University, Gold Coast, QLD, Australia
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Gérain P, Zech E. A Harmful Care: The Association of Informal Caregiver Burnout With Depression, Subjective Health, and Violence. JOURNAL OF INTERPERSONAL VIOLENCE 2022; 37:NP9738-NP9762. [PMID: 33399030 DOI: 10.1177/0886260520983259] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Providing informal care to a relative can lead to informal caregiver burnout, which is expected to lead to deleterious consequences. Among these consequences lie the risk of perpetrating violent behaviors against the care-recipient, the caregivers' risk of depression, and their low subjective health. To investigate these associations, a sample of 499 informal caregivers completed a questionnaire addressing informal caregiver burnout, depression, subjective health, and violence. Hierarchical regression models were used to investigate the potential association of burnout with these potential consequences, while controlling for sociodemographic variables and received violence. The results show that burnout, and especially emotional exhaustion, is significantly associated with depression, low subjective health, and perpetrated physical violence, but not with perpetrated psychological violence. For both psychological and physical violence, it appears that receiving violence is one of the best predictors of perpetrating violence. With these results, this cross-sectional study confirms the association of informal caregiver burnout with deleterious consequences-even if this observation must be pondered-and the central role of received violence in predicting perpetrated violence, suggesting the risk of violence escalation. The implications of these results suggest that the emotional state of informal caregivers is one of the indicators of potential deleterious consequences and should, as such, be considered as a warning signal by field workers.
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Affiliation(s)
- Pierre Gérain
- Fonds National pour la Recherche Scientifique, Brussels, Belgium
- UCLouvain, Louvain-la-Neuve, Belgium
| | - Emmanuelle Zech
- Fonds National pour la Recherche Scientifique, Brussels, Belgium
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Burnout Syndrome and Related Factors in Mexican Police Workforces. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19095537. [PMID: 35564932 PMCID: PMC9102065 DOI: 10.3390/ijerph19095537] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/13/2022] [Revised: 04/28/2022] [Accepted: 04/29/2022] [Indexed: 11/29/2022]
Abstract
Burnout (BO) is a response to prolonged exposure to work-related stressors characterized by emotional exhaustion (EE), depersonalization (DP), and reduced personal accomplishment (PA). The police working environment includes continued critical life-threatening situations, violence, and injuries, among other related factors putting them at high risk of distress. The objective of this study was to evaluate the association between Burnout Syndrome and sociodemographic, occupational, and health factors in Mexican police officers. We applied the Maslach Burnout Inventory Human Services Survey (MBI-HSS) to 351 active members of the Mexican police workforce. In addition, a specific questionnaire identified the presence of chronic degenerative diseases, hypertension, diabetes, digestive diseases, self-perception of food quality, and hours of sleep. Furthermore, 23.36% of police workforces presented high levels of burnout; 44.16% of police were highly emotionally exhausted, 49.29% had lost empathy with people, and 41.03% presented low personal achievement. Moreover, the worst levels of the syndrome were present in people with a poor self-perceived health status, poor perception of diet quality, without regular mealtimes, bad sleep habits, and elevated Body Mass Index. Data suggest that in Mexican police officers, BO is dimensionally different from all other groups previously studied (DP > EE > PA).
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Is the Occupational Depression Inventory predictive of cognitive performance? A focus on inhibitory control and effortful reasoning. PERSONALITY AND INDIVIDUAL DIFFERENCES 2022. [DOI: 10.1016/j.paid.2021.111213] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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Bakusic J, Ghosh M, Polli A, Bekaert B, Schaufeli W, Claes S, Godderis L. Role of NR3C1 and SLC6A4 methylation in the HPA axis regulation in burnout. J Affect Disord 2021; 295:505-512. [PMID: 34509065 DOI: 10.1016/j.jad.2021.08.081] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2021] [Revised: 07/23/2021] [Accepted: 08/25/2021] [Indexed: 11/26/2022]
Abstract
BACKGROUND Work-related stress and burnout have become major occupational health concerns. Dysregulation of HPA axis is considered one of the central mechanisms and is potentially moderated through epigenetics. In the present study, we aim to investigate epigenetic regulation of the HPA axis in burnout, by focusing on salivary cortisol and cortisone and DNA methylation of the glucocorticoid receptor gene (NR3C1) and the serotonin transporter gene (SLC6A4). METHODS We conducted a cross-sectional study with 59 subjects with burnout and 70 healthy controls recruited from the general population. All participants underwent a clinical interview and psychological assessment. Saliva samples were collected at 0, 30 and 60 min after awakening and were used to quantify cortisol and cortisone. Pyrosequencing was performed on whole blood-derived DNA to assess DNA methylation. RESULTS There were no between-group differences in cortisol levels, whereas burnout participants had higher levels of cortisone. Job stress was associated with increased cortisol and cortisone. We observed both increased and decreased NR3C1 and SLC6A4 methylation in the burnout group compared to the control group. Some of these methylation changes correlated with burnout symptoms dimensionally. Increased methylation in a specific CpG in the SLC6A4 promoter region moderated the association between job stress and burnout. DNA methylation in this CpG was also associated with increased cortisol. In addition, average methylation of NR3C1 was negatively associated with cortisone levels. LIMITATIONS This is a cross-sectional study and therefore no conclusions on causality could be made. CONCLUSIONS We provide first evidence of changes in DNA methylation of NR3C1 and SLC6A4 in burnout, which were further associated with cortisol and cortisone. Further, increased cortisol and cortisone seemed to reflect job stress rather than burnout itself.
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Affiliation(s)
- Jelena Bakusic
- Centre for Environment and Health, Department of Public Health and Primary Care, KU Leuven, Leuven, Belgium.
| | - Manosij Ghosh
- Centre for Environment and Health, Department of Public Health and Primary Care, KU Leuven, Leuven, Belgium
| | - Andrea Polli
- Centre for Environment and Health, Department of Public Health and Primary Care, KU Leuven, Leuven, Belgium; Pain in Motion (PAIN) Department, Vrije Universiteit Brussel, Brussels, Belgium
| | - Bram Bekaert
- Department of Forensic Medicine; Laboratory of Forensic Genetics and Molecular Archaeology; KU Leuven, Leuven, Belgium; Department of Imaging & Pathology, KU Leuven, Leuven, Belgium
| | - Wilmar Schaufeli
- Work, Organisational and Personnel Psychology, KU Leuven, Leuven, Belgium; Department of Psychology, Utrecht University, Utrecht, the Netherlands
| | - Stephan Claes
- Psychiatry Research Group, Department of Neuroscience, KU Leuven, Leuven, Belgium
| | - Lode Godderis
- Centre for Environment and Health, Department of Public Health and Primary Care, KU Leuven, Leuven, Belgium; IDEWE, External Service for Prevention and Protection at Work, Heverlee, Belgium
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Strikwerda M, Beulens JW, Remmelzwaal S, Schoonmade LJ, van Straten A, Schram MT, Elders PJ, Rutters F. The Association of Burnout and Vital Exhaustion With Type 2 Diabetes: A Systematic Review and Meta-Analysis. Psychosom Med 2021; 83:1013-1030. [PMID: 34334726 DOI: 10.1097/psy.0000000000000995] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE This study aimed to investigate the association of burnout and vital exhaustion with measures of glycemic control and type 2 diabetes (T2D) in a systematic review and meta-analysis. METHODS PubMed, Embase, and PsycINFO were searched from inception to April 2, 2020. Data extraction and quality assessment were performed using the Effective Public Health Practice Project tool. When possible, results were meta-analyzed using random-effects models and rated using the Grading of Recommendations, Assessment, Development and Evaluation. RESULTS A total of 5317 titles/abstracts were screened, 140 articles were read full text, of which 29 studies were included. Eighteen studies were cross-sectional, three prospective and eight were case-control studies. Burnout and vital exhaustion were significantly associated with T2D, with a pooled odds ratio of 1.8 (95% confidence interval [CI] = 1.4 to 2.4, I2 = 79%; 9 studies). Glycated hemoglobin A1c levels were not significantly higher in people with burnout and vital exhaustion, compared to those without, with a pooled standardized mean difference of 0.35 (95% CI = -0.62 to 1.33, I2 = 98%; 7 studies). In addition, no differences in glucose levels were observed (standardized mean difference = 0.02, 95% CI = -0.26 to 0.30, I2 = 90%; 9 studies). Sensitivity analyses showed no decrease in heterogeneity when excluding studies with low quality (I2glucose = 89%) or studies with a study n < 40 population (I2T2D = 77%). The level of Grading of Recommendations, Assessment, Development and Evaluation evidence was moderate to low quality because of 18 studies having a cross-sectional design. CONCLUSIONS Burnout and vital exhaustion might be associated with a higher risk of T2D, but not with glycemic control. Methodological shortcomings and high heterogeneity of the studies included complicate the interpretation of our results.
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Affiliation(s)
- Marije Strikwerda
- From the Amsterdam UMC, location VUmc, Department of Epidemiology and Data Science (Strikwerda, Beulens, Remmelzwaal, Rutters), Amsterdam Public Health Research Institute (Strikweda, Beulens, Remmelzwaal, Elders); Julius Centre for Health Sciences and Primary Care (Beulens), University Medical Centre Utrecht, Utrecht; the University Library (Schoonmade), VU, Amsterdam; Faculty of Behavioural and Movement Sciences and Amsterdam Public Health Research Institute (van Straten), Vrije Universiteit, HV Amsterdam; Department of Internal Medicine, Cardiovascular Research Institute Maastricht (CARIM), MHeNS School for Mental Health and Neuroscience (Schram), Maastricht University Medical Center+, Maastricht; and Amsterdam UMC, location VUmc, Department of General Practice (Elders), Amsterdam Public Health Research Institute, Amsterdam, the Netherlands
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Rippon D, McDonnell A, Bristow M, Smith MA, McCreadie M, Wetherell MA. Elevated levels of hair cortisol concentrations in professional dementia caregivers. Stress 2021; 24:945-951. [PMID: 34392773 DOI: 10.1080/10253890.2021.1968821] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
Abstract
Providing care for people with dementia can be a highly stressful profession. Hair Cortisol Concentration (HCC) levels have been used as a biological marker for HPA axis activity to demonstrate that informal caregivers of people with dementia could be vulnerable to chronic stress. The current study aimed to progress the findings of research conducted with informal caregivers and is the first study to assess HCC as a biological indicator of stress in professional carers of people with dementia. HCC levels were compared between 32 professional dementia caregivers (30 females with a mean age of 45.83 and 2 males with a mean age of 24.50), 45 employees working in higher education settings (42 females with a mean age of 38.66 and 3 males with a mean age of 31.89) and 88 undergraduate students (67 females with a mean age of 24.04 and 21 males with a mean age of 23.91). Analysis of HCC was used to assess HPA axis activity over 1 month. A one-way ANCOVA, with age and gender being included as covariates, revealed that higher levels of HCC were observed in professional dementia carers than people who worked within higher education settings and undergraduate students. The results indicated that professional dementia caregivers may experience stress to the extent of activating biological stress responses at a greater frequency in comparison to people who work in higher education and undergraduate students. However, no significant differences were observed in the perceived stress levels reported across dementia caregivers, professionals working in higher education, and undergraduate students. These findings highlight the requirement to ascertain the extent to which work-related tasks or other factors, specific to the profession of caring for people with dementia, could elicit heightened HPA stress reactivity.
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Affiliation(s)
- Daniel Rippon
- School of Health and Life Sciences, Department of Psychology, University of Northumbria at Newcastle, Newcastle upon Tyne, UK
| | | | - Matt Bristow
- Faculty of Science and Engineering, Division of Psychology, Anglia Ruskin University, Cambridge, UK
| | - Michael A Smith
- School of Health and Life Sciences, Department of Psychology, University of Northumbria at Newcastle, Newcastle upon Tyne, UK
| | | | - Mark A Wetherell
- School of Health and Life Sciences, Department of Psychology, University of Northumbria at Newcastle, Newcastle upon Tyne, UK
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Abstract
OBJECTIVES Burnout is a state of exhaustion resulting from prolonged and excessive workplace stress. We sought to examine biological underpinnings of burnout, focussing on mechanisms and physical consequences. METHODS We searched the literature on burnout and evaluated studies examining biological parameters in patient populations (i.e. 'clinical' burnout) as well as in individuals from the general population judged as having some degree of burnout evaluated using a dimensional approach. RESULTS Findings suggest that burnout is associated with sustained activation of the autonomic nervous system and dysfunction of the sympathetic adrenal medullary axis, with alterations in cortisol levels. Limited studies have also shown altered immune function and changes in other endocrine systems. Consequences of burnout include increased allostatic load, structural and functional brain changes, excito-toxicity, systemic inflammation, immunosuppression, metabolic syndrome, cardiovascular disease and premature death. Limitations of studies include variability in study populations, low specificity of burnout measures, and mostly cross-sectional studies precluding examination of changes across the course of burnout. CONCLUSIONS Further examination of biological mechanisms of burnout would benefit from more homogeneous clinical samples, challenge tests and prospective studies. This would assist in differentiation from conditions such as depression and aid with development of specific treatment targets for burnout.
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Affiliation(s)
- Adam Bayes
- School of Psychiatry, UNSW, Sydney, Australia.,Black Dog Institute, Sydney, Australia
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Trousselard M, Claverie D, Fromage D, Becker C, Houël JG, Benoliel JJ, Canini F. The Relationship between Allostasis and Mental Health Patterns in a Pre-Deployment French Military Cohort. Eur J Investig Health Psychol Educ 2021; 11:1239-1253. [PMID: 34698145 PMCID: PMC8544679 DOI: 10.3390/ejihpe11040090] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2021] [Revised: 09/30/2021] [Accepted: 10/01/2021] [Indexed: 11/27/2022] Open
Abstract
(1) Background: While a number of studies among military personnel focus on specific pathologies such as post-traumatic stress disorder (PTSD), anxiety, and depression, they do not address the cumulative impact on mental health of stressors related to the profession. The present study aims to determine the relationship between allostatic load and mental health status in a cohort of fit-for-duty soldiers prior to their deployment to Afghanistan. The aim is to better-define the consequences of stressor adjustment. (2) Methods: A cohort of 290 soldiers was evaluated in a cross-sectional study with respect to psychopathology (PTSD, anxiety, depression), psychological functioning (stress reactivity, psychological suffering), and allostatic profile (urinary cortisol and 8-iso-PGF2α, blood cortisol and BDNF). A hierarchical cluster analysis was used to identify allostatic patterns. (3) Results: Around 10% of the cohort reported high scores for psychopathology, and biological alterations were identified. For the remainder, four allostatic profiles could be identified by their psychological functioning. (4) Conclusions: Both biological and psychological assessments are needed to characterize subthreshold symptomatology among military personnel. The psychological significance of allostatic load should be considered as a way to improve health outcomes.
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Affiliation(s)
- Marion Trousselard
- Département Neurosciences & Sciencs Cognitives, Institut de Recherche Biomédicale des Armées (IRBA), CEDEX, 91223 Brétigny-sur-Orge, France; (D.C.); (D.F.); (F.C.)
- Ecole du Val de Grâce, 1 place A. Laveran, 75005 Paris, France
- APEMAC EA 4360 UDL, 57000 Metz, France
- Correspondence: ; Tel.: +33-1-78651255
| | - Damien Claverie
- Département Neurosciences & Sciencs Cognitives, Institut de Recherche Biomédicale des Armées (IRBA), CEDEX, 91223 Brétigny-sur-Orge, France; (D.C.); (D.F.); (F.C.)
- Faculteé des Sciences Fondamentales et Biomeédicales, Universiteé de Paris, INSERM UMRS 1124, 45 Rue des Saints-Pères, 75006 Paris, France; (C.B.); (J.-J.B.)
| | - Dominique Fromage
- Département Neurosciences & Sciencs Cognitives, Institut de Recherche Biomédicale des Armées (IRBA), CEDEX, 91223 Brétigny-sur-Orge, France; (D.C.); (D.F.); (F.C.)
- Ecole du Val de Grâce, 1 place A. Laveran, 75005 Paris, France
| | - Christel Becker
- Faculteé des Sciences Fondamentales et Biomeédicales, Universiteé de Paris, INSERM UMRS 1124, 45 Rue des Saints-Pères, 75006 Paris, France; (C.B.); (J.-J.B.)
| | | | - Jean-Jacques Benoliel
- Faculteé des Sciences Fondamentales et Biomeédicales, Universiteé de Paris, INSERM UMRS 1124, 45 Rue des Saints-Pères, 75006 Paris, France; (C.B.); (J.-J.B.)
| | - Frédéric Canini
- Département Neurosciences & Sciencs Cognitives, Institut de Recherche Biomédicale des Armées (IRBA), CEDEX, 91223 Brétigny-sur-Orge, France; (D.C.); (D.F.); (F.C.)
- Ecole du Val de Grâce, 1 place A. Laveran, 75005 Paris, France
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Gajewski PD, Getzmann S, Bröde P, Burke M, Cadenas C, Capellino S, Claus M, Genç E, Golka K, Hengstler JG, Kleinsorge T, Marchan R, Nitsche MA, Reinders J, van Thriel C, Watzl C, Wascher E. Impact of biological and lifestyle factors on cognitive aging and work ability in the Dortmund Vital Study: Protocol of an interdisciplinary, cross-sectional, and longitudinal study (Preprint). JMIR Res Protoc 2021; 11:e32352. [PMID: 35285810 PMCID: PMC8961345 DOI: 10.2196/32352] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Revised: 12/14/2021] [Accepted: 12/15/2021] [Indexed: 12/26/2022] Open
Affiliation(s)
- Patrick D Gajewski
- Leibniz Research Centre for Working Environment and Human Factors (IfADo) at the Technical University of Dortmund, Dortmund, Germany
| | - Stephan Getzmann
- Leibniz Research Centre for Working Environment and Human Factors (IfADo) at the Technical University of Dortmund, Dortmund, Germany
| | - Peter Bröde
- Leibniz Research Centre for Working Environment and Human Factors (IfADo) at the Technical University of Dortmund, Dortmund, Germany
| | - Michael Burke
- Leibniz Research Centre for Working Environment and Human Factors (IfADo) at the Technical University of Dortmund, Dortmund, Germany
| | - Cristina Cadenas
- Leibniz Research Centre for Working Environment and Human Factors (IfADo) at the Technical University of Dortmund, Dortmund, Germany
| | - Silvia Capellino
- Leibniz Research Centre for Working Environment and Human Factors (IfADo) at the Technical University of Dortmund, Dortmund, Germany
| | - Maren Claus
- Leibniz Research Centre for Working Environment and Human Factors (IfADo) at the Technical University of Dortmund, Dortmund, Germany
| | - Erhan Genç
- Leibniz Research Centre for Working Environment and Human Factors (IfADo) at the Technical University of Dortmund, Dortmund, Germany
| | - Klaus Golka
- Leibniz Research Centre for Working Environment and Human Factors (IfADo) at the Technical University of Dortmund, Dortmund, Germany
| | - Jan G Hengstler
- Leibniz Research Centre for Working Environment and Human Factors (IfADo) at the Technical University of Dortmund, Dortmund, Germany
| | - Thomas Kleinsorge
- Leibniz Research Centre for Working Environment and Human Factors (IfADo) at the Technical University of Dortmund, Dortmund, Germany
| | - Rosemarie Marchan
- Leibniz Research Centre for Working Environment and Human Factors (IfADo) at the Technical University of Dortmund, Dortmund, Germany
| | - Michael A Nitsche
- Leibniz Research Centre for Working Environment and Human Factors (IfADo) at the Technical University of Dortmund, Dortmund, Germany
| | - Jörg Reinders
- Leibniz Research Centre for Working Environment and Human Factors (IfADo) at the Technical University of Dortmund, Dortmund, Germany
| | - Christoph van Thriel
- Leibniz Research Centre for Working Environment and Human Factors (IfADo) at the Technical University of Dortmund, Dortmund, Germany
| | - Carsten Watzl
- Leibniz Research Centre for Working Environment and Human Factors (IfADo) at the Technical University of Dortmund, Dortmund, Germany
| | - Edmund Wascher
- Leibniz Research Centre for Working Environment and Human Factors (IfADo) at the Technical University of Dortmund, Dortmund, Germany
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McCanlies EC, Leppma M, Mnatsakanova A, Allison P, Fekedulegn D, Andrew ME, Violanti JM. Associations of burnout with awakening and diurnal cortisol among police officers. COMPREHENSIVE PSYCHONEUROENDOCRINOLOGY 2021; 4. [PMID: 34553178 PMCID: PMC8455162 DOI: 10.1016/j.cpnec.2020.100016] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
The aim of this cross-sectional study was to assess the associations of burnout with cortisol parameters in 197 police officers from the Buffalo Cardio-Metabolic Occupational Police Stress (BCOPS) study (2010–2014). The Maslach Burnout Inventory-General Survey assessed depersonalization, exhaustion, and professional efficacy. Officers provided salivary cortisol samples collected upon awakening, and 15, 30, and 45 min thereafter as well as three additional samples at lunchtime, dinnertime, and bedtime. Total area under the curve with respect to increase (AUCWI for waking and AUCDI for diurnal), total area under the curve with respect to ground (AUCWG for waking and AUCDG for diurnal), and diurnal slope were determined and used in this study. Unadjusted and adjusted (age, sex, and race/ethnicity) associations were examined using linear regression. The mean age of the officers was 48 years and 72% were males. The depersonalization component of burnout was negatively associated with AUCDG (β = −108.4; p = 0.036). Similarly, as exhaustion increased, AUCWI (β = −9.58, p = 0.038), AUCDG (β = −114.7, p = 0.029) and the diurnal slope (β = −0.000038; p = 0.017) decreased. The Professional efficacy was not associated with any of the cortisol parameters. These results suggest that certain characteristics of burnout may be associated with diminished cortisol secretion in this group of urban police officers. Our findings add to previous studies examining associations of burnout with the cortisol awakening response. Future longitudinal studies are needed to evaluate the temporal relationship between burnout and these cortisol parameters. Burnout component scores and cortisol parameter values did not differ significantly between male and female officers. Adjusted models demonstrated significant negative associations between the burnout components and cortisol parameters. As depersonalization increased, AUCDG decreased. As exhaustion increased, AUCWI, AUCDG, and the diurnal slope decreased. Professional efficacy was not associated with either AUCWI or AUCDG.
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Affiliation(s)
- E C McCanlies
- Bioanalytics Branch, Health Effects Laboratory Division, National Institute for Occupational Safety and Health, Morgantown, WV, USA
| | - M Leppma
- West Virginia University, Department of Counseling, Rehabilitation Counseling, and Counseling Psychology, Morgantown, WV, USA
| | - A Mnatsakanova
- Bioanalytics Branch, Health Effects Laboratory Division, National Institute for Occupational Safety and Health, Morgantown, WV, USA
| | - P Allison
- Bioanalytics Branch, Health Effects Laboratory Division, National Institute for Occupational Safety and Health, Morgantown, WV, USA
| | - D Fekedulegn
- Bioanalytics Branch, Health Effects Laboratory Division, National Institute for Occupational Safety and Health, Morgantown, WV, USA
| | - M E Andrew
- Bioanalytics Branch, Health Effects Laboratory Division, National Institute for Occupational Safety and Health, Morgantown, WV, USA
| | - J M Violanti
- University at Buffalo, State University of New York, Department of Epidemiology and Environmental Health, Buffalo, NY, USA
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Becker L, Dupke A, Rohleder N. Associations Between C-Reactive Protein Levels, Exercise Addiction, and Athlete Burnout in Endurance Athletes. Front Psychol 2021; 12:615715. [PMID: 34149506 PMCID: PMC8211739 DOI: 10.3389/fpsyg.2021.615715] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2020] [Accepted: 05/11/2021] [Indexed: 12/02/2022] Open
Abstract
Regular physical activity can support long-term health maintenance, e.g., by reducing inflammatory markers such as C-reactive protein (CRP) levels. However, excessive physical activity can promote the development of both mental and physical illness as well. From a psychological perspective, excessive exercise can lead to the development of exercise addiction (EA) and athlete burnout (AB). However, EA and AB have been rarely investigated so far and it is still unknown whether they are associated with risk factors for physical diseases such as increased CRP levels. In our study, we investigated whether EA and AB in endurance athletes are associated with CRP concentrations. Furthermore, sex differences and prevalence rates of EA were investigated. Ninety-five endurance athletes participated (54.7% female, mean age = 31.8 ± 15.02 years). CRP levels were assessed by means of Dried Blood Spots. For EA and AB assessment, the Exercise Addiction Inventory (EAI) and the Athlete Burnout Questionnaire (ABQ) were used. Exercise addiction was negatively associated with CRP in men. No associations were found for women. None of the ABQ subscales (physical and emotional exhaustion, devaluation of sports, and reduced sense of accomplishment) was associated with CRP levels or with EA. Prevalence of EA was 4.2%. More than 80% of the participants were at risk for EA development. Our results suggest that EA is not necessarily associated with a higher risk for physical diseases through inflammatory pathways. However, EA is a serious mental illness that is widespread in athletes, at least at a subclinical level.
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Affiliation(s)
- Linda Becker
- Chair of Health Psychology, Department of Psychology, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Anna Dupke
- Chair of Health Psychology, Department of Psychology, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Nicolas Rohleder
- Chair of Health Psychology, Department of Psychology, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
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Shackleton GL. Towards a biochemical approach to occupational stress management. Heliyon 2021; 7:e07175. [PMID: 34141933 PMCID: PMC8187824 DOI: 10.1016/j.heliyon.2021.e07175] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Revised: 10/04/2020] [Accepted: 05/26/2021] [Indexed: 12/11/2022] Open
Abstract
Given the immense and growing cost of occupational stress to society through lost productivity and the burden to healthcare systems, current best practices for detecting, managing and reducing stress in the workplace are clearly sub-optimal and substantially better methods are required. Subjective, self-reported psychology and psychiatry-based instruments are prone to biases whereas current objective, biology-based measures produce conflicting results and are far from reliable. A multivariate approach to occupational stress research is required that reflects the broad, coordinated, physiological response to demands placed on the body by exposure to diverse occupational stressors. A literature review was conducted to determine the extent of application of the emerging multivariate technology of metabolomics to occupational stress research. Of 170 articles meeting the search criteria, three were identified that specifically studied occupational stressors using metabolomics. A further ten studies were not specifically occupational or were of indirect or peripheral relevance. The occupational studies, although limited in number highlight the technological challenges associated with the application of metabolomics to investigate occupational stress. They also demonstrate the utility to evaluate stress more comprehensively than univariate biomarker studies. The potential of this multivariate approach to enhance our understanding of occupational stress has yet to be established. This will require more studies with broader analytical coverage of the metabolome, longitudinal sampling, combination with experience sampling methods and comparison with psychometric models of occupational stress. Progress will likely involve combining multi-omic data into a holistic, systems biology approach to detecting, managing and reducing occupational stress and optimizing workplace performance.
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Neuropathic Low Back Pain and Burnout among Hungarian Workers. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18052693. [PMID: 33800049 PMCID: PMC7967417 DOI: 10.3390/ijerph18052693] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Revised: 03/02/2021] [Accepted: 03/03/2021] [Indexed: 11/17/2022]
Abstract
Burnout is an increasingly prevalent syndrome mainly involving those working in human services. Although it is categorized as an occupational phenomenon and not as a medical condition, it seems to be strongly associated with several diseases such as pain syndromes. However, no studies examined the association between neuropathic low back pain and burnout. This questionnaire-based study was carried out between April 2019 and March 2020 in three main sites among teachers, social workers and healthcare workers. Demographic criteria included age, gender, marital status, number of children, type of work, years spent with work, work schedule, legal relation, secondary employment. Included diseases were diabetes, hypertension, ischemic heart disease, generalized pain (pain involving more than one area of the body) and depression. Low back pain was assessed by the painDETECT questionnaire, burnout was measured with the Maslach Burnout Inventory (MBI) and depression was measured by the Beck Depression Inventory. Dysfunctional attitudes were also recorded. Overall, 1500 questionnaires were successfully delivered and 1141 responses received (response rate of 76%). Three hundred social workers, 399 teachers, 339 paramedics, 35 doctors and 68 medical attendants have completed our survey. In a multivariate analysis including of all factors (demographic criteria, burnout, depression, dysfunctional attitudes, comorbidity etc.) neuropathic low back pain was associated with age > 62 (OR = 3.981, p = 0.01), number of children ≥ 2 (OR = 2.638, p = 0.003), job type (being a social worker) (OR = 6.654, p < 0.001), burnout (OR = 2.577, p < 0.001), current depression (OR = 2.397, p < 0.001), and suffering from generalized pain (OR= 4.076, p < 0.001). This is the first study showing the association of burnout and neuropathic low back pain, which is the most common cause of disability. Based on our results neuropathic low back pain and burnout have similar risk factors and consequences which raises the possibility of similar pathophysiology.
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Tsou M, Pai T, Chiang T, Huang W, Lin H, Lee S. Burnout and metabolic syndrome among different departments of medical center nurses in Taiwan-Cross-sectional study and biomarker research. J Occup Health 2021; 63:e12188. [PMID: 33469969 PMCID: PMC7815683 DOI: 10.1002/1348-9585.12188] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2020] [Revised: 11/04/2020] [Accepted: 12/01/2020] [Indexed: 12/14/2022] Open
Abstract
OBJECTIVES The cross-sectional study aimed to analyze the association between burnout, work-related factors, and metabolic syndrome (Mets) in nurses from several departments of a tertiary hospital in Taiwan. Exploring biomarkers could provide for prevention. METHODS Demographic data were obtained through a written questionnaire and include the following information: gender, age, education level, psychosocial and work situations, such as departments, working hours, work shift, depression, and sleep time. Burnout was evaluated according to the Chinese Burnout inventory, Mets was evaluated according to the criteria of the National Cholesterol Education Program of Taiwan-Treatment Panel for Adults III (NCEP-ATP III). RESULTS A total of 1758 nurses participated with a median age of 35.2 years. The prevalence of burnout and Mets was 6.4% and 13.84%, respectively. The results showed that burnout induced higher risk of Mets, odds ratio (OR) 1.70 (95% confidence interval, 1.04-3.05). Other factors, such as out-patient nurses, seniority (4-10 and >10 years), working hours (51-59 h/wk), nigh shift, Brief Symptom Rating Scale-5 (score 10-14 and ≧15), poor self-rated health status, and inadequate sleep time, led to higher risk of Mets. Biomarkers research showed that Glycated hemoglobin (Hba1c) was significantly associated with burnout nurses (OR = 24.72, P < .001), but thyroid-stimulating hormone and free thyroxin were not. CONCLUSIONS Results suggested positive associations between burnout and Mets in nurses. For nurses with higher seniority, long hours of work, night shifts, poor physical and mental conditions, and poor lifestyle habits in different departments, strategies are needed to prevent burnout and Mets.
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Affiliation(s)
- Meng‐Ting Tsou
- Department of Family MedicineMackay Memorial HospitalTaipeiTaiwan
- Department of Occupation MedicineMackay Memorial HospitalTaipeiTaiwan
- Mackay Junior College of Medicine, Nursing, and ManagementNew TaipeiTaiwan
| | - Tsung‐Ping Pai
- Department of Family Medicine and Occupation MedicineLian‐Xin ClinicTaoyuanTaiwan
| | - Te‐Ming Chiang
- Department of Family MedicineMackay Memorial HospitalTaipeiTaiwan
| | - Wei‐Hsin Huang
- Department of Family MedicineMackay Memorial HospitalTaipeiTaiwan
- Department of Occupation MedicineMackay Memorial HospitalTaipeiTaiwan
- Department of MedicineMackay Medical CollegeNew TaipeiTaiwan
| | - Hsiu‐Mei Lin
- Department of Occupational Safety &HealthMackay Memorial HospitalTaipeiTaiwan
| | - Shu‐Chen Lee
- Department of Community Health CenterMackay Memorial HospitalTaipeiTaiwan
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Sjörs Dahlman A, Jonsdottir IH, Hansson C. The hypothalamo-pituitary-adrenal axis and the autonomic nervous system in burnout. HANDBOOK OF CLINICAL NEUROLOGY 2021; 182:83-94. [PMID: 34266613 DOI: 10.1016/b978-0-12-819973-2.00006-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Burnout constitutes a serious health concern in the modern working environment. It is a stress-related condition that has developed as a result of a prolonged psychosocial stress exposure causing a persistent mismatch between demands and resources. The main symptom is emotional exhaustion, but physical fatigue, diminished professional efficacy, cynicism, and cognitive impairments are also associated with this condition. Burnout has been used both as a psychologic term in occupational settings and as a clinical diagnosis in patient populations, and there is currently no universally accepted definition and diagnostic criteria of burnout. It has been hypothesized that the two main stress response systems, the autonomic nervous system (ANS) and the hypothalamus-pituitary-adrenal axis (HPA axis), are involved in the pathogenesis of burnout. A common hypothesis is that in the early stages of chronic stress, the HPA axis and sympathetic ANS activity tend to be higher, while it will decrease with a longer duration of chronic stress to ultimately reach a state of hypoactivity in clinical burnout. The current research in this field shows many contradictory results. Thus there is no compelling evidence of either ANS or HPA dysfunction in burnout. However, there is partial support for the hypothesis of HPA and sympathetic hyperactivity in early stages, and HPA hyporeactivity and low vagal activity in more severe burnout cases, but high-quality studies investigating the causal links are still lacking.
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Affiliation(s)
- Anna Sjörs Dahlman
- Institute of Stress Medicine, Region Västra Götaland, Gothenburg, Sweden; Human Factors Department, Swedish National Road and Transport Research Institute, Gothenburg, Sweden.
| | - Ingibjörg H Jonsdottir
- Institute of Stress Medicine, Region Västra Götaland, Gothenburg, Sweden; School of Public Health and Community Medicine, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden
| | - Caroline Hansson
- Institute of Stress Medicine, Region Västra Götaland, Gothenburg, Sweden; Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, University of Gothenburg, Gothenburg, Sweden
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Tsou M, Chen J. Burnout and metabolic syndrome among healthcare workers: Is subclinical hypothyroidism a mediator? J Occup Health 2021; 63:e12252. [PMID: 34286911 PMCID: PMC8291686 DOI: 10.1002/1348-9585.12252] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Revised: 06/17/2021] [Accepted: 06/25/2021] [Indexed: 12/20/2022] Open
Abstract
OBJECTIVES Evidence suggests that subclinical hypothyroidism (SCH) is associated with burnout and metabolic syndrome (MetS). We examined the relationship between burnout and MetS among healthcare workers (HCWs) and investigated the potential mediation of SCH. METHODS This cross-sectional study included HCWs from a tertiary medical center; demographic data were obtained using a questionnaire. Burnout was evaluated according to the Chinese version of the Maslach Burnout Inventory-Health Services Survey (MBI-HSS). MetS and thyroid function data were obtained from a physical check-up. Logistic regression models were used to evaluate the adjusted odds ratio (aOR), and mediation analysis was employed to examine the mediation effect. RESULTS Among 945 non-doctor/nurse and 1868 doctor/nurse staff, MetS was 30% and 14%, respectively, and the prevalence of burnout was nearly 6.5%. The results showed that burnout induced higher aOR of MetS in the doctor/nurse group (1.27, 95% confidence interval [CI]: 1.05-3.62). Thyroid-stimulating hormone (TSH) showed a positive association factor of MetS in doctor/nurse group-adjusted burnout (aOR = 1.15, 95% CI: 1.01-4.19). A higher TSH level was associated with an increased odds of MetS in younger doctor/nurse staff with burnout syndrome (aOR = 1.74; 95% CI: 1.04-3.22). There was a borderline significant mediation effect of SCH in the association between burnout and MetS in doctor/nurse staff. CONCLUSIONS The results showed that higher TSH levels were positively associated with burnout and MetS in doctor/nurse professionals, especially in the young cohort. Burnout may rely on the borderline mediation effect of SCH, which is likely to affect MetS.
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Affiliation(s)
- Meng‐Ting Tsou
- Department of Family MedicineMacKay Memorial HospitalTaipei CityTaiwan
- Department of Occupation MedicineMacKay Memorial HospitalTaipei CityTaiwan
- Department of MacKay Junior College of Medicine, Nursing, and ManagementNew Taipei CityTaiwan
| | - Jau‐Yuan Chen
- Department of Family MedicineChang‐Gung Memorial HospitalLinkou BranchTaiwan
- Chang Gung University College of MedicineTaoyuanTaiwan
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Orosz A, Federspiel A, Eckert A, Seeher C, Dierks T, Tschitsaz A, Cattapan K. Exploring the effectiveness of a specialized therapy programme for burnout using subjective report and biomarkers of stress. Clin Psychol Psychother 2020; 28:852-861. [PMID: 33283948 DOI: 10.1002/cpp.2539] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2018] [Revised: 11/23/2020] [Accepted: 11/24/2020] [Indexed: 11/07/2022]
Abstract
The increasing prevalence of stress-related disorders such as burnout urges the need for specialized treatment approaches. Programmes combining psychotherapy and regenerative interventions emerge to be the most successful. However, evaluated therapy programmes are scarce and usually involve subjective symptom quantification without consideration of physiologic parameters. The aim of the present exploratory, single-group study was the multimodal investigation of the effectiveness of a specialized holistic therapy programme by assessing symptoms and biological markers of chronic stress. Seventy-one in-patients (39 men/32 women; age 46.8 ± 9.9 years) of a specialized burnout ward with the additional diagnosis of burnout (Z73.0) in conjunction with a main diagnosis of depressive disorder (F32 or F33) according to the International Classification of Diseases (ICD)-10 were included in the study. In addition to symptomatology, the stress-responsive biomarkers heart rate variability (HRV) and serum brain-derived neurotrophic factor (BDNF) were measured in patients at admittance to and discharge from the burnout ward applying a 6-week specialized treatment programme. At discharge, patients showed a significant reduction of symptom burden and a significant increase in serum BDNF, while HRV remained unchanged. The findings implicate that the therapy programme may have beneficial effects on symptomatology and neuroplasticity of patients with burnout. As therapy was often supplemented by psychopharmacological treatment, a relevant influence of antidepressant medication especially on BDNF has to be considered.
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Affiliation(s)
- Ariane Orosz
- Centre for Stress-Related Illnesses, Sanatorium Kilchberg, Private Clinic for Psychiatry and Psychotherapy, Kilchberg, Switzerland.,University Hospital of Psychiatry and Psychotherapy, Division of Systems Neuroscience of Psychopathology, Translational Research Center, University Bern Psychiatric Services (UPD), Bern, Switzerland
| | - Andrea Federspiel
- University Hospital of Psychiatry and Psychotherapy, Division of Systems Neuroscience of Psychopathology, Translational Research Center, University Bern Psychiatric Services (UPD), Bern, Switzerland
| | - Anne Eckert
- Neurobiology Laboratory for Brain Aging and Mental Health, Transfaculty Research Platform Molecular and Cognitive Neuroscience (MCN), University of Basel, Psychiatric University Clinics Basel, Basel, Switzerland
| | - Christian Seeher
- Centre for Stress-Related Illnesses, Sanatorium Kilchberg, Private Clinic for Psychiatry and Psychotherapy, Kilchberg, Switzerland
| | - Thomas Dierks
- University Hospital of Psychiatry and Psychotherapy, Division of Systems Neuroscience of Psychopathology, Translational Research Center, University Bern Psychiatric Services (UPD), Bern, Switzerland
| | - Armita Tschitsaz
- University Hospital for Child and Adolescent Psychiatry and Psychotherapy Bern, Moosseedorf, Switzerland
| | - Katja Cattapan
- Centre for Stress-Related Illnesses, Sanatorium Kilchberg, Private Clinic for Psychiatry and Psychotherapy, Kilchberg, Switzerland.,University Hospital of Psychiatry and Psychotherapy, Division of Systems Neuroscience of Psychopathology, Translational Research Center, University Bern Psychiatric Services (UPD), Bern, Switzerland
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Duncan AR, Hellman CM. The Potential Protective Effect of Hope on Students' Experience of Perceived Stress and Burnout during Medical School. Perm J 2020; 24:1. [PMID: 33482963 PMCID: PMC7849308 DOI: 10.7812/tpp/19.240] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2019] [Revised: 02/27/2020] [Accepted: 03/15/2020] [Indexed: 11/30/2022]
Abstract
BACKGROUND A major problem facing today's physicians and medical students is burnout. Christina Maslach and fellow researchers have described burnout as a product of chronic stress and a lack of protective psychological factors like hope. The purpose of this study was to explore the relationships between hope, stress, and burnout among medical students. METHODS This study involved an online survey of 329 first- through fourth-year allopathic and osteopathic medical students. Validated psychometric scales were used to measure the primary variables. We conducted Pearson correlation, hierarchical regression, and mediation analyses to test the relationships between hope, stress, and burnout and to determine whether hope directly impacts stress and burnout. RESULTS We found significant correlations between hope, stress, and burnout. Hierarchical regression revealed that hope accounted for significant variance in burnout over and above psychological stress and that stress and hope together accounted for 48% of this variance. We discovered that hope may be partially mediating the relationship between stress and burnout. CONCLUSION Hope may play a significant protective role in the stress-burnout relationship in the context of medical students: higher levels of hope are associated with lower levels of stress and burnout. Our study supports the idea of using hope-based interventions in medical student populations and investing more resources into this area of research.
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Affiliation(s)
- Ashten R Duncan
- School of Community Medicine, University of Oklahoma, Tulsa, OK
| | - Chan M Hellman
- Anne and Henry Zarrow School of Social Work, University of Oklahoma, Tulsa, OK
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Magnesium Status and Stress: The Vicious Circle Concept Revisited. Nutrients 2020; 12:nu12123672. [PMID: 33260549 PMCID: PMC7761127 DOI: 10.3390/nu12123672] [Citation(s) in RCA: 42] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Revised: 11/24/2020] [Accepted: 11/25/2020] [Indexed: 12/11/2022] Open
Abstract
Magnesium deficiency and stress are both common conditions among the general population, which, over time, can increase the risk of health consequences. Numerous studies, both in pre-clinical and clinical settings, have investigated the interaction of magnesium with key mediators of the physiological stress response, and demonstrated that magnesium plays an inhibitory key role in the regulation and neurotransmission of the normal stress response. Furthermore, low magnesium status has been reported in several studies assessing nutritional aspects in subjects suffering from psychological stress or associated symptoms. This overlap in the results suggests that stress could increase magnesium loss, causing a deficiency; and in turn, magnesium deficiency could enhance the body’s susceptibility to stress, resulting in a magnesium and stress vicious circle. This review revisits the magnesium and stress vicious circle concept, first introduced in the early 1990s, in light of recent available data.
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Kulikowski K. Cognitive abilities - a new direction in burnout research. EUROPEAN JOURNAL OF WORK AND ORGANIZATIONAL PSYCHOLOGY 2020. [DOI: 10.1080/1359432x.2020.1841284] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
- Konrad Kulikowski
- Faculty of Management, University of Social Sciences, Społeczna Akademia Nauk, Łódz, Poland
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De Hert S. Burnout in Healthcare Workers: Prevalence, Impact and Preventative Strategies. Local Reg Anesth 2020; 13:171-183. [PMID: 33149664 PMCID: PMC7604257 DOI: 10.2147/lra.s240564] [Citation(s) in RCA: 194] [Impact Index Per Article: 48.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Accepted: 10/13/2020] [Indexed: 11/23/2022] Open
Abstract
Approximately, one in three physicians is experiencing burnout at any given time. This may not only interfere with own wellbeing but also with the quality of delivered care. This narrative review discusses several aspects of the burnout syndrome: prevalence, symptoms, etiopathogenesis, diagnosis, impact, and strategies on how to deal with the problem.
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Affiliation(s)
- Stefan De Hert
- Department of Anesthesiology and Perioperative Medicine, Ghent University Hospital, Ghent University, Ghent, Belgium
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Association of occupational burnout and occupational exposure factors on psychological health among factory workers and miners: a propensity score analysis. Int Arch Occup Environ Health 2020; 94:441-450. [PMID: 33108547 DOI: 10.1007/s00420-020-01587-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2019] [Accepted: 10/05/2020] [Indexed: 10/23/2022]
Abstract
PURPOSE This study is to explore the association of occupational burnout and occupational exposure factors on psychological health among factory workers and miners. METHODS A total of 6130 factories workers and miners in Urumqi, China were included using a cluster sampling method. The occupational burnout and psychological health were investigates using the Chinese Maslach Burnout Inventory (CMBI) and the Symptom Check List-90 (SCL-90). The propensity score analysis (PSA) was used to eliminate the influence of individual characteristics, and 2164 pairs of participants on psychological healthy and unhealthy were matched. After PSA, the relationship between occupational burnout, occupational hazard exposure, and psychological health was evaluated. RESULTS The results showed that asbestos dust (OR 1.65, CI 95% 1.35-2.02) and CMBI (OR 2.59, CI 95% 2.39-2.83) were risk factors affecting psychological health (P < 0.001). CONCLUSIONS Measures need to be taken to ease occupational burnout among factories workers and miners, and strengthen personal protection to improve their psychological health.
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Bakusic J, Ghosh M, Polli A, Bekaert B, Schaufeli W, Claes S, Godderis L. Epigenetic perspective on the role of brain-derived neurotrophic factor in burnout. Transl Psychiatry 2020; 10:354. [PMID: 33077716 PMCID: PMC7573604 DOI: 10.1038/s41398-020-01037-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2020] [Revised: 09/11/2020] [Accepted: 10/01/2020] [Indexed: 11/09/2022] Open
Abstract
Brain-derived neurotrophic factor (BDNF) plays a potential role in the neurobiology of burnout, but there are no studies investigating the underlying genetic and epigenetic mechanisms. Our aim is to further explore the role of BDNF in burnout, by focusing on the Val66Met polymorphism and methylation patterns of the BDNF gene and serum BDNF (sBDNF) protein expression. We conducted a cross-sectional study by recruiting 129 individuals (59 with burnout and 70 healthy controls). Participants underwent a clinical interview, psychological assessment and blood sample collection. Polymorphism and DNA methylation were measured on DNA from whole blood, using pyrosequencing and sBDNF levels were measured using ELISA. We found significantly increased methylation of promoter I and IV in the burnout group, which also correlated with burnout symptoms. In addition, DNA methylation of promoter I had a significant negative effect on sBDNF. For DNA methylation of exon IX, we did not find a significant difference between the groups, nor associations with sBDNF. The Val66Met polymorphism neither differed between groups, nor was it associated with sBDNF levels. Finally, we did not observe differences in sBDNF level between the groups. Interestingly, we observed a significant negative association between depressive symptoms and sBDNF levels. The current study is the first to show that BDNF DNA methylation changes might play an important role in downregulation of the BDNF protein levels in burnout. The presence of depressive symptoms might have an additional impact on these changes.
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Affiliation(s)
- Jelena Bakusic
- Centre for Environment and Health, Department of Public Health and Primary Care, KU Leuven, Leuven, Belgium.
| | - Manosij Ghosh
- grid.5596.f0000 0001 0668 7884Centre for Environment and Health, Department of Public Health and Primary Care, KU Leuven, Leuven, Belgium
| | - Andrea Polli
- grid.5596.f0000 0001 0668 7884Centre for Environment and Health, Department of Public Health and Primary Care, KU Leuven, Leuven, Belgium ,grid.8767.e0000 0001 2290 8069Pain in Motion research group (PAIN), Department of Physiotherapy, Human Physiology and Anatomy, Vrije Universiteit Brussel, Brussels, Belgium
| | - Bram Bekaert
- grid.5596.f0000 0001 0668 7884Department of Forensic Medicine, Laboratory of Forensic Genetics and Molecular Archaeology; KU Leuven, Leuven, Belgium
| | - Wilmar Schaufeli
- grid.5596.f0000 0001 0668 7884Work, Organisational and Personnel Psychology, KU Leuven, Leuven, Belgium
| | - Stephan Claes
- grid.5596.f0000 0001 0668 7884Psychiatry Research Group, Department of Neuroscience, KU Leuven, Leuven, Belgium
| | - Lode Godderis
- grid.5596.f0000 0001 0668 7884Centre for Environment and Health, Department of Public Health and Primary Care, KU Leuven, Leuven, Belgium ,IDEWE, External Service for Prevention and Protection at Work, Heverlee, Belgium
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Effects of Occupational Hazards on Job Stress and Mental Health of Factory Workers and Miners: A Propensity Score Analysis. BIOMED RESEARCH INTERNATIONAL 2020; 2020:1754897. [PMID: 32904478 PMCID: PMC7456464 DOI: 10.1155/2020/1754897] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/02/2020] [Revised: 06/10/2020] [Accepted: 06/22/2020] [Indexed: 01/13/2023]
Abstract
This study is to evaluate the effects of different occupational hazards on job stress and mental health of factory workers and miners. A total of 6120 workers from factories and mining enterprises in seven districts and one district of Urumqi were determined using the stratified cluster random sampling method. The Effort-Reward Imbalance (ERI) questionnaire and the Symptom Checklist-90 (SCL-90) were used to evaluate the effects of occupational hazard factors on job stress and mental health of workers. The propensity score analysis was used to control the confounding factors. The occupational hazards affecting job stress of workers were asbestos dust (OR = 1.3, 95% CI: 1.09-1.55), benzene (OR = 1.25, 95% CI: 1.10-1.41), and noise (OR = 1.39, 95% CI: 1.22-1.59). The occupational hazards affecting the mental health of workers were coal dust (OR = 1.19, 95% CI: 1.02-1.38), asbestos dust (OR = 1.58, 95% CI: 1.32-1.92), benzene (OR = 1.28, 95% CI: 1.13-1.47), and noise (OR = 1.23, 95% CI: 1.07-1.42). Different occupational hazards have certain influence on job stress and mental health of factory workers and miners. The enhancements in occupational hazard and risk assessment, occupational health examination, and occupational protection should be taken to relieve job stress and enhance the mental health of factory workers and miners.
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Current methods for stress marker detection in saliva. J Pharm Biomed Anal 2020; 191:113604. [PMID: 32957066 PMCID: PMC7474833 DOI: 10.1016/j.jpba.2020.113604] [Citation(s) in RCA: 37] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Revised: 08/26/2020] [Accepted: 08/28/2020] [Indexed: 02/06/2023]
Abstract
Introduction of relevant biomarkers in stress conditions. Reference ranges of biomarkers in normal conditions. Saliva as easy-accessible specimen. Review of analytical methods for biomarker determination in saliva. Possibilities for design of point-of-care devices.
Stress and stress-related diseases are leading to drastic consequences in private and professional life. Therefore, the need for stress prevention strategies is of personal and economic interest. Especially during the recent period related to covid-19 outbreak and lock-down, an ongoing discussion of increasing stress etiology is reported. Biomarker analysis may help to assist diagnosis and classification of stress-related diseases and therefore support therapeutical decisions. Due to its non-invasive sampling, the analysis of saliva has become highly attractive compared to the detection methods in other specimen. This review article summarizes the status of research, innovative approaches, and trends. Scientific literature published since 2011 was excerpted with concentration on the detection of up to seven promising marker substances. Most often reported cortisol represents the currently best evaluated stress marker, while norepinephrine (noradrenaline) or its metabolite 3-methoxy-4-hydroxyphenylglycol is also a quite commonly considered stress marker. Other complementary stress marker candidates are testosterone, dehydroepiandrosterone (DHEA) and its sulfonated analogue DHEA-S, alpha-amylase, secretory immunoglobulin A, and chromogranin A. Several working groups are researching in the field of stress marker detection to develop reliable, fast, and affordable methods. Analytical methods reported mainly focused on immunological and electrochemical as well as chromatographic methods hyphenated to mass spectrometric detection to yield the required detection limits.
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Wendsche J, Ihle A, Wegge J, Penz MS, Kirschbaum C, Kliegel M. Prospective associations between burnout symptomatology and hair cortisol. Int Arch Occup Environ Health 2020; 93:779-788. [PMID: 32170362 PMCID: PMC8443510 DOI: 10.1007/s00420-020-01528-3] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2019] [Accepted: 02/14/2020] [Indexed: 11/14/2022]
Abstract
OBJECTIVES Burnout is a stress-related, psychological syndrome due to high levels of job stressors. It has been found to be related to impairments of well-being, health, and job outcomes. Alterations of glucocorticoid secretion might be a mechanism explaining the linkage between burnout and reduced psychophysical functioning. Regarding hair cortisol as indicator this assumption, so far, has been only examined in cross-sectional studies. Therefore, we aimed to compare cross-sectional and prospective associations between different burnout symptoms and hair cortisol, additionally investigating potential nonlinear associations. METHODS The prospective study sample comprises 194 employees (95% nurses) from German geriatric care. We assessed burnout symptoms at baseline (t1) and 6 months later (t2) and collected hair samples for cortisol analyses at t2. RESULTS We found significant cross-sectional and prospective nonlinear (i.e., exponential) but not linear relationships between an aggregated measure of the burnout subscales emotional exhaustion, cynicism, and reduced efficacy and hair cortisol, even after adjusting for BMI and depressive mood. None of the single subscales of burnout was related to hair cortisol after adjusting for confounders. CONCLUSIONS Our findings further support the assumption that accumulated burnout symptoms and hypercorticolism are positively related.
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Affiliation(s)
- Johannes Wendsche
- Federal Institute for Occupational Safety and Health, Fabricestrasse 8, 01099 Dresden, Germany
| | - Andreas Ihle
- Department of Psychology, University of Geneva, Boulevard du Pont d’Arve 40, 1211 Geneve 4, Switzerland
| | - Jürgen Wegge
- Faculty of Psychology, TU Dresden, Technische Universität Dresden, 01062 Dresden, Germany
| | - Marlene Sophie Penz
- Department of Psychotherapy and Psychosomatic Medicine, TU Dresden, University Hospital Carl Gustav Carus Dresden, Fetscherstraße 74, 01307 Dresden, Germany
| | - Clemens Kirschbaum
- Faculty of Psychology, TU Dresden, Technische Universität Dresden, 01062 Dresden, Germany
| | - Matthias Kliegel
- Department of Psychology, University of Geneva, Boulevard du Pont d’Arve 40, 1211 Geneve 4, Switzerland
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Hod K, Melamed S, Dekel R, Maharshak N, Sperber AD. Burnout, but not job strain, is associated with irritable bowel syndrome in working adults. J Psychosom Res 2020; 134:110121. [PMID: 32371342 DOI: 10.1016/j.jpsychores.2020.110121] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2020] [Revised: 04/18/2020] [Accepted: 04/18/2020] [Indexed: 02/07/2023]
Abstract
OBJECTIVE Although stress is an important component of irritable bowel syndrome (IBS) pathophysiology, the possibility that work-related stress is implicated in the pathophysiology of IBS has not been widely studied. This study aimed to examine whether job strain (a combination of high job demands and low control at work) and/or burnout, the outcome of a gradual depletion of energetic resources resulting from chronic exposure to work-related stress, are associated with IBS. METHODS Fifty-five patients fulfilling the Rome III criteria for IBS and 214 matched healthy controls (HC) participated in this cross-sectional study. All participants completed a job strain measure, the Shirom - Melamed Burnout Measure (SMBM), and dietary and health questionnaires. RESULTS There was no significant difference in the prevalence of job strain between IBS patients and HC (25.5% vs. 23.0%, respectively). Job strain was not associated with increased IBS prevalence (adjusted OR = 1.99, 95% CI: 0.54-7.33). In contrast, the mean burnout score in the IBS group was significantly higher than in HC (2.9 ± 1.1 vs. 2.1 ± 0.8, p < .001). Burnout was associated with a 2.41-fold elevated prevalence of IBS (95% CI: 1.16-5.02), after adjusting for potential confounding variables including job strain. Moreover, the odds of having IBS increased in patients with a high burnout level (adjusted OR = 3.3, 95% CI:1.09-10.03). CONCLUSION Burnout, but not job strain, is associated with the prevalence of IBS in working adults.
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Affiliation(s)
- Keren Hod
- Department of Academy and Research, Assuta Medical Center, Tel-Aviv, Israel.
| | - Samuel Melamed
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Roy Dekel
- Department of Gastroenterology and Liver Diseases, Tel-Aviv Medical Centre, Affiliated to the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Nitsan Maharshak
- Department of Gastroenterology and Liver Diseases, Tel-Aviv Medical Centre, Affiliated to the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Ami D Sperber
- Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
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Ndongo JM, Lélé CEB, Manga LJO, Ngalagou PTM, Ayina CNA, Tanga MYL, Guessogo WR, Barth N, Bongue B, Mandengue SH, Ngoa LSE, Ndemba PBA. Epidemiology of burnout syndrome in four occupational sectors in Cameroon-impact of the practice of physical activities and sport. AIMS Public Health 2020; 7:319-335. [PMID: 32617359 PMCID: PMC7327400 DOI: 10.3934/publichealth.2020027] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2020] [Accepted: 05/25/2020] [Indexed: 01/26/2023] Open
Abstract
BACKGROUND The purpose of this study was to determine the prevalence of Burnout syndrome (BOS), risk factors and the effect of physical activity in six professions in Cameroon. METHODS 2012 participants completed questionnaires related to socio-demographic conditions and work perception. Appropriate Maslach Burnout Inventory (MBI) psychometers were used for specific professions. Level of physical activity and sports practice was determined using the Ricci and Gagnon scale. RESULTS The overall prevalence of burnout was 67.9%; with 5.3% high; 34.3% moderate; and 60.4% low degree. 42.2% of victims of BOS were in high loss of personal achievement, 39.9% in high depersonalization of and 38.2% in high emotional exhaustion. Higher prevalence of BOS was found in Army (85.3%) and educational sectors (78.5% in secondary school teachers (SET) and 68% in university teaching staff (UTS)). BOS was significantly associated (p < 0.05) with distance from home to workplace, number of children per participant, number of hospitals attended, number of guards per month, labour hours per day, conflicts with the hierarchy, conflicts with colleagues, poor working conditions, unsatisfactory salary, part time teaching in private university institutions, job seniority, sedentariness. Apart from UTS, no association was observed between the level of physical activity and occurrence of BOS. CONCLUSION Burnout is a reality in occupational environments in Cameroon.
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Affiliation(s)
- J Mekoulou Ndongo
- Physiology and Medicine of Physical Activities and Sports Unit, University of Douala, Cameroon
| | - CE Bika Lélé
- Physiology and Medicine of Physical Activities and Sports Unit, University of Douala, Cameroon
- Institute of Medicinal Plants, Ministry of Scientific Research and Innovation, Yaounde, Cameroon
| | - LJ Owona Manga
- Physiology and Medicine of Physical Activities and Sports Unit, University of Douala, Cameroon
- Department of Public Health, Faculty of Medicine and Pharmaceutical Sciences, University of Douala, Cameroon
| | - PT Moueleu Ngalagou
- Physiology and Medicine of Physical Activities and Sports Unit, University of Douala, Cameroon
| | - CN Ayina Ayina
- Physiology and Medicine of Physical Activities and Sports Unit, University of Douala, Cameroon
| | - MY Lobe Tanga
- Physiology and Medicine of Physical Activities and Sports Unit, University of Douala, Cameroon
| | - WR Guessogo
- Physiology and Medicine of Physical Activities and Sports Unit, University of Douala, Cameroon
- National Institute of Youth and Sport, University of Yaounde I, Cameroon
| | - N Barth
- Laboratoire EA 4607 SNA-EPIS, Université Jean Monnet, 42100 Saint-Etienne, France
| | - B Bongue
- Laboratoire EA 4607 SNA-EPIS, Université Jean Monnet, 42100 Saint-Etienne, France
| | - SH Mandengue
- Physiology and Medicine of Physical Activities and Sports Unit, University of Douala, Cameroon
| | - LS Etoundi Ngoa
- Department of Physiology, Faculty of Medicine and Biomedical Sciences, University of Yaounde I, Cameroon
| | - PB Assomo Ndemba
- Physiology and Medicine of Physical Activities and Sports Unit, University of Douala, Cameroon
- Department of Physiology, Faculty of Medicine and Biomedical Sciences, University of Yaounde I, Cameroon
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