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Turner W, Brühl A, Böker H, Schulze B, Marschall K, La Marca R, Pfaff M, Russmann T, Schmidt-Trucksäss A. Heart rate vARiability and physical activity in inpatient treatMent of burnOut and DepressIon (HARMODI): protocol of a cross-sectional study with up to 8-week follow up. BMJ Open 2024; 14:e081299. [PMID: 38925684 PMCID: PMC11202726 DOI: 10.1136/bmjopen-2023-081299] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Accepted: 05/30/2024] [Indexed: 06/28/2024] Open
Abstract
INTRODUCTION Chronic stress can cause an imbalance within the autonomic nervous system, thereby affecting cardiovascular and mental health. Physical activity (PA) may have a positive effect on the autonomic nervous system and stress-related disorders, such as depression and burnout. Heart rate variability (HRV) is a non-invasive marker of the autonomic nervous system. However, limited and inconsistent data exist on the exact relationship between HRV, PA and depression and burnout symptoms. The HARMODI study aims to explore whether HRV is a feasible marker of depression and burnout symptoms and aims to evaluate the role of PA in the treatment of stress-related disorders. METHODS AND ANALYSES This is an observational study with a cross-sectional up to 8 week follow-up study design. A total of 153 patients, undergoing psychiatric inpatient treatment with burnout syndrome (Z73) and depressive episode (F32 or F33) or adjustment disorder (F43.2), will be recruited. Data on depression and burnout symptoms, HRV recordings (24-hour, supine, standing and exercise stress test), cognitive function, cardiorespiratory fitness, cardiovascular health, balance and strength will be collected at baseline (T1) and after up to 8 weeks (T2). Continuous data on PA and Ecological Momentary Assessments of exhaustion, mood and tension will be monitored daily throughout inpatient treatment. Multiple regression models, adjusted for potential confounders, will assess the association between HRV as the primary outcome, PA and depression and burnout severity score. ETHICS AND DISSEMINATION The protocol has been approved by Swiss Ethics Committee, Cantonal Ethics Committee Zürich. Results of HARMODI will be disseminated through peer-reviewed journals and conference presentations. TRIAL REGISTRATION NUMBER NCT05874856.
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Affiliation(s)
- Wiebke Turner
- Division of Sport and Exercise Medicine, Department of Sport, Exercise and Health, University of Basel, Basel, Switzerland
- Clinica Holistica Engiadina SA, Susch, Switzerland
| | - Annette Brühl
- Department of Psychiatry, University Psychiatric Clinics Basel, Basel, Switzerland
| | - Heinz Böker
- Department of Psychiatric Research, Psychiatric University Hospital Zurich, Zurich, Switzerland
| | | | | | | | | | | | - Arno Schmidt-Trucksäss
- Division of Sport and Exercise Medicine, Department of Sport, Exercise and Health, University of Basel, Basel, Switzerland
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Lawton R, Frankenberg E, Seeman T, Crimmins E, Sumantri C, Thomas D. Exposure to the Indian Ocean Tsunami shapes the HPA-axis resulting in HPA "burnout" 14 years later. Proc Natl Acad Sci U S A 2023; 120:e2306497120. [PMID: 37844215 PMCID: PMC10622908 DOI: 10.1073/pnas.2306497120] [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: 04/20/2023] [Accepted: 08/29/2023] [Indexed: 10/18/2023] Open
Abstract
Despite significant research on the effects of stress on the hypothalamic-pituitary-adrenal (HPA) axis, questions remain regarding long-term impacts of large-scale stressors. Leveraging data on exposure to an unanticipated major natural disaster, the 2004 Indian Ocean tsunami, we provide causal evidence of its imprint on hair cortisol levels fourteen years later. Data are drawn from the Study of the Tsunami Aftermath and Recovery, a population-representative longitudinal study of tsunami survivors who were living along the coast of Aceh, Indonesia, when the tsunami hit. Annual rounds of data, collected before, the year after and 2 y after the disaster provide detailed information about tsunami exposures and self-reported symptoms of post-traumatic stress. Hair samples collected 14 y after the tsunami from a sample of adult participants provide measures of cortisol levels, integrated over several months. Hair cortisol concentrations are substantially and significantly lower among females who were living, at the time of the tsunami, in communities directly damaged by the tsunami, in comparison with similar females living in other, nearby communities. Differences among males are small and not significant. Cortisol concentrations are lowest among those females living in damaged communities who reported elevated post-traumatic stress symptoms persistently for two years after the tsunami, indicating that the negative effects of exposure were largest for them. Low cortisol is also associated with contemporaneous reports of poor self-rated general and psychosocial health. Taken together, the evidence points to dysregulation in the HPA axis and "burnout" among these females fourteen years after exposure to the disaster.
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Affiliation(s)
- Ralph Lawton
- Graduate School of Arts and Sciences, Harvard University, Cambridge, MA02115
| | | | - Teresa Seeman
- Department of Medicine, Division of Geriatrics, University of California, Los Angeles, CA90095
| | - Eileen Crimmins
- Andrus Gerontology Center, Davis School of Gerontology, University of Southern California, Los Angeles, CA90089
| | | | - Duncan Thomas
- Department of Economics, Duke University, Durham, NC27708
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Jõgi AL, Aulén AM, Pakarinen E, Lerkkanen MK. Teachers' daily physiological stress and positive affect in relation to their general occupational well-being. BRITISH JOURNAL OF EDUCATIONAL PSYCHOLOGY 2023; 93:368-385. [PMID: 36336902 PMCID: PMC10098726 DOI: 10.1111/bjep.12561] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Accepted: 10/16/2022] [Indexed: 11/09/2022]
Abstract
BACKGROUND Teachers' stress, affect and general occupational well-being influence their teaching and their students. However, how teachers' daily physiological stress and positive affect are related in the classroom is unknown. To reduce teachers' stress and enhance their positive affect, it is crucial to understand how occupational well-being relates to stress and affect. AIM The aim of the study was to examine the relationships between teachers' daily physiological stress and positive affect in authentic classroom settings and the roles played by teachers' self-efficacy beliefs, perceptions of school climate and burnout symptoms in daily stress and affect. SAMPLE The sample consisted of 45 classroom teachers. METHOD Daily physiological stress was assessed by measuring salivary cortisol levels three times in two days. Positive affect was reported by experience sampling at the same time that cortisol was collected. Questionnaires were used to assess self-efficacy beliefs, perceptions of school climate and burnout symptoms. Three-level modelling with random intercepts and slopes was used to analyse the relationships between daily stress and affect and the effect of teachers' general occupational well-being on stress and affect. RESULTS No relationships were evident between teachers' physiological stress and positive affect or between daily changes of stress and affect. Self-efficacy beliefs were related to lower stress and higher affect in the middle of the school day. Having sufficient school resources were related to higher positive affect. Teachers' burnout symptoms were associated with lower positive affect. CONCLUSIONS We emphasize the potential for self-efficacy and perceptions of school resources as targets for intervening in teachers' stress and affect.
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Affiliation(s)
- Anna-Liisa Jõgi
- Department of Teacher Education, University of Jyväskylä, Jyväskylä, Finland.,School of Educational Sciences, Tallinn University, Tallinn, Estonia
| | - Anna-Mari Aulén
- Department of Teacher Education, University of Jyväskylä, Jyväskylä, Finland
| | - Eija Pakarinen
- Department of Teacher Education, University of Jyväskylä, Jyväskylä, Finland
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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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De Beer LT, Schaufeli WB, De Witte H. The psychometric properties and measurement invariance of the Burnout Assessment Tool (BAT-23) in South Africa. BMC Public Health 2022; 22:1555. [PMID: 35971108 PMCID: PMC9378260 DOI: 10.1186/s12889-022-13978-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Accepted: 08/05/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Burnout is an increasing public health concern that afflicts employees globally. The measurement of burnout is not without criticism, specifically in the context of its operational definition as a syndrome, also recently designated as such by the World Health Organisation. The Burnout Assessment Tool (BAT-23) is a new measure for burnout that addresses many of the criticisms surrounding burnout scales. The aim of this study is to determine the validity, reliability, and measurement invariance of the BAT-23 in South Africa. METHOD A quantitative, cross-sectional survey, approach was taken (n = 1048). Latent variable modelling was implemented to investigate the construct-relevant multidimensionality that is present in the BAT. For measurement invariance, the configural, metric, scalar, and strict models were tested. RESULTS The analyses showed that the hierarchical operationalisation of BAT-assessed burnout was the most appropriate model for the data. Specifically, a bifactor ESEM solution. Composite reliability estimates were all well above the cut-off criteria for both the global burnout factor and the specific factors. The measurement invariance tests showed that gender achieved not only strong invariance, but also strict invariance. However, ethnicity initially only showed strong invariance, but a test of partial strict invariance did show that the mean scores could be fairly compared between the groups when releasing certain constraints. CONCLUSIONS The BAT-23 is a valid and reliable measure to investigate burnout within the Southern African context.
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Affiliation(s)
- Leon T De Beer
- WorkWell Research Unit, Potchefstroom Campus, North-West University, Potchefstroom, 2531, South Africa.
| | - Wilmar B Schaufeli
- Department of Psychology, Utrecht University, 3584, CS, Utrecht, The Netherlands.,Research Unit Occupational & Organizational Psychology and Professional Learning KU Leuven, 3000, Louvain, Belgium
| | - Hans De Witte
- Research Unit Occupational & Organizational Psychology and Professional Learning KU Leuven, 3000, Louvain, Belgium.,Optentia Research Unit, Vanderbijlpark Campus, North-West University, Vanderbijlpark, 1900, South Africa
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Altintas E, El Haj M, Boudoukha A, Olivier C, Lizio A, Luyat M, Gallouj K. Emotional exhaustion and fear of COVID-19 in geriatric facilities during the COVID-19 pandemic. Int J Geriatr Psychiatry 2022; 37:10.1002/gps.5781. [PMID: 35789036 PMCID: PMC9350400 DOI: 10.1002/gps.5781] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Accepted: 06/21/2022] [Indexed: 11/21/2022]
Abstract
OBJECTIVE Since the onset of the COVID-19 pandemic, healthcare workers, especially those employed in hospital settings, have been exposed to a variety of stressors in the workplace. The aim of this study was to explore the Emotional Exhaustion (EE) of workers in geriatric facilities during the COVID-19 crisis. We accordingly sought to investigate the short-term impact of the COVID-19 pandemic in terms of the EE experienced by workers in geriatric facilities, and to examine the manner in which psychosocial conditions and fear of COVID-19 in the workplace have affected EE. METHODS Surveys were administered in the midst of the COVID-19 crisis (October to December 2020). The study included 118 French healthcare workers with a mean age of 35.61 ± 0.73 recruited in geriatric facilities. We assessed EE, psychosocial conditions (e.g., demands at work, health and well-being, etc.) and fear of COVID-19 in the workplace. RESULTS The analysis yielded two main outcomes. First, 34.75% workers (41) reported severe levels of EE. Second, demands at work and the fear of COVD-19 increased EE. Health and well-being were, however, demonstrated to protect against EE. DISCUSSION Furthermore, fear of COVID-19 was shown to contribute significantly to EE healthcare workers in geriatric facilities. It is likely that Covid-19 indirectly contributes to EE by influencing demands at work.
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Affiliation(s)
- Emin Altintas
- Univ. LilleULR 4072 – PSITEC – Psychologie : Interactions, Temps, Emotions, Cognition, F‐59000LilleFrance,Unité de GériatrieCenter Hospitalier de TourcoingTourcoingFrance
| | - Mohamad El Haj
- Unité de GériatrieCenter Hospitalier de TourcoingTourcoingFrance,Laboratoire de Psychologie des Pays de la Loire (EA 4638)Université de NantesNantesFrance,Institut Universitaire de FranceParisFrance
| | - Abdel‐Halim Boudoukha
- Laboratoire de Psychologie des Pays de la Loire (EA 4638)Université de NantesNantesFrance
| | - Camille Olivier
- Unité de GériatrieCenter Hospitalier de TourcoingTourcoingFrance
| | - Andréa Lizio
- Unité de GériatrieCenter Hospitalier de TourcoingTourcoingFrance
| | - Marion Luyat
- Univ. LilleULR 4072 – PSITEC – Psychologie : Interactions, Temps, Emotions, Cognition, F‐59000LilleFrance
| | - Karim Gallouj
- Univ. LilleULR 4072 – PSITEC – Psychologie : Interactions, Temps, Emotions, Cognition, F‐59000LilleFrance,Unité de GériatrieCenter Hospitalier de TourcoingTourcoingFrance
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Thielmann B, Karlsen HR, Darius S, Böckelmann I. Heart Rate Variability in Different Levels of Burnout-Cross-Sectional Study of Different Occupational Groups Heart Rate Variability and Burnout. J Occup Environ Med 2021; 63:e622-e630. [PMID: 34173785 DOI: 10.1097/jom.0000000000002307] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
OBJECTIVES The aim of this study was a subjective and objective stress analysis of occupational groups. METHODS The study examined 414 employees with patients or children contact on work. The age ranged from 22 to 63 years. Subjective stress was measured using the Maslach Burnout Inventory and objective stress with heart rate variability (HRV). RESULTS Twenty-one percent of subjects showed a high level of exhaustion, 12.9% a high level of cynicism and low performance. There were significant group differences between cynicism levels in meanNN (P = .008) and meanHR (P = .002). There were no significant differences in HRV for exhaustion and professional efficacy. CONCLUSIONS The health-impairing manifestations of the three dimensions of the burnout syndrome are not associated with the lower HRV. However, healthy subjects from a "screening" study who had not been clinically diagnosed with burnout were examined here.
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Affiliation(s)
- Beatrice Thielmann
- Institute of Occupational Medicine, Medical Faculty, Otto-von-Guericke-University, Magdeburg, Germany (Dr Thielmann, Dr Darius, and Prof Böckelmann); Department of Psychology, Norwegian University of Science and Technology, Trondheim, Norway (Mr Karlsen)
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Abstract
PURPOSE OF REVIEW Diabetes represents a chronic illness with significant physical and psychological morbidities. This review aims to summarize current conceptualizations of diabetes burnout in individuals with diabetes and describe its associated adverse outcomes in this population while proposing possible mechanisms of action and targets of intervention. RECENT FINDINGS "Diabetes burnout" may result in adverse long-term outcomes including poor treatment compliance, diabetes complications, and depression. Diabetes burnout may impact not only individuals, but also providers, and caregivers and family members of affected individuals. Diabetes burnout may results from sustained cognitive stresses of chronic treatment adherence, assessment of realistic treatment goals, and treatment challenges. Early screening and interdisciplinary approaches for patient-centered diabetes care are critical for sustained diabetes social support. Future work exploring these approaches may identify early support and targeted interventions for the long-term support of individuals with diabetes.
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Affiliation(s)
- Samereh Abdoli
- College of Nursing, University of Tennessee, Knoxville, TN, USA.
| | - Danielle Hessler
- Department of Family and Community Medicine, University of California, 500 Parnassus Avenue, San Francisco, CA, 94117, USA
| | - Mehri Doosti-Irani
- School of Nursing and Midwifery, Shahrekord University of Medical Sciences, Shahrekord, Iran
| | - Bernard P Chang
- Department of Emergency Medicine, Columbia University Irving Medical Center, New York, NY, USA
| | - Heather Stuckey
- College of Medicine, Humanities and Public Health Sciences, Penn State University, Hershey, PA, USA
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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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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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Relationship between job burnout and somatic diseases: a network analysis. Sci Rep 2020; 10:18438. [PMID: 33116176 PMCID: PMC7595180 DOI: 10.1038/s41598-020-75611-7] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2020] [Accepted: 10/16/2020] [Indexed: 12/02/2022] Open
Abstract
Job burnout, characterized by feelings of exhaustion, cynicism and reduced personal efficacy, has been defined as a risk state for the development of diseases, but its association with somatic diseases is underexplored. Study participants were 5671 respondents (mean age 44.1 years, range 18–70; 38.6% men) to an online survey of job burnout, using a mobile health web application. Respondents provided data on sociodemographic characteristics, symptoms of burnout, measured with the Maslach Burnout Inventory-General Survey, depressive symptoms, measured with the Profile of Mood States, and 11 categories of somatic diseases. Adjusting for age, sex, educational level, depressive symptoms, and all disease categories included, network analysis showed a significant association of high exhaustion with “high blood pressure” and a category of “other chronic somatic diseases”. Low personal efficacy showed a significant association with “chronic lung diseases”. In network analysis, clinically relevant depressive symptoms were also significantly associated with “high blood pressure”, “other chronic somatic diseases” and “skin diseases”. Logistic regression analysis confirmed these associations. Burnout dimensions were significantly associated with an increased risk for somatic diseases, independently of sociodemographic factors and clinically relevant depressive symptoms. This relationship seems particularly evident for the exhaustion dimension of job burnout.
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Brand S, Ebner K, Mikoteit T, Lejri I, Gerber M, Beck J, Holsboer-Trachsler E, Eckert A. Influence of Regular Physical Activity on Mitochondrial Activity and Symptoms of Burnout-An Interventional Pilot Study. J Clin Med 2020; 9:jcm9030667. [PMID: 32131484 PMCID: PMC7141353 DOI: 10.3390/jcm9030667] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2020] [Revised: 02/26/2020] [Accepted: 02/26/2020] [Indexed: 12/20/2022] Open
Abstract
Background: Occupational burnout is both a serious public and individual health concern. Psychopharmacological and psychological interventions are often employed, while interventions involving physical activity have been less frequently studied. The aims of the present study were (1) to investigate the effects of physical activity on mitochondrial activity levels and symptoms of burnout, (2) to compare the mitochondrial activity levels and symptoms of burnout of individuals suffering burnout with those of healthy controls (HCs), and (3) to explore the associations between mitochondrial activity and burnout symptoms. Methods: Twelve males with burnout (mean age: M = 45.8 years) took part in the study. At baseline and after 12 weeks of an intervention involving physical activity, participants completed questionnaires covering symptoms of burnout and depression. In parallel, blood samples were taken to measure changes in mitochondrial functional outcomes, such as ATP levels, oxygen consumption and complex I. For comparison, baseline values of healthy controls (HCs; depression and burnout questionnaires; blood samples) were assessed. Results: Over time, symptoms of burnout (emotional exhaustion and depersonalization) and depression significantly decreased in participants with burnout (large effect sizes) but remained significantly higher than those of HCs (medium to large effect sizes). Personal accomplishment increased over time (medium effect size) but was still lower than for HCs (large effect size). At baseline and compared to HCs, individuals with burnout had significantly lower ATP levels of mitochondrial functional outcomes. Over time, mitochondrial activity levels increased among individuals with burnout. High baseline mitochondrial activity was significantly correlated with lower depression and burnout scores both at baseline and at the end of the study. Conclusions: In individuals with burnout, regular physical activity had positive effects on mitochondrial activity and on symptoms of burnout and depression. However, when compared to healthy controls, full remission was not achieved.
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Affiliation(s)
- Serge Brand
- Psychiatric Clinics (UPK), Center for Affective, Stress and Sleep Disorders, University of Basel, 4001 Basel, Switzerland; (T.M.); (E.H.-T.)
- Department of Sport, Exercise and Health, Division of Sport Science and Psychosocial Health, University of Basel, 4052 Basel, Switzerland;
- Substance Abuse Prevention Research Center, Health Institute, Kermanshah University of Medical Sciences (KUMS), 6719851115 Kermanshah, Iran
- Sleep Disorders Research Center, Kermanshah University of Medical Sciences (KUMS), 6719851115 Kermanshah, Iran
- School of Medicine, Tehran University of Medical Sciences, 1416753955 Tehran, Iran
- Correspondence: ; Tel.: +41-6132-5509-7
| | - Katarina Ebner
- Transfaculty Research Platform, Molecular and Cognitive Neuroscience, Neurobiology Laboratory for Brain Aging and Mental Health, Psychiatric Clinics (UPK), University of Basel, 4001 Basel, Switzerland; (K.E.); (I.L.); (A.E.)
| | - Thorsten Mikoteit
- Psychiatric Clinics (UPK), Center for Affective, Stress and Sleep Disorders, University of Basel, 4001 Basel, Switzerland; (T.M.); (E.H.-T.)
- Psychiatric Services Solothurn and Faculty of Medicine of the University of Basel, 4503 Solothurn, Switzerland
| | - Imane Lejri
- Transfaculty Research Platform, Molecular and Cognitive Neuroscience, Neurobiology Laboratory for Brain Aging and Mental Health, Psychiatric Clinics (UPK), University of Basel, 4001 Basel, Switzerland; (K.E.); (I.L.); (A.E.)
| | - Markus Gerber
- Department of Sport, Exercise and Health, Division of Sport Science and Psychosocial Health, University of Basel, 4052 Basel, Switzerland;
| | - Johannes Beck
- Psychiatric Hospital Sonnenhalde, 4125 Riehen, Switzerland;
| | - Edith Holsboer-Trachsler
- Psychiatric Clinics (UPK), Center for Affective, Stress and Sleep Disorders, University of Basel, 4001 Basel, Switzerland; (T.M.); (E.H.-T.)
| | - Anne Eckert
- Transfaculty Research Platform, Molecular and Cognitive Neuroscience, Neurobiology Laboratory for Brain Aging and Mental Health, Psychiatric Clinics (UPK), University of Basel, 4001 Basel, Switzerland; (K.E.); (I.L.); (A.E.)
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Jahangard L, Hedayati M, Abbasalipourkabir R, Haghighi M, Ahmadpanah M, Faryadras M, Mikoteit T, Sadeghi Bahmani D, Brand S. Omega-3-polyunsatured fatty acids (O3PUFAs), compared to placebo, reduced symptoms of occupational burnout and lowered morning cortisol secretion. Psychoneuroendocrinology 2019; 109:104384. [PMID: 31382171 DOI: 10.1016/j.psyneuen.2019.104384] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2019] [Revised: 07/11/2019] [Accepted: 07/17/2019] [Indexed: 01/06/2023]
Abstract
BACKGROUND Occupational burnout is both a serious health concern at both public and individual levels. Treatment options are psychopharmacological, psychological and physical activity-related interventions. Here, we tested whether, compared to placebo, omega-3-polyunsaturated fatty acids (O3PUFAs) have a positive impact on burnout and morning cortisol secretion. METHOD A total of 43 individuals (mean age: 38.4 years, 76.7% females) took part in the present double-blind and placebo-controlled intervention. Participants were randomly assigned either to the O3PUFA or to the placebo condition. At baseline and again eight weeks later, participants completed the Maslach Burnout Inventory and collected morning saliva samples for analysis of the cortisol awakening response (CAR). RESULTS Emotional exhaustion and depersonalization decreased, and sense of personal accomplishment increased over time, but more so in the O3PUFA condition than in the placebo condition. Likewise, CAR decreased over time, but again more so in the O3PUFA condition than in the placebo condition. CONCLUSIONS The present pattern of results suggests that, compared to placebo, administration of daily omega-3-polyunsaturated fatty acids for eight consecutive weeks positively influences both psychological and physiological markers of occupational burnout.
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Affiliation(s)
- Leila Jahangard
- Research Center for Behavioral Disorders and Substance Abuse, Hamadan University of Medical sciences, Hamadan, Iran
| | - Mahmoud Hedayati
- Research Center for Behavioral Disorders and Substance Abuse, Hamadan University of Medical sciences, Hamadan, Iran
| | | | - Mohammad Haghighi
- Research Center for Behavioral Disorders and Substance Abuse, Hamadan University of Medical sciences, Hamadan, Iran
| | - Mohammad Ahmadpanah
- Research Center for Behavioral Disorders and Substance Abuse, Hamadan University of Medical sciences, Hamadan, Iran
| | - Mohammad Faryadras
- Department of Biostatistics and Epidemiology, School of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Thorsten Mikoteit
- University of Basel, Psychiatric Clinics, Center for Affective, Stress and Sleep Disorders, Basel, Switzerland; University of Basel, Psychiatric Hospital Solothurn, Solothurn, Switzerland
| | - Dena Sadeghi Bahmani
- University of Basel, Psychiatric Clinics, Center for Affective, Stress and Sleep Disorders, Basel, Switzerland; Kermanshah University of Medical Sciences (KUMS), Substance Abuse Prevention Research Center, Kermanshah, Iran; Kermanshah University of Medical Sciences (KUMS), Sleep Disorders Research Center, Kermanshah, Iran; Isfahan University of Medical Sciences, Neurosciences Research Center, Alzahra Research Institute, Isfahan, Iran
| | - Serge Brand
- University of Basel, Psychiatric Clinics, Center for Affective, Stress and Sleep Disorders, Basel, Switzerland; Kermanshah University of Medical Sciences (KUMS), Substance Abuse Prevention Research Center, Kermanshah, Iran; Kermanshah University of Medical Sciences (KUMS), Sleep Disorders Research Center, Kermanshah, Iran; University of Basel, Department of Sport, Exercise and Health, Division of Sport Science and Psychosocial Health, Basel, Switzerland.
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Chin MS, Kales SN. Is There an Optimal Autonomic State for Enhanced Flow and Executive Task Performance? Front Psychol 2019; 10:1716. [PMID: 31474898 PMCID: PMC6702786 DOI: 10.3389/fpsyg.2019.01716] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2019] [Accepted: 07/09/2019] [Indexed: 11/13/2022] Open
Abstract
Introduction Flow describes a state of optimal experience that can promote a positive adaptation to increasing stress. The aim of the current study is to identify the ideal autonomic state for peak cognitive performance by correlating sympathovagal balance during cognitive stress with (1) perceived flow immersion and (2) executive task performance. Materials and Methods Autonomic states were varied in healthy male participants (n = 48) using combinations of patterned breathing and skeletal muscle contraction that are known to induce differing levels of autonomic response. After autonomic variation, a Stroop test was performed on participants to induce a mild stress response, and autonomic arousal was assessed using heart rate variability. Subjective experience of flow was measured by standardized self-report, and executive task performance was measured by reaction time on the Stroop test. Results There were significant associations between autonomic state and flow engagement with an inverted U-shaped function for parasympathetic stimulation, sympathetic response, and overall sympathovagal balance. There were also significant associations between autonomic states and reaction times. Combining sympathetic and parasympathetic responses to evaluate overall sympathovagal balance, there was a significant U-shaped relationship with reaction time. Discussion Our results support the flow theory of human performance in which the ideal autonomic state lies at the peak of an inverted-U function, and extremes at either end lead to both suboptimal flow experience. Similarly, cognitive task performance was maximized at the bottom of the U-function. Our findings suggest that optimal performance may be associated with predominant, but not total, sympathetic response.
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Affiliation(s)
- Michael S Chin
- Division of General Internal Medicine and Public Health, Vanderbilt University School of Medicine, Nashville, TN, United States.,Vanderbilt Occupational Health, Vanderbilt University Medical Center, Nashville, TN, United States
| | - Stefanos N Kales
- Environmental and Occupational Medicine and Epidemiology Program, Harvard T.H. Chan School of Public Health, Boston, MA, United States.,Department of Occupational Medicine, Cambridge Health Alliance, Harvard Medical School, Boston, MA, United States
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Trifu S. NEUROENDOCRINE INSIGHTS INTO BURNOUT SYNDROME. ACTA ENDOCRINOLOGICA-BUCHAREST 2019; 15:404-405. [PMID: 32010363 DOI: 10.4183/aeb.2019.404] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Debates flow in the medical and psychological field about burnout symptoms: from considering it as a distinct illness, a separate entity or correlated with physiological changes and/or job-related reaction. Seen as a form of depression, the researches are investigating the correlations between various changes in the normal human body functioning, environmental and job lever / implications. The following pages refer to the recent studies of neuroendocrine indicators involved in burnout. It is known that the endocrine system is highly interrelated with the immune and neural systems, the neuro-immuno-endocrine axis is subject to clear biphasic changes in the acute and chronic phases of a critical illness, most likely reflecting a beneficial adaptation.
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Affiliation(s)
- S Trifu
- "Carol Davila" University of Medicine and Pharmacy - Neurosciences, Bucharest, Romania
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