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Gao Y, Wang L. A study on the relationship and path between mental health and burnout of Chinese athletes. Front Psychol 2024; 15:1422207. [PMID: 39100557 PMCID: PMC11295933 DOI: 10.3389/fpsyg.2024.1422207] [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: 04/23/2024] [Accepted: 06/27/2024] [Indexed: 08/06/2024] Open
Abstract
Background This study aims to explore the relationship and influencing pathways between mental health indicators and athlete burnout among Chinese competitive athletes. Methods A cross-sectional study was conducted on 501 elite Chinese athletes from several national and provincial sports teams. Generalized Anxiety Disorder Scale (GAD-7) was used to measure anxiety, Patient Health Questionnaire (PHQ- 9) was used to measure depression, Athlete Psychological Strain Questionnaire (APSQ) was used to measure perceived stress, and Athlete Burnout Questionnaire (ABQ) was used to measure burnout. The results were derived using reliability testing, descriptive statistics, correlation analyses, and structural equation modeling. Results The following results were obtained: (a) the clinical detection rates of anxiety and depression in this sample were within normal levels, but the detection rate of perceived stress (78.64%) was relatively high; (b) all three mental health indicators were significantly correlated with athlete burnout; (c) in our model, there was a direct path with APSQ directly contributing to 69.95% of the variance in athlete burnout, and two indirect paths with APSQ exerting an indirect effect through depression or/and anxiety accounting for 30.05% of the variance. Conclusion The findings revealed the psychological characteristics of Chinese competitive athletes and the direct and indirect effects of the APSQ on burnout. Future research should actively promote the international development and application of burnout assessment tools, conduct more comprehensive studies on athlete mental health monitoring, and intensify efforts in athlete education, treatment, and support services, as well as strategies for athlete's coping stress.
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Affiliation(s)
- Yun Gao
- Department of Physical Education, Shanghai Jiao Tong University, Shanghai, China
| | - Lei Wang
- School of Physical Education, Shanghai University of Sport, Shanghai, China
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Szczerbińska K, Barańska I, Kijowska V, Stodolska A, Wójcik G, Różańska A, Wójkowska-Mach J. Factors associated with burnout among hospital-based healthcare workers during the COVID-19 pandemic: A cross-sectional CRACoV-HHS study. J Clin Nurs 2024; 33:304-321. [PMID: 36792068 DOI: 10.1111/jocn.16654] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Revised: 12/19/2022] [Accepted: 01/24/2023] [Indexed: 02/17/2023]
Abstract
AIMS To assess the prevalence of burnout and associated factors among healthcare workers (HCWs) working in a hospital admitting patients with COVID-19. BACKGROUND Burnout among HCWs is related to age, gender and occupation. However, little is known about organisational factors associated with burnout during the COVID-19 pandemic. DESIGN A cross-sectional study of 1412 hospital HCWs (748 nurses) was carried out via online survey during the COVID-19 pandemic between 4 and 19 January 2021. METHODS The Maslach Burnout Inventory-Human Services Survey, the Checklist Individual Strength questionnaire, the interRAI items covering mental health, the WHO questionnaire items assessing HCWs' preparedness and exposure to SARS-CoV-2 were used. Univariable and multivariable linear regression analyses were conducted to clarify factors associated with emotional exhaustion (EE), depersonalisation (DP) and personal accomplishment (PA). This study adheres to the STROBE guidelines. RESULTS Burnout prevalence varied from 10.0% to 22.0%. Most respondents (83.6%) reported low PA, 22.9% high EE and 18.7% high DP. Nurses and physicians had the highest levels of EE and DP. Staff exposed or uncertain if exposed to contaminated patients' body fluids and materials had higher levels of burnout. Preparedness (training) (b = 1.15; 95%CI 0.26 to 2.05) and adherence to infection prevention and control procedures (b = 1.57; 95%CI 0.67 to 2.47) were associated with higher PA, and accessibility of personal protective equipment (PPE) (b = -1.37; 95%CI -2.17 to -0.47) was related to lower EE. HCWs working in wards for patients with COVID-19 reported lower EE (b = -1.39; 95%CI -2.45 to -0.32). HCWs who contracted COVID-19 reported lower DP (b = -0.71, 95%CI -1.30 to -0.12). CONCLUSIONS Organisational factors such as better access to PPE, training, and adherence to infection prevention and control procedures were associated with a lower level of burnout. RELEVANCE TO CLINICAL PRACTICE Healthcare managers should promote strategies to reduce burnout among HCWs with regard to preparedness of all staff.
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Affiliation(s)
- Katarzyna Szczerbińska
- Laboratory for Research on Aging Society, Department of Sociology of Medicine, Epidemiology and Preventive Medicine Chair, Medical Faculty, Jagiellonian University Medical College, Kraków, Poland
- The University Hospital in Cracow, Kraków, Poland
| | - Ilona Barańska
- Laboratory for Research on Aging Society, Department of Sociology of Medicine, Epidemiology and Preventive Medicine Chair, Medical Faculty, Jagiellonian University Medical College, Kraków, Poland
| | - Violetta Kijowska
- Laboratory for Research on Aging Society, Department of Sociology of Medicine, Epidemiology and Preventive Medicine Chair, Medical Faculty, Jagiellonian University Medical College, Kraków, Poland
| | - Agata Stodolska
- Laboratory for Research on Aging Society, Department of Sociology of Medicine, Epidemiology and Preventive Medicine Chair, Medical Faculty, Jagiellonian University Medical College, Kraków, Poland
| | - Grzegorz Wójcik
- Laboratory for Research on Aging Society, Department of Sociology of Medicine, Epidemiology and Preventive Medicine Chair, Medical Faculty, Jagiellonian University Medical College, Kraków, Poland
- Faculty of Management and Social Communication, Institute of Applied Psychology, Jagiellonian University, Kraków, Poland
| | - Anna Różańska
- Chair of Microbiology Medical Faculty Jagiellonian University Medical College, Kraków, Poland
| | - Jadwiga Wójkowska-Mach
- Chair of Microbiology Medical Faculty Jagiellonian University Medical College, Kraków, Poland
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Subramanian M, McAuliffe T, Agrawal H. Assessing Variability in Reporting Severity of the Same Symptom (Fatigue) in the Context of Different Psychiatric Syndromes. Cureus 2023; 15:e44112. [PMID: 37750117 PMCID: PMC10518187 DOI: 10.7759/cureus.44112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/25/2023] [Indexed: 09/27/2023] Open
Abstract
Objective The objective of this study is to examine the variability in the self-reported fatigue symptom severity in major depressive disorder (MDD) compared to generalized anxiety disorder (GAD). Methods A retrospective chart review was conducted of 100 patients evaluated for fatigue using depression and anxiety questionnaires. The study examined whether ratings of fatigue varied based on whether fatigue was being rated by the patient in the context of MDD vs. when fatigue was being rated by the same patient in the context of GAD. A related-sample Wilcoxon signed-rank test and Mann-Whitney U test were used to compare the median differences between depression and anxiety fatigue scores. The significance level used was 0.05. Results This study found a statistically significant difference in the median difference of the paired depression fatigue and anxiety fatigue scores (depression score - anxiety score) regardless of the order of administration (Wilcoxon signed-rank test statistic = 135.500, p-value =.008, N = 100 paired scores). Conclusion The study's conclusions show that although the symptom of fatigue is listed in the Diagnostic Statistical Manual 5 (DSM-5) criteria for MDD as well as GAD, it may be perceived by patients differently based on the context of the syndrome. This emphasizes the importance of considering the context of symptom reporting in patients with MDD and GAD to improve diagnostic methodologies and treatment strategies.
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Affiliation(s)
- Maya Subramanian
- College of Medicine, Medical College of Wisconsin, Milwaukee, USA
| | - Timothy McAuliffe
- Psychiatry and Behavioral Medicine, Medical College of Wisconsin, Milwaukee, USA
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Wu L, Chen Y, Liu X, Fang P, Feng T, Sun K, Ren L, Liang W, Lu H, Lin X, Li Y, Wang L, Li C, Zhang T, Ni C, Wu S. The influence of job burnout on the attention ability of army soldiers and officers: Evidence from ERP. Front Neurosci 2022; 16:992537. [PMID: 36419460 PMCID: PMC9676458 DOI: 10.3389/fnins.2022.992537] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Accepted: 10/18/2022] [Indexed: 10/19/2023] Open
Abstract
Job burnout is one of the most widespread mental problems in today's society and seriously affects the mental health and combat effectiveness of soldiers and officers. Herein, the effect of burnout on individual attention is studied from the perspective of neuroelectrophysiology. A total of 1,155 army soldiers and officers were included in this investigation and completed the Job Burnout Scale for Military Personnel. A total of 42 soldiers and officers were randomly selected from those with and without burnout to participate in an event-related potential (ERP) study using a visual oddball task. The characteristics of visual P3a and P3b at Fz, FCz, Cz, CPz, and Pz were recorded and analyzed by repeated-measures analysis of variance (ANOVA). P < 0.05 was the criterion for a significant difference. The total average score on the Job Burnout Scale for Military Personnel among the participants was 0.74 ± 0.46, and the detection rate of job burnout was 29.85%. In the Oddball task, the average number of target stimuli counted in the burnout group was lower than that in the control group, but no significant difference was found. For P3a, the Fz, FCz, Cz, CPz, and Pz amplitudes in the burnout group were significantly lower than those in the control group. The average amplitude of P3a evoked in the central parietal area was larger than that in the prefrontal area. For P3b, the amplitudes of the five electrodes in the burnout group were significantly lower than those in the control group. The average amplitude of P3b evoked in the parietal region was larger than those in the prefrontal and central parietal regions. A certain degree of job burnout is evident in army soldiers and officers. The voluntary attention and involuntary attention of individuals with burnout are both affected to some extent, as reflected by the lower amplitudes of P3a and P3b. The results suggest that P3a and P3b can be used as indicators to monitor cognitive neural function in soldiers and officers with burnout and can also be used as references for evaluating the effects of cognitive training and screening methods. In this study, ERP was used to research the attention ability of soldiers and officers with job burnout, and related issues were discussed from the aspects of the burnout results, behavioral results, ERP results, compensation effect of cognitive resources, application in the military field, limitations, and prospects.
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Affiliation(s)
- Lin Wu
- Department of Military Medical Psychology, Air Force Medical University, Xi’an, China
| | - Yanfeng Chen
- Nursing School, Air Force Medical University, Xi’an, China
| | - Xufeng Liu
- Department of Military Medical Psychology, Air Force Medical University, Xi’an, China
| | - Peng Fang
- Department of Military Medical Psychology, Air Force Medical University, Xi’an, China
| | - Tingwei Feng
- Department of Military Medical Psychology, Air Force Medical University, Xi’an, China
| | - Kewei Sun
- Department of Military Medical Psychology, Air Force Medical University, Xi’an, China
| | - Lei Ren
- Department of Military Medical Psychology, Air Force Medical University, Xi’an, China
| | - Wei Liang
- Department of Military Medical Psychology, Air Force Medical University, Xi’an, China
| | - Huijie Lu
- Department of Military Medical Psychology, Air Force Medical University, Xi’an, China
| | - Xinxin Lin
- Department of Military Medical Psychology, Air Force Medical University, Xi’an, China
| | - Yijun Li
- Department of Military Medical Psychology, Air Force Medical University, Xi’an, China
| | - Lingling Wang
- Department of Military Medical Psychology, Air Force Medical University, Xi’an, China
| | - Chenxi Li
- Department of Military Medical Psychology, Air Force Medical University, Xi’an, China
| | - Tian Zhang
- Department of Military Medical Psychology, Air Force Medical University, Xi’an, China
| | - Chunping Ni
- Nursing School, Air Force Medical University, Xi’an, China
| | - Shengjun Wu
- Department of Military Medical Psychology, Air Force Medical University, Xi’an, China
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Sars D. PE augmented mindfulness: A neurocognitive framework for research and future healthcare. Front Hum Neurosci 2022; 16:899988. [PMID: 36082227 PMCID: PMC9446465 DOI: 10.3389/fnhum.2022.899988] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2022] [Accepted: 07/21/2022] [Indexed: 11/13/2022] Open
Abstract
Various well-controlled studies have suggested that practitioners in mindfulness can be prone to patient drop-out (e.g., due to chronic stress, pathology, cognitive reactivity), despite researchers having identified the underlying mechanisms that link mindfulness to mental health. In this article, a framework for physical exercise (PE) augmented mindfulness is proposed, which posits that consistently practiced PE before meditation can support (early-stage) mindfulness. Neurocognitive research shows PE (aerobic exercises or yoga) and mindfulness to impact similar pathways of stress regulation that involve cognitive control and stress regulation, thereby supporting the proposed synergistic potential of PE augmented mindfulness. Research focused on the psychophysiological impact of PE, showed its practice to promote short-term neurocognitive changes that can promote both cognitive control and the attainment of mindful awareness (MA). In order to chart dose responses required for protocol development, further research will be presented. Together these findings are discussed in light of future research on this multidisciplinary topic, protocol development, mindful walking, and further application in healthcare and beyond.
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Affiliation(s)
- David Sars
- Mettaminds.org, Mindfulness Based Projects, Amsterdam, Netherlands
- Centre for Integral Rehabilitation (CIR), Amsterdam, Netherlands
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Symptoms of Burnout Syndrome among Physicians during the Outbreak of COVID-19 Pandemic—A Systematic Literature Review. Healthcare (Basel) 2022; 10:healthcare10060979. [PMID: 35742031 PMCID: PMC9223230 DOI: 10.3390/healthcare10060979] [Citation(s) in RCA: 25] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Revised: 05/20/2022] [Accepted: 05/21/2022] [Indexed: 02/04/2023] Open
Abstract
Background: Studies in the recent decades show that the medical profession has a high risk to develop burnout due to constant exposure to mental and physical suffering or death. The pandemic period induced additional stress for healthcare professionals due to the likelihood of a high rate of infection, long working shifts, using protective equipment, staying away from family, implementing new medical procedures. The present study is focusing on assessing the prevalence of burnout among physicians working in the healthcare system during the COVID-19 pandemic, and discovering the main factors associated with burnout syndrome among the population of physicians. Material and methods: A systematic review was conducted by searching PubMed, Wiley, and Google Scholar in November 2021. A total of 35 studies were eligible for the evaluation. Results: The samples ranged from 39 to 3071 physicians, and the overall burnout ranged from 14.7% to 90.4%. Sociodemographic characteristics associated with a high prevalence of burnout were the female gender, less experienced, not having children, and single marital status, associated with high levels of anxiety, depression, and stress in the female gender. The highest level of burnout among all the studies was 90.4% on a sample of physicians from the Republic of Korea, 80.2% among psychiatrists in Saudi Arabia, followed by a study in Ireland with a 77% level of burnout among senior and specialist physicians, and 74.7% prevalence of burnout for emergency physicians in USA. Conclusions: During the pandemic, the factors that contribute to burnout are the lack of personal protective equipment and the violence of issues related to organizational health; the high prevalence of burnout symptoms is associated with anxiety, depression, and stress.
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Figueiredo-Ferraz H, Gil-Monte PR, Grau-Alberola E, Ribeiro do Couto B. The Mediator Role of Feelings of Guilt in the Process of Burnout and Psychosomatic Disorders: A Cross-Cultural Study. Front Psychol 2022; 12:751211. [PMID: 35027899 PMCID: PMC8748256 DOI: 10.3389/fpsyg.2021.751211] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2021] [Accepted: 11/12/2021] [Indexed: 02/05/2023] Open
Abstract
Burnout was recently declared by WHO as an “occupational phenomenon” in the International Classification of Diseases 11th revision (ICD-11), recognizing burnout as a serious health issue. Earlier studies have shown that feelings of guilt appear to be involved in the burnout process. However, the exact nature of the relationships among burnout, guilt and psychosomatic disorders remains unclear. The purpose of this study was to investigate the mediator role of feelings of guilt in the relationship between burnout and psychosomatic disorders, and perform a cross-cultural validation of the multi-dimensional model by Gil-Monte in two samples of teachers (Portuguese vs. Spanish). The study sample was composed of 1,266 teachers, 1,062 from Spain, and 204 from Portugal. Burnout was measured by the Spanish Burnout Inventory. Hypotheses were tested together in a path model. The results obtained provide empirical evidence for the mediator role of guilt in the relationship between the Burnout syndrome and psychosomatic disorders in the sample of teachers from Spain and Portugal, and they contribute to the empirical validation of the model by Gil-Monte. The results indicate that guilt should be incorporated as a symptom of burnout in order to identify individuals affected by burnout and profiles or types of burnout to differentiate it from other pathologies like depression.
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Affiliation(s)
- Hugo Figueiredo-Ferraz
- Facultad de Ciencias Sociales y Jurídicas, Universidad Internacional de Valencia, Valencia, Spain
| | - Pedro R Gil-Monte
- Department of Social Psychology, Unidad de Investigación Psicosocial de la Conducta Organizacional (UNIPSICO), University of Valencia, Valencia, Spain
| | - Ester Grau-Alberola
- Facultad de Educación, Universidad International de La Rioja (UNIR), Logroño, Spain
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Koutsimani P, Montgomery A. Cognitive functioning in non-clinical burnout: Using cognitive tasks to disentangle the relationship in a three-wave longitudinal study. Front Psychiatry 2022; 13:978566. [PMID: 36061283 PMCID: PMC9428402 DOI: 10.3389/fpsyt.2022.978566] [Citation(s) in RCA: 4] [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: 06/26/2022] [Accepted: 08/01/2022] [Indexed: 11/13/2022] Open
Abstract
Burnout is often characterized by cognitive deficits and it has been associated with depression and anxiety. However, it is not clear whether cognitive impairment is a burnout consequence or employees with poor cognitive skills are more prone in developing burnout. Moreover, the exact nature of the association between burnout and depression, and burnout and anxiety is still unknown. Depression and anxiety are also related to cognitive impairments but their prospective associations are not fully understood. The aim of the present three-wave longitudinal study was to investigate the causality between cognitive functioning, burnout, depression, and anxiety among non-clinical burnout employees. The cause-effect associations of burnout with depression and anxiety were also explored. Perceived family support as a protective factor against cognitive decline, burnout, depression and anxiety was examined as well. A wide range of cognitive tasks tapping different cognitive domains were administered to employees of the general working population. Burnout, depression, anxiety, and perceived family support were assessed with self-reported questionnaires. Present results suggest that visuospatial functioning deficits are a burnout consequence and they indicate the role of automatic processing skills and executive functions in burnout onset. Additionally, current findings support that burnout is differentiated from depression and anxiety but it is reciprocally associated with the two psychological phenomena. Lastly, current results support the inclusion of perceived family support as an intervention to help individuals who suffer from mental health and cognitive difficulties.
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Affiliation(s)
- Panagiota Koutsimani
- Department of Educational and Social Policy, School of Social Sciences, Humanities and Arts, University of Macedonia, Thessaloniki, Greece
| | - Anthony Montgomery
- Department of Psychology, Northumbria University Newcastle, Newcastle upon Tyne, United Kingdom
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Robba HCS, Costa AA, Kozu KT, Silva CA, Farhat SCL, Ferreira JCDOA. Mental health impacts in pediatric nurses: a cross-sectional study in tertiary pediatric hospital during the COVID-19 pandemic. Rev Lat Am Enfermagem 2022. [PMCID: PMC9109469 DOI: 10.1590/1518-8345.5750.3530] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Objective: to assess mental health issues in pediatric nurses during coronavirus pandemic in 2019. Method: cross-sectional study was conducted with pediatric nurses at the Instituto da Criança e do Adolescente based on online self-rated survey about clinical practice and mental health impact during COVID-19 pandemic. Validated self-reported scales for anxiety, depression and burnout were used for assessing these professionals. Results: 107/298 (36%) nurses answered, 90% were female, median age was 41(23-64) years, 68% worked with adolescents, 66% in frontline. Burnout, anxiety and moderate/severe depression occurred in 65%, 72% and 74%, respectively. Lack of standardized treatment protocol for nurses (27%vs.10%, p=0.049), moderate/severe depression (74% vs. 16%, p=0.002) and burnout (82% vs. 58%, p=0.01) were significantly higher in pediatric nurses with anxiety compared to those without. Pediatric nurses that worked with adolescents compared to those that did not showed higher frequency of burnout in the former group (77% vs. 32%, p=0.0001). Multivariable analysis revealed that adequate quarantine adherence increased the presence of anxiety in 4.6 times [OR4.6(CI 1.1-20.2), p=0.04]. Conclusion: most pediatric nurses who had worked in the frontline of COVID-19 were under precarious conditions, working with reduced team, and with an expressive changes in their monthly income. Current anxiety was a relevant issue, burnout was also an important mental condition for these professionals, reinforcing culture of good teamwork, collaboration practices and psychological/psychiatric approach.
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Robba HCS, Costa AA, Kozu KT, Silva CA, Farhat SCL, Ferreira JCDOA. Impacto en la salud mental de enfermeros pediátricos: un estudio transversal en un hospital pediátrico de tercer nivel durante la pandemia de COVID-19. Rev Lat Am Enfermagem 2022. [DOI: 10.1590/1518-8345.5750.3582] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Resumen Objetivo: evaluar los problemas de salud mental en enfermeros pediátricos durante la pandemia del coronavirus 2019. Método: estudio transversal realizado con enfermeros pediátricos del Instituto da Criança e do Adolescente mediante una encuesta de autoevaluación en línea sobre la práctica clínica y el impacto en la salud mental durante la pandemia de COVID-19. Se evaluaron escalas de autoevaluación validadas para ansiedad, depresión y burnout. Resultados: respondieron 107/298 (36%) de los enfermeros, de los cuales 90% eran del sexo femenino, la mediana de edad actual fue de 41 (23-64) años, 68% trabajaban con adolescentes, 66% trabajaban en primera línea. Burnout, ansiedad y depresión moderada/grave ocurrieron en 65%, 72% y 74% de los enfermeros, respectivamente. Falta de protocolo de tratamiento estandarizado en las enfermerías (27% vs. 10%, p=0,049), depresión moderada/grave (74% vs. 16%, p=0,002) y burnout (82% vs. 58%, p=0,01) fueron significativamente mayores en enfermeros pediátricos con ansiedad en comparación con enfermeros sin esta condición. Los enfermeros pediátricos que trabajaban con adolescentes presentaron mayor frecuencia de burnout en comparación con los que no trabajaban con adolescentes (77% vs. 32%, p=0,0001). El análisis multivariado reveló que el adecuado cumplimiento de la cuarentena aumentó 4,6 veces la presencia de ansiedad [OR 4.6(IC 1,1-20,2), p=0,04]. Conclusión: La mayoría de los enfermeros pediátricos trabajaban en la primera línea de la COVID-19, en condiciones precarias, trabajando con un equipo reducido y enfrentando importantes pérdidas de ingresos. La ansiedad actual fue un tema relevante y el burnout también fue una condición mental importante para estos profesionales, reforzando la cultura del buen trabajo en equipo, las prácticas colaborativas y la atención psicológica/psiquiátrica.
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Robba HCS, Costa AA, Kozu KT, Silva CA, Farhat SCL, Ferreira JCDOA. Impacto na saúde mental de enfermeiros pediátricos: um estudo transversal em hospital pediátrico terciário durante a pandemia de COVID-19. Rev Lat Am Enfermagem 2022. [DOI: 10.1590/1518-8345.5750.3583] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Resumo Objetivo: avaliar problemas de saúde mental em enfermeiros pediátricos durante a pandemia causada pelo coronavírus 2019. Método: estudo transversal realizado com enfermeiros pediátricos do Instituto da Criança e do Adolescente, por meio de uma pesquisa online de autoavaliação sobre prática clínica e impacto na saúde mental, durante a pandemia de COVID-19. Foram avaliadas escalas de autoavaliação validadas para ansiedade, depressão e burnout. Resultados: 107/298(36%) enfermeiros responderam, dos quais 90% eram do sexo feminino, a mediana de idade atual era 41(23-64) anos, 68% trabalhavam com adolescentes, 66% trabalhavam na linha de frente. Burnout, ansiedade e depressão moderada/grave ocorreram em 65%, 72% e 74% dos enfermeiros, respectivamente. Falta de protocolo de tratamento padronizado nas enfermarias (27% vs. 10%, p=0,049), depressão moderada/grave (74% vs. 16%, p=0,002) e burnout (82% vs. 58%, p=0,01) foram significativamente maiores em enfermeiros pediátricos com ansiedade, em comparação com enfermeiros sem essa condição. Os enfermeiros pediátricos que trabalhavam com adolescentes apresentaram maior frequência de burnout, quando comparados aos que não trabalhavam com esse grupo (77% vs. 32%, p=0,0001). A análise multivariada revelou que o cumprimento adequado da quarentena aumentou a presença de ansiedade em 4,6 vezes [OR 4.6(IC 1,1-20,2), p=0,04]. Conclusão: a maioria dos enfermeiros pediátricos atuava na linha de frente da COVID-19, em condições precárias, trabalhando com equipe reduzida e enfrentando perdas expressivas de renda. A ansiedade atual foi um tema relevante e o burnout também foi uma condição mental importante para esses profissionais, reforçando a cultura do bom trabalho em equipe, das práticas de colaboração e do cuidado psicológico/psiquiátrico.
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Kim HD, Park SG, Kim WH, Min KB, Min JY, Hwang SH. Development of Korean Version Burnout Syndrome Scale (KBOSS) Using WHO's Definition of Burnout Syndrome. Saf Health Work 2021; 12:522-529. [PMID: 34900372 PMCID: PMC8640625 DOI: 10.1016/j.shaw.2021.08.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Revised: 07/22/2021] [Accepted: 08/13/2021] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND Burnout syndrome (BOS) is defined by the World Health Organization (WHO) as a syndrome conceptualized as resulting from chronic workplace stress that has not been successfully managed. This study aims to create the Korean version burnout syndrome scale (KBOSS) that conforms to WHO's definition of BOS and present the cut-off points for screening. METHODS We developed the KBOSS based on WHO's definition of BOS. An online survey was conducted through a specialized online research company. We recruited 444 workers for this research. The validity of the KBOSS was assessed using factor analysis and Pearson's correlation. The KBOSS reliability was assessed using Cronbach's alpha coefficient. The cut-off points for each of the three dimensions were derived using the upper quartile score. RESULTS The validity and reliability of the KBOSS were good. Regarding reliability, the scale's overall Cronbach's alpha was 0.813. Cronbach's alpha of each three-dimension was as follows: exhaustion, 0.916; cynicism, 0.865; and professional inefficacy, 0.819. The cut-off points of BOS three dimensions are exhaustion ≧ 21; cynicism ≧ 18; and inefficacy ≧ 15. CONCLUSION The developed questionnaire (KBOSS) can be a useful tool for screening of BOS.
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Key Words
- BCSQ, Burnout Clinical Subtypes Questionnaire
- BOS, burnout syndrome
- Burnout syndrome
- Burnout, Professional
- Burnout, Professional / diagnosis
- Exhaustion
- FSS, Fatigue Severity Scale
- GAD, Generalized Anxiety Disorder
- KBOSS, Korean version burnout syndrome scale
- MBI, Maslach Burnout Inventory
- Mental disorder
- Mental health
- PHQ, Patient Health Questionnaires
- WHO, World Health Organization
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Affiliation(s)
- Hyung Doo Kim
- Department of Occupational and Environmental Medicine, Inha University Hospital, Incheon, Republic of Korea
- Department of Environmental Sciences, Seoul National University Graduate School of Public Health, Seoul, Republic of Korea
| | - Shin-Goo Park
- Department of Occupational and Environmental Medicine, Inha University Hospital, Incheon, Republic of Korea
| | - Won-Hyoung Kim
- Department of Psychiatry, Inha University Hospital, Inha University School of Medicine, Incheon, Republic of Korea
| | - Kyoung-Bok Min
- Department of Preventive Medicine, College of Medicine, Seoul National University, Seoul, Republic of Korea
| | - Jin-Young Min
- Institute of Health and Environment, Seoul National University, Seoul, Republic of Korea
| | - Sang-Hee Hwang
- Department of Dentistry, Keimyung University School of Medicine, Dalseo-Gu, Daegu, Republic of Korea
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van Dam A. A clinical perspective on burnout: diagnosis, classification, and treatment of clinical burnout. EUROPEAN JOURNAL OF WORK AND ORGANIZATIONAL PSYCHOLOGY 2021. [DOI: 10.1080/1359432x.2021.1948400] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Arno van Dam
- Tranzo Scientific Center for Care and Welfare, Tilburg School of Social and Behavioral Sciences, Tilburg University, Tilburg, The Netherlands
- Department Research and Innovation, GGZ WNB Mental Health Institute, Research and Innovation, Halsteren, The Netherlands
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Smoktunowicz E, Lesnierowska M, Carlbring P, Andersson G, Cieslak R. Resource-Based Internet Intervention (Med-Stress) to Improve Well-Being Among Medical Professionals: Randomized Controlled Trial. J Med Internet Res 2021; 23:e21445. [PMID: 33427674 PMCID: PMC7834939 DOI: 10.2196/21445] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2020] [Accepted: 10/28/2020] [Indexed: 12/02/2022] Open
Abstract
Background Medical professionals are exposed to multiple and often excessive demands in their work environment. Low-intensity internet interventions allow them to benefit from psychological support even when institutional help is not available. Focusing on enhancing psychological resources—self-efficacy and perceived social support—makes an intervention relevant for various occupations within the medical profession. Previously, these resources were found to operate both individually or sequentially with self-efficacy either preceding social support (cultivation process) or following it (enabling process). Objective The objective of this randomized controlled trial is to compare the efficacy of 4 variants of Med-Stress, a self-guided internet intervention that aims to improve the multifaceted well-being of medical professionals. Methods This study was conducted before the COVID-19 pandemic. Participants (N=1240) were recruited mainly via media campaigns and social media targeted ads. They were assigned to 1 of the following 4 groups: experimental condition reflecting the cultivation process, experimental condition reflecting the enabling process, active comparator enhancing only self-efficacy, and active comparator enhancing only perceived social support. Outcomes included 5 facets of well-being: job stress, job burnout, work engagement, depression, and job-related traumatic stress. Measurements were taken on the web at baseline (time 1), immediately after intervention (time 2), and at a 6-month follow-up (time 3). To analyze the data, linear mixed effects models were used on the intention-to-treat sample. The trial was partially blinded as the information about the duration of the trial, which was different for experimental and control conditions, was public. Results At time 2, job stress was lower in the condition reflecting the cultivation process than in the one enhancing social support only (d=−0.21), and at time 3, participants in that experimental condition reported the lowest job stress when compared with all 3 remaining study groups (ds between −0.24 and −0.41). For job-related traumatic stress, we found a significant difference between study groups only at time 3: stress was lower in the experimental condition in which self-efficacy was enhanced first than in the active comparator enhancing solely social support (d=−0.24). The same result was found for work engagement (d=−0.20), which means that it was lower in exactly the same condition that was found beneficial for stress relief. There were no differences between study conditions for burnout and depression neither at time 2 nor at time 3. There was a high dropout in the study (1023/1240, 82.50% at posttest), reflecting the pragmatic nature of this trial. Conclusions The Med-Stress internet intervention improves some components of well-being—most notably job stress—when activities are completed in a specific sequence. The decrease in work engagement could support the notion of dark side of this phenomenon, but further research is needed. Trial Registration ClinicalTrials.gov NCT03475290; https://clinicaltrials.gov/ct2/show/NCT03475290 International Registered Report Identifier (IRRID) RR2-10.1186/s13063-019-3401-9
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Affiliation(s)
- Ewelina Smoktunowicz
- Department of Psychology, SWPS University of Social Sciences and Humanities, Warsaw, Poland.,Department of Psychology, Stockholm University, Stockholm, Sweden
| | - Magdalena Lesnierowska
- Department of Psychology, SWPS University of Social Sciences and Humanities, Warsaw, Poland
| | - Per Carlbring
- Department of Psychology, Stockholm University, Stockholm, Sweden
| | - Gerhard Andersson
- Department of Behavioural Sciences and Learning, Linköping University, Linköping, Sweden.,Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Roman Cieslak
- Department of Psychology, SWPS University of Social Sciences and Humanities, Warsaw, Poland.,Trauma, Health, and Hazards Center, University of Colorado Colorado Springs, Colorado Springs, CO, United States
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Arenas G, Brisson G. The Sibs Program: A Structured Peer-Mentorship Program to Reduce Burnout for First-Year Medical Students. MEDEDPUBLISH 2020; 9:287. [PMID: 38058868 PMCID: PMC10697449 DOI: 10.15694/mep.2020.000287.1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/08/2023] Open
Abstract
This article was migrated. The article was marked as recommended. First-year medical students are at risk for burnout despite resources available to help them manage stress. In 2015, a structured peer-mentorship program was created at our institution for incoming medical students (M1s) by second-year medical students (M2s) with a goal of reducing risk factors for burnout; a secondary goal was to improve the mentoring skills of M2s. Over the course of the year, we surveyed M1s about their anxiety, prioritization skills, and work-life balance; M2s from the previous year's unstructured peer-mentorship program served as a control group. 164 M1s and 164 M2s participated in this program. Among M1s, a structured peer-mentorship program significantly reduced anxiety levels (p=<0.01), improved prioritization skills (p=<0.01), and facilitated greater awareness of the importance of striving to maintain work-life balance (p=<0.01). M2s felt neutral-to-agreeable in their ability to provide guidance, refer students for help, and remain invested in their mentees. A structured peer-mentorship program, therefore, may reduce anxiety, improve prioritization skills, and emphasize the importance of work-life balance among M1s, elements that have been associated with reduced rates of burnout. Furthermore, this program can augment the professional development of M2s by motivating them to maintain longitudinal mentoring relationships with underclassmen.
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Misiolek-Marín A, Soto-Rubio A, Misiolek H, Gil-Monte PR. Influence of Burnout and Feelings of Guilt on Depression and Health in Anesthesiologists. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E9267. [PMID: 33322399 PMCID: PMC7764134 DOI: 10.3390/ijerph17249267] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/29/2020] [Revised: 12/05/2020] [Accepted: 12/07/2020] [Indexed: 02/05/2023]
Abstract
BACKGROUND AND OBJECTIVE The WHO has included burnout as an occupational phenomenon in the ICD-11. According to the WHO, burnout is a syndrome conceptualized as resulting from chronic workplace stress that has not been successfully managed. The study aimed to evaluate the influence of feelings of guilt and burnout on health in Polish anesthesiologists. Alcohol and tobacco intake, psychosomatic disorders, and depression were assessed. METHODS The study had a non-randomized cross-sectional character. The sample consisted of 372 Polish anesthesiologists. Burnout was measured by the Spanish burnout inventory. RESULTS Post hoc analysis for burnout consequences: depression (F(5,366) = 17.51, p < 0.001, ηp2 = 0.193), psychosomatic disorders (F(5,366) = 13.11, p < 0.001, ηp2 = 0.152), and tobacco intake (F(5,366) = 6.23, p < 0.001, ηp2 = 0.078), showed significant differences between burnout with and without the highest levels of feelings of guilt. All the instruments applied were reliable. CONCLUSIONS Depression, psychosomatic disorders, and alcohol and tobacco intake are suspected to be consequences of the highest guilt levels related to burnout, i.e., Profile 2 according to the burnout model of Gil-Monte. Participation in prevention programs is recommended for these cases.
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Affiliation(s)
| | - Ana Soto-Rubio
- Department of Personality, Assessment and Psychological Treatments, Faculty of Psychology, University of Valencia, Av. Blasco Ibáñez, 21, 46010 Valencia, Spain
| | - Hanna Misiolek
- Department of Anesthesiology and Intensive Therapy, Medical University of Silesia in Katowice, Poniatowskiego 15, 40-055 Katowice, Poland;
| | - Pedro R. Gil-Monte
- Department of Social Psychology, Faculty of Psychology, Unidad de Investigación Psicosocial de la Conducta Organizacional (UNIPSICO), University of Valencia, Av. Blasco Ibáñez, 21, 46010 Valencia, Spain;
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Vévodová Š, Vévoda J, Grygová B. Mobbing, subjective perception, demographic factors, and prevalence of burnout syndrome in nurses. Cent Eur J Public Health 2020; 28 Suppl:S57-S64. [PMID: 33069183 DOI: 10.21101/cejph.a6211] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2020] [Accepted: 08/23/2020] [Indexed: 11/15/2022]
Abstract
OBJECTIVES The aim of the study was to assess the prevalence of burnout syndrome and mobbing, to determine their mutual relationship, and to identify predictors related to the probability of occurrence of burnout syndrome in general nurses working in hospitals. METHODS The work is designed as a cross-sectional study. The research took place in 2018 and the sample included 250 general nurses. Statistical evaluation was performed by means of descriptive statistics, Spearman's correlation coefficient, and logistic regression. Three standardized questionnaires were used - Maslach Burnout Inventory, Negative Questionnaire Act and SUPSO. RESULTS The research revealed burnout syndrome in the area of emotional exhaustion in 28.8% of nurses, of depersonalization in 15.2%, and in the area of personal accomplishment in 38.4%. 51.2% of nurses never experienced mobbing at workplace, one act of mobbing over the last six months was reported by 17.6% of respondents, two and more acts by 31.2%. Logistic regression revealed that the probability of occurrence of burnout syndrome in the area of emotional exhaustion is influenced by age, sex and by the size of an urban area, it is increased by anxiety and depression. In the area of depersonalization the probability of incidence increases with impulsiveness and dejection. In the area of personal accomplishment the probability of burnout syndrome incidence is increased by the lack of psychological wellbeing and activeness, by restlessness and impulsiveness. Though there were found significant relationships between all component parts of burnout syndrome and mobbing, multivariate logistic regression did not show the impact of any component part of mobbing on the probability of occurrence of burnout syndrome. CONCLUSIONS The research revealed that the probability of burnout syndrome incidence is related to socio-demographic factors as well as to an individual's psychological states and perceptions. Direct impact of mobbing on the probability of burnout syndrome incidence was inconclusive.
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Affiliation(s)
- Šárka Vévodová
- Department of Humanities and Social Sciences, Faculty of Health Sciences, Palacky University in Olomouc, Olomouc, Czech Republic
| | - Jiří Vévoda
- Department of Humanities and Social Sciences, Faculty of Health Sciences, Palacky University in Olomouc, Olomouc, Czech Republic
| | - Bronislava Grygová
- Department of Humanities and Social Sciences, Faculty of Health Sciences, Palacky University in Olomouc, Olomouc, Czech Republic
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Development and preliminary validation of the Maternal Burnout Scale (MBS) in a French sample of mothers: bifactorial structure, reliability, and validity. Arch Womens Ment Health 2020; 23:573-583. [PMID: 31773348 DOI: 10.1007/s00737-019-00993-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2018] [Accepted: 07/22/2019] [Indexed: 10/25/2022]
Abstract
The study and evaluation of burnout in the context of parenthood have been of growing interest over the last years. The aim of this study is to develop and validate the Maternal Burnout Scale (MBS) to contribute knowledge of the assessment of parental burnout. Items were developed based on elements from an extensive literature review that defined the significant dimensions interesting to the parental context. These items were also examined by expert clinicians. The revised version was submitted for an exploratory testing on 673 French mothers (mean age 31.69 ± 5.52 years) having at least one child living at home (0-25 years); then, it was submitted for a confirmatory analysis of 1277 (mean age 32.67 ± 5.49 years) mothers having the same parental profile (child aged 0.1-24 years). The exploratory analysis suggests a three-factor structure that accounted for 51% of the variance: negative emotional-behavioral manifestations (25%), physical and emotional exhaustion (15%), and a sense of parental achievement (13%). The confirmatory analysis retained a bifactorial structure recognizing maternal burnout as a common factor as well as the three other factors. According to the established threshold scores, 6.6% (n = 84) of the mothers could experience clinical maternal burnout. Indeed, Maternal Burnout Scale (MBS) has shown good psychometric properties with a high internal consistency both for the general score and for subscales. Furthermore, the validity of the scale was also confirmed. The MBS appears to be an applicable and reliable tool to determine the presence and severity of burnout symptoms among mothers. As a conclusion, the prevalence of maternal burnout indicates the importance of studying this syndrome in order to establish measures of prevention and actions to be taken.
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Hardy P, Costemale-Lacoste JF, Trichard C, Butlen-Ducuing F, Devouge I, Cerboneschi V, Jacob E, Buferne R, Benyamina A, Cantero A, Gravier V, Ghanem T, Guérin A, Meidinger A, Baleyte JM, Pelissolo A, Corruble E. Comparison of burnout, anxiety and depressive syndromes in hospital psychiatrists and other physicians: Results from the ESTEM study. Psychiatry Res 2020; 284:112662. [PMID: 31703985 DOI: 10.1016/j.psychres.2019.112662] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2019] [Revised: 10/25/2019] [Accepted: 10/26/2019] [Indexed: 11/26/2022]
Abstract
AIMS To compare prevalence and risk factors for burnout, anxiety and depression among hospital psychiatrists and non-psychiatrists. METHOD Regional online survey of psychiatric and non-psychiatric hospital physicians was performed including: a job-stress scale, the Hospital Anxiety and Depression Scale (HADS), the Copenhagen Burnout Inventory (CBI), a stressful work relationships list and a six items scale about work-related psychosocial risk factors (PRFs). The client-related burnout scale of the CBI has been changed to an interpersonal burnout scale. Cases were defined by a score of 8+ for the HADS-A/HADS-D and 50+ for the three CBI subscales. RESULTS 285 psychiatrists and 326 non-psychiatrists participated. The prevalence of depression, personal burnout and work-related burnout did not differ between physicians. Anxiety was lower in psychiatrists and interpersonal burnout was higher in senior psychiatrists. Multivariate analysis showed two main PRFs, common to both groups of physicians: "work intensity and time" was associated with four of the five syndromes and "emotional demands" with the three burnout syndromes. Interpersonal burnout was associated with stressful relationships with leaders, but not with patients. CONCLUSION Reducing the workload, improving the management of emotions and increasing managerial skills are important approaches for prevention.
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Affiliation(s)
- Patrick Hardy
- CESP/UMR-S1178, Equipe "Dépression et Antidépresseurs", Univ Paris-Sud, Faculté de Médecine, INSERM, 94270 Le Kremlin-Bicêtre, France; Service Hospitalo-Universitaire de Psychiatrie de Bicêtre, Hôpital Bicêtre, Hôpitaux Universitaires Paris Sud, Assistance Publique-Hôpitaux de Paris, 94275 Le Kremlin-Bicêtre, France; Dispositif Territorial de Recherche et de Formation (DTRF) Paris Sud, 94275 Le Kremlin-Bicêtre, France.
| | - Jean-François Costemale-Lacoste
- CESP/UMR-S1178, Equipe "Dépression et Antidépresseurs", Univ Paris-Sud, Faculté de Médecine, INSERM, 94270 Le Kremlin-Bicêtre, France; Dispositif Territorial de Recherche et de Formation (DTRF) Paris Sud, 94275 Le Kremlin-Bicêtre, France; Service Hospitalo-Universitaire de Psychiatrie de l'adulte et du sujet âgé, Hôpital Corentin-Celton, Hôpitaux Universitaires Paris Ouest, Assistance Publique-Hôpitaux de Paris, 92130 Issy-les-Moulineaux, France
| | - Christian Trichard
- Dispositif Territorial de Recherche et de Formation (DTRF) Paris Sud, 94275 Le Kremlin-Bicêtre, France; Secteur 91G05, EPS Barthélémy Durand, 91150 Etampes, France
| | - Florence Butlen-Ducuing
- CESP/UMR-S1178, Equipe "Dépression et Antidépresseurs", Univ Paris-Sud, Faculté de Médecine, INSERM, 94270 Le Kremlin-Bicêtre, France; Service Hospitalo-Universitaire de Psychiatrie de Bicêtre, Hôpital Bicêtre, Hôpitaux Universitaires Paris Sud, Assistance Publique-Hôpitaux de Paris, 94275 Le Kremlin-Bicêtre, France; Dispositif Territorial de Recherche et de Formation (DTRF) Paris Sud, 94275 Le Kremlin-Bicêtre, France
| | - Isabelle Devouge
- Dispositif Territorial de Recherche et de Formation (DTRF) Paris Sud, 94275 Le Kremlin-Bicêtre, France; Pôle 92G13, Groupe Hospitalier Paul Guiraud, 94800 Villejuif, France
| | - Valérie Cerboneschi
- Dispositif Territorial de Recherche et de Formation (DTRF) Paris Sud, 94275 Le Kremlin-Bicêtre, France; Secteur 92G18, Groupe Hospitalier Paul Guiraud, 92140 Clamart, France
| | - Elisabeth Jacob
- Dispositif Territorial de Recherche et de Formation (DTRF) Paris Sud, 94275 Le Kremlin-Bicêtre, France; Unité intersectorielle de réinsertion, EPS Erasme, 92160 Antony, France
| | - Richard Buferne
- Dispositif Territorial de Recherche et de Formation (DTRF) Paris Sud, 94275 Le Kremlin-Bicêtre, France; CH Fondation Vallée, 94250 Gentilly, France
| | - Amine Benyamina
- Dispositif Territorial de Recherche et de Formation (DTRF) Paris Sud, 94275 Le Kremlin-Bicêtre, France; Département de psychiatrie et d'addictologie, Hôpital Paul Brousse, Hôpitaux Universitaires Paris Sud, Assistance Publique-Hôpitaux de Paris, 94800 Villejuif, France
| | - Alain Cantero
- Dispositif Territorial de Recherche et de Formation (DTRF) Grand Paris Est, 94000 Créteil, France; Pôle 94G16, Hôpitaux de Saint-Maurice, 94410 Saint-Maurice, France
| | - Véronique Gravier
- Dispositif Territorial de Recherche et de Formation (DTRF) Grand Paris Est, 94000 Créteil, France; Grand Hôpital de l'Est Francilien, 77100 Meaux, France
| | - Teim Ghanem
- Dispositif Territorial de Recherche et de Formation (DTRF) Paris Sud, 94275 Le Kremlin-Bicêtre, France; Pôle de psychiatrie d'adultes, GH Nord-Essonne, 91440 Bures-sur-Yvette, France
| | - Agnès Guérin
- Dispositif Territorial de Recherche et de Formation (DTRF) Grand Paris Est, 94000 Créteil, France; Pôle 94G05, CH Les Murets, 94510 La Queue-en-Brie, France
| | - Antoine Meidinger
- Dispositif Territorial de Recherche et de Formation (DTRF) Paris Sud, 94275 Le Kremlin-Bicêtre, France; Dispositif Territorial de Recherche et de Formation (DTRF) Grand Paris Est, 94000 Créteil, France; Clinique L'abbaye (CLINEA), 91170 Viry-Châtillon, France
| | - Jean-Marc Baleyte
- Dispositif Territorial de Recherche et de Formation (DTRF) Grand Paris Est, 94000 Créteil, France; Service universitaire de psychiatrie de l'enfant et de l'adolescent, CHI Créteil, 94000 Créteil, France; Faculté de médecine, UPEC, Université Paris-Est, 94000 Créteil, France; INSERM, IMRB, U955, Team 15, 94000 Créteil, France
| | - Antoine Pelissolo
- Dispositif Territorial de Recherche et de Formation (DTRF) Grand Paris Est, 94000 Créteil, France; Faculté de médecine, UPEC, Université Paris-Est, 94000 Créteil, France; Assistance Publique-Hôpitaux de Paris, Pôle de Psychiatrie, Hôpitaux Universitaires Henri-Mondor, 94000 Créteil, France; INSERM, IMRB, U955, Team 15, 94000 Créteil, France
| | - Emmanuelle Corruble
- CESP/UMR-S1178, Equipe "Dépression et Antidépresseurs", Univ Paris-Sud, Faculté de Médecine, INSERM, 94270 Le Kremlin-Bicêtre, France; Service Hospitalo-Universitaire de Psychiatrie de Bicêtre, Hôpital Bicêtre, Hôpitaux Universitaires Paris Sud, Assistance Publique-Hôpitaux de Paris, 94275 Le Kremlin-Bicêtre, France; Dispositif Territorial de Recherche et de Formation (DTRF) Paris Sud, 94275 Le Kremlin-Bicêtre, France
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Feng LR, Wolff BS, Liwang J, Regan JM, Alshawi S, Raheem S, Saligan LN. Cancer‑related fatigue during combined treatment of androgen deprivation therapy and radiotherapy is associated with mitochondrial dysfunction. Int J Mol Med 2019; 45:485-496. [PMID: 31894256 PMCID: PMC6984780 DOI: 10.3892/ijmm.2019.4435] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2019] [Accepted: 12/06/2019] [Indexed: 01/02/2023] Open
Abstract
Combined androgen deprivation therapy (ADT) and radiation therapy (RT) is the standard of care treatment for non-metastatic prostate cancer (NMPC). Despite the efficacy, treatment-related symptoms including fatigue greatly reduce the quality of life of cancer patients. The goal of the study is to examine the influence of combined ADT/RT on fatigue and understand its underlying mechanisms. A total of 64 participants with NMPC were enrolled. Fatigue was assessed using the Functional Assessment of Cancer Therapy-Fatigue. Mitochondrial function parameters were measured as oxygen consumption from peripheral blood mononuclear cells (PBMCs) extracted from participants' whole blood. An ADT/RT-induced fatigue mouse model was developed, with fatigue measured as a reduction in voluntary wheel-running activity (VWRA) in 54 mice. Mitochondrial function was assessed in the ADT/RT mouse brains using western blot analysis of glucose transporter 4 (GLUT4) and transcription factor A, mitochondrial (TFAM). The results demonstrated that fatigue in the ADT group was exacerbated during RT compared with the non-ADT group. This effect was specific to fatigue, as depressive symptoms were unaffected. PBMCs of fatigued subjects exhibited decreased ATP coupling efficiency compared to non-fatigued subjects, indicative of mitochondrial dysfunction. The ADT/RT mice demonstrated the synergistic effect of ADT and RT in decreasing VWRA. Brain tissues of ADT/RT mice exhibited decreased levels of GLUT4 and TFAM suggesting that impaired neuronal metabolic homeostasis may contribute to fatigue pathogenesis. In conclusion, these findings suggest that fatigue induced by ADT/RT may be attributable to mitochondrial dysfunction both peripherally and in the central nervous system (CNS). The synergistic effect of ADT/RT is behaviorally reproducible in a mouse model and its mechanism may be related to bioenergetics in the CNS.
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Affiliation(s)
- Li Rebekah Feng
- Division of Intramural Research, National Institute of Nursing Research, National Institutes of Health, Bethesda, MD 20892, USA
| | - Brian S Wolff
- Division of Intramural Research, National Institute of Nursing Research, National Institutes of Health, Bethesda, MD 20892, USA
| | - Josephine Liwang
- Division of Intramural Research, National Institute of Nursing Research, National Institutes of Health, Bethesda, MD 20892, USA
| | - Jeniece M Regan
- Division of Intramural Research, National Institute of Nursing Research, National Institutes of Health, Bethesda, MD 20892, USA
| | - Sarah Alshawi
- Division of Intramural Research, National Institute of Nursing Research, National Institutes of Health, Bethesda, MD 20892, USA
| | - Sumiyya Raheem
- Division of Intramural Research, National Institute of Nursing Research, National Institutes of Health, Bethesda, MD 20892, USA
| | - Leorey N Saligan
- Division of Intramural Research, National Institute of Nursing Research, National Institutes of Health, Bethesda, MD 20892, USA
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Smoktunowicz E, Lesnierowska M, Cieslak R, Carlbring P, Andersson G. Efficacy of an Internet-based intervention for job stress and burnout among medical professionals: study protocol for a randomized controlled trial. Trials 2019; 20:338. [PMID: 31182128 PMCID: PMC6558742 DOI: 10.1186/s13063-019-3401-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2018] [Accepted: 05/06/2019] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Medical professionals are at high risk of job stress and burnout. Research shows that work-related stress can be reduced through enhancing psychological resources, in particular, self-efficacy and perceived social support. These psychological resources can operate either individually or sequentially: in line with the cultivation hypothesis, self-efficacy precedes and cultivates perceived social support, whereas according to the enabling hypothesis it is perceived social support that comes first and enables self-efficacy. Based on this theoretical framework we developed an internet-based intervention, Med-Stress, dedicated to healthcare providers and aimed at reducing job stress and burnout. Med-Stress contains two modules that enhance self-efficacy and perceived social support, which are tested in four variants reflected in four study conditions. We expect that sequential enhancement of resources: self-efficacy and social support or social support and self-efficacy will yield larger posttest results than individual enhancement. METHODS In this four-arm randomized controlled trial we will test four variants of the Med-Stress intervention. The trial is open for professionally active medical providers aged at least 18 years (N = 1200) with access to an Internet-connected device. We will compare the effects of two experimental conditions reflecting cultivation and enabling effects of self-efficacy and perceived social support (sequential enhancement of resources), and two active controls strengthening self-efficacy or perceived social support. Job stress and job burnout will be the primary outcomes, whereas depression, job-related traumatic stress, and work engagement will be secondary ones. Additionally, we will measure perceived social support, self-efficacy to manage job stress and burnout, and the ability to obtain social support, exposure to traumatic events, and users' expectancy and credibility of the intervention. All assessments will be applied before the intervention, at posttest (at 3 or 6 weeks depending on the study condition), and at 6-month and 12-month follow up. In the case of experimental groups, additional measurements will be taken after enhancing each resource. DISCUSSION Resource-based interventions are relatively context-free and could potentially benefit medical professionals across the field. If Med-Stress is successful, its most effective variant could be implemented in the healthcare system as a standalone, supportive tool for employees. TRIAL REGISTRATION ClinicalTrials.gov, NCT03475290 Registered on 23 March 2018.
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Affiliation(s)
- Ewelina Smoktunowicz
- Department of Psychology, SWPS University of Social Sciences and Humanities, Chodakowska 19/31, 03–815 Warsaw, Poland
| | - Magdalena Lesnierowska
- Department of Psychology, SWPS University of Social Sciences and Humanities, Chodakowska 19/31, 03–815 Warsaw, Poland
| | - Roman Cieslak
- Department of Psychology, SWPS University of Social Sciences and Humanities, Chodakowska 19/31, 03–815 Warsaw, Poland
- Trauma, Health, and Hazards Center, University of Colorado, Colorado Springs, CO USA
| | - Per Carlbring
- Department of Psychology, Stockholm University, Stockholm, Sweden
- Department of Psychology, University of Southern Denmark, Odense, Denmark
| | - Gerhard Andersson
- Department of Behavioural Sciences and Learning, Linköping University, Linköping, Sweden
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
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Canazei M, Bassa D, Jimenez P, Papousek I, Fink A, Weiss E. Effects of an adjunctive, chronotype-based light therapy in hospitalized patients with severe burnout symptoms - a pilot study. Chronobiol Int 2019; 36:993-1004. [PMID: 31068015 DOI: 10.1080/07420528.2019.1604539] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Light therapy is a well-established treatment option for seasonal affective disorders and is effective in reducing sleep problems and daytime fatigue. Symptoms of severe burnout include feelings of exhaustion and impaired sleep and mood. Thus, light therapy seems promising for burnout treatment. So far, light therapy effects in burnout were investigated in outpatient settings only, with inconclusive results. The present study targeted light therapy effects in an inpatient setting. Participants with severe burnout were recruited in two psychosomatic clinics and randomly assigned to a control group with multimodal psychiatric treatment or an add-on light treatment group. Participants in the latter group were additionally exposed to morning bright light (illuminance: 4246 lux, irradiance: 1802.81 µW.cm-2) for 3 weeks, 30 minutes a day, timed to their chronotypes. Light effects on burnout symptoms, depression, well-being, daytime sleepiness, sleep quality, and attentional performance were measured twice (pre-/postintervention design). Adjunctive chronotype-based bright light therapy was well tolerated and improved burnout symptoms and well-being without additional effect on severity of depression. Furthermore, reduced daytime sleepiness, improved nighttime sleep quality, a sleep phase advance of 25 minutes, shortened sleep latency, less sleep disturbances and increased sleep duration were observed in the light treatment group. No group differences were found in attentional performance. Chronotype-based bright light therapy seems to be effective in improving burnout symptoms and sleep problems in patients with severe burnout symptoms. Further studies with larger sample sizes and objective measures of sleep are necessary to confirm these preliminary results before practical recommendations can be made.
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Affiliation(s)
- Markus Canazei
- a Research Department , Bartenbach GmbH , Aldrans , Austria
| | - Daniela Bassa
- b Department of Psychology , Karl-Franzens-Universitat Graz
| | | | - Ilona Papousek
- b Department of Psychology , Karl-Franzens-Universitat Graz
| | - Andreas Fink
- b Department of Psychology , Karl-Franzens-Universitat Graz
| | - Elisabeth Weiss
- c Department of Psychology , University of Graz , Graz , Austria
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Dunne PJ, Lynch J, Prihodova L, O'Leary C, Ghoreyshi A, Basdeo SA, Cox DJ, Breen R, Sheikhi A, Carroll Á, Walsh C, McMahon G, White B. Burnout in the emergency department: Randomized controlled trial of an attention-based training program. JOURNAL OF INTEGRATIVE MEDICINE-JIM 2019; 17:173-180. [PMID: 30956141 DOI: 10.1016/j.joim.2019.03.009] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/23/2018] [Accepted: 03/14/2019] [Indexed: 01/18/2023]
Abstract
BACKGROUND Burnout (encompassing emotional exhaustion, depersonalization and personal accomplishment) in healthcare professionals is a major issue worldwide. Emergency medicine physicians are particularly affected, potentially impacting on quality of care and attrition from the specialty. OBJECTIVE The aim of this study was to apply an attention-based training (ABT) program to reduce burnout among emergency multidisciplinary team (MDT) members from a large urban hospital. DESIGN, SETTING, PARTICIPANTS AND INTERVENTIONS Emergency MDT members were randomized to either a no-treatment control or an intervention group. Intervention group participants engaged in a four session (4 h/session) ABT program over 7 weeks with a practice target of 20 min twice-daily. Practice adherence was measured using a smart phone application together with a wearable Charge 2 device. MAIN OUTCOME MEASURES The primary outcome was a change in burnout, comprising emotional exhaustion, depersonalization and personal achievement. The secondary outcomes were changes in other psychological and biometric parameters. RESULTS The ABT program resulted in a significant reduction (P < 0.05; T1 [one week before intervention] vs T3 [follow-up at two months after intervention]) in burnout, specifically, emotional exhaustion, with an effect size (probability of superiority) of 59%. Similar reductions were observed for stress (P < 0.05) and anxiety (P < 0.05). Furthermore, ABT group participants demonstrated significant improvements in heart rate variability, resting heart rate, sleep as well as an increase in pro-inflammatory cytokine expression. CONCLUSION This study describes a positive impact of ABT on emergency department staff burnout compared to a no-treatment control group. TRIAL REGISTRATION ClinicalTrials.gov identifier NCT02887300.
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Affiliation(s)
- Pádraic J Dunne
- Trinity Translational Medicine Institute, Trinity College, Dublin D08 W9RT, Ireland.
| | - Julie Lynch
- Research Department, Royal College of Physicians of Ireland, Dublin D02 E434, Ireland
| | - Lucia Prihodova
- Research Department, Royal College of Physicians of Ireland, Dublin D02 E434, Ireland
| | - Caoimhe O'Leary
- Research Department, Royal College of Physicians of Ireland, Dublin D02 E434, Ireland
| | - Atiyeh Ghoreyshi
- Department of Innovation, Fitbit Inc., San Francisco, CA 94105, USA
| | - Sharee A Basdeo
- Health Research Institute, Main Building, University of Limerick, Limerick V94 X5K6, Ireland
| | - Donal J Cox
- Health Research Institute, Main Building, University of Limerick, Limerick V94 X5K6, Ireland
| | - Rachel Breen
- Research Department, Royal College of Physicians of Ireland, Dublin D02 E434, Ireland
| | - Ali Sheikhi
- Health Research Institute, Main Building, University of Limerick, Limerick V94 X5K6, Ireland
| | - Áine Carroll
- Health Service Executive, Dr Steevens' Hospital, Dublin D08 W2A8, Ireland
| | - Cathal Walsh
- Health Research Institute, Main Building, University of Limerick, Limerick V94 X5K6, Ireland
| | - Geraldine McMahon
- Department of Emergency Medicine, St. James's Hospital, Dublin D08 W9RT, Ireland
| | - Barry White
- National Centre for Hereditary Coagulation Disorders, St. James's Hospital, Dublin D08 W9RT, Ireland
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Koutsimani P, Montgomery A, Georganta K. The Relationship Between Burnout, Depression, and Anxiety: A Systematic Review and Meta-Analysis. Front Psychol 2019; 10:284. [PMID: 30918490 PMCID: PMC6424886 DOI: 10.3389/fpsyg.2019.00284] [Citation(s) in RCA: 416] [Impact Index Per Article: 83.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2018] [Accepted: 01/29/2019] [Indexed: 12/21/2022] Open
Abstract
Background: Burnout is a psychological syndrome characterized by emotional exhaustion, feelings of cynicism and reduced personal accomplishment. In the past years there has been disagreement on whether burnout and depression are the same or different constructs, as they appear to share some common features (e.g., loss of interest and impaired concentration). However, the results so far are inconclusive and researchers disagree with regard to the degree to which we should expect such overlap. The aim of this systematic review and meta-analysis is to examine the relationship between burnout and depression. Additionally, given that burnout is the result of chronic stress and that working environments can often trigger anxious reactions, we also investigated the relationship between burnout and anxiety. Method: We searched the online databases SCOPUS, Web of Science, MEDLINE (PubMed), and Google Scholar for studies examining the relationship between burnout and depression and burnout and anxiety, which were published between January 2007 and August 2018. Inclusion criteria were used for all studies and included both cross-sectional and longitudinal designs, published and unpublished research articles, full-text articles, articles written in the English language, studies that present the effects sizes of their findings and that used reliable research tools. Results: Our results showed a significant association between burnout and depression (r = 0.520, SE = 0.012, 95% CI = 0.492, 0.547) and burnout and anxiety (r = 0.460, SE = 0.014, 95% CI = 0.421, 0.497). However, moderation analysis for both burnout-depression and burnout-anxiety relationships revealed that the studies in which either the MBI test was used or were rated as having better quality showed lower effect sizes. Conclusions: Our research aims to clarify the relationship between burnout-depression and burnout-anxiety relationships. Our findings revealed no conclusive overlap between burnout and depression and burnout and anxiety, indicating that they are different and robust constructs. Future studies should focus on utilizing more longitudinal designs in order to assess the causal relationships between these variables.
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Affiliation(s)
| | - Anthony Montgomery
- Department of Educational & Social Policy, School of Social Sciences, Humanities and Arts, University of Macedonia, Thessaloniki, Greece
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Sharpley CF, Bitsika V, McMillan ME, Jesulola E, Agnew LL. The association between cortisol:C-reactive protein ratio and depressive fatigue is a function of CRP rather than cortisol. Neuropsychiatr Dis Treat 2019; 15:2467-2475. [PMID: 31695383 PMCID: PMC6717724 DOI: 10.2147/ndt.s213839] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2019] [Accepted: 07/29/2019] [Indexed: 12/13/2022] Open
Abstract
PURPOSE Hormonal and inflammatory factors have been suggested as potentially influencing depressive state and depressive symptoms, but rarely compared for their relative contribution to these states and to specific depressive symptoms. This study examined cortisol:C-reactive protein (CRP) ratio, plus cortisol and CRP separately, as correlates of global depression and fatigue-related depression. PATIENTS AND METHODS One hundred and twenty-six community volunteers from rural Australia provided saliva and serum samples, and also completed a depression inventory. RESULTS There was a significant correlation between cortisol:CRP ratio and depression-related fatigue, and this resolved to the effects of CRP rather than cortisol. Most of the variance in this association came from patients who were "depressed", and there were no significant gender associations. CONCLUSION Inflammation, rather than HPA-axis activity, was associated with depression-related fatigue, supporting a model that places inflammation as a contributor to one of the major symptoms and predictors of depression. Individualization of therapy for depression-related fatigue in chronically stressed or physically ill patients might benefit from future research into cytokine therapy.
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Affiliation(s)
- Christopher F Sharpley
- Brain-Behaviour Research Group, University of New England, Armidale, NSW 2351, Australia
| | - Vicki Bitsika
- Brain-Behaviour Research Group, University of New England, Armidale, NSW 2351, Australia
| | - Mary E McMillan
- Brain-Behaviour Research Group, University of New England, Armidale, NSW 2351, Australia
| | - Emmanuel Jesulola
- Emergency Department, Bathurst Base Hospital, Bathurst, NSW 2795, Australia
| | - Linda L Agnew
- Brain-Behaviour Research Group, University of New England, Armidale, NSW 2351, Australia
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Physician Wellness and Practice Sustainability. Int Anesthesiol Clin 2018; 57:95-113. [PMID: 30520751 DOI: 10.1097/aia.0000000000000212] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Golonka K, Mojsa-Kaja J, Marek T, Gawlowska M. Stimulus, response and feedback processing in burnout - An EEG study. Int J Psychophysiol 2018; 134:86-94. [PMID: 30359633 DOI: 10.1016/j.ijpsycho.2018.10.009] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2018] [Revised: 10/18/2018] [Accepted: 10/19/2018] [Indexed: 10/28/2022]
Abstract
Professional burnout is a syndrome that is characterized by psychophysical or emotional exhaustion, depersonalization and diminished professional efficacy. Research on burnout often indicates deficits in cognitive functioning, such as memory problems or impaired voluntary control over attention. Many studies focus on behavioral and self-reported measures of burnout consequences; however, a limited number have focused on its consequences on a neural level. In our EEG study (N = 88; 42 with burnout), we analyzed the event-related potentials (ERP) associated with stimulus, response and feedback processing using two experimental procedures - the Go/NoGo Task and the Doors Task. Our results show that while there is no difference in performance between burnout and control group, on the neural level there are significant differences in all analyzed aspects of information processing: stimulus, response and feedback processing, indicated by the N200 and P300, Pe, and P200 event-related potentials, respectively.
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Affiliation(s)
- Krystyna Golonka
- Department of Neurobiology and Neuropsychology, Institute of Applied Psychology, Jagiellonian University, Krakow, Poland
| | - Justyna Mojsa-Kaja
- Department of Neurobiology and Neuropsychology, Institute of Applied Psychology, Jagiellonian University, Krakow, Poland
| | - Tadeusz Marek
- Department of Cognitive Neuroscience and Neuroergonomics, Institute of Applied Psychology, Jagiellonian University, Krakow, Poland
| | - Magda Gawlowska
- Department of Cognitive Neuroscience and Neuroergonomics, Institute of Applied Psychology, Jagiellonian University, Krakow, Poland.
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Pfeffer MM, Paletta A, Suchar G. New Perspectives on Burnout: A Controlled Study on Movement Analysis of Burnout Patients. Front Psychol 2018; 9:1150. [PMID: 30038594 PMCID: PMC6046446 DOI: 10.3389/fpsyg.2018.01150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2018] [Accepted: 06/15/2018] [Indexed: 11/17/2022] Open
Abstract
Introduction: Despite extensive research on burnout, there has been to date no systematic movement analysis of burnout patients, although it is well known that psychiatric diseases express themselves through movements, such as psychomotor retardation or agitation. Since the movement expression of burnout patients has not been systematically investigated so far, the aim of this study is to close this knowledge gap in order to obtain a new perspective on burnout. Methods: Hospitalized burnout patients (n = 22; age 47.2 ± 9.1 years) and health controls (n = 20; age 41.5 ± 15.0 years) participated in a standardized movement sequence with verbal instructions. The objective Burnout Inventory Scale and diagnostics by psychiatrists were used for diagnosis. Two certified movement-analysts independently rated each participant via video by using the Effort System of Laban Movement Analysis as an instrument of dance therapy and behavior observation. Cohen's Kappa was used to test the inter-rater reliability of the movement analysts and non-parametric Mann-Whitney U tests were undertaken to assess the differences between the two groups. Results: The rater-agreement Kappa ranges from 0.66 to 0.92 (p < 0.001) with the Confidence Interval (95%) from 0.46 to 1.1. Results of the Mann-Whitney U tests indicate that burnout patients show significantly less frequent movements for the following Effort elements: Bound U(n1 = 22, n2 = 20) = 112.5, p = 0.001; Indirect U(n1 = 22, n2 = 20) = 114.5, p = 0.001; Light U(n1 = 22, n2 = 20) = 115, p = 0.001 and Sustained U(n1 = 22, n2 = 20) = 130, p = 0.01. Discussion: Burnout patients have significant deficits in all four Effort elements of the Laban Movement Analysis (Flow, Space, Time, Weight) and therefore have deficits regarding their body movement. The findings presented here provide an additional perspective on burnout.
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Affiliation(s)
| | - Andrea Paletta
- Institute of Sport Science, University of Graz, Graz, Austria
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29
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van Hooff MLM, Flaxman PE, Söderberg M, Stride CB, Geurts SAE. Basic Psychological Need Satisfaction, Recovery State, and Recovery Timing. HUMAN PERFORMANCE 2018. [DOI: 10.1080/08959285.2018.1466889] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
Affiliation(s)
| | - Paul E. Flaxman
- Psychology Department, City, University of London, London, United Kingdom
| | - M. Söderberg
- Psychology Department, City, University of London, London, United Kingdom
| | - Chris B. Stride
- Management School, University of Sheffield, Sheffield, United Kingdom
| | - Sabine A. E. Geurts
- Behavioural Science Institute, Radboud University, Nijmegen, The Netherlands
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30
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Bauernhofer K, Bassa D, Canazei M, Jiménez P, Paechter M, Papousek I, Fink A, Weiss EM. Subtypes in clinical burnout patients enrolled in an employee rehabilitation program: differences in burnout profiles, depression, and recovery/resources-stress balance. BMC Psychiatry 2018; 18:10. [PMID: 29343237 PMCID: PMC5773035 DOI: 10.1186/s12888-018-1589-y] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2017] [Accepted: 01/02/2018] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND Burnout is generally perceived a unified disorder with homogeneous symptomatology across people (exhaustion, cynicism, and reduced professional efficacy). However, increasing evidence points to intra-individual patterns of burnout symptoms in non-clinical samples such as students, athletes, healthy, and burned-out employees. Different burnout subtypes might therefore exist. Yet, burnout subtypes based on burnout profiles have hardly been explored in clinical patients, and the samples investigated in previous studies were rather heterogeneous including patients with various physical, psychological, and social limitations, symptoms, and disabilities. Therefore, the aim of this study is to explore burnout subtypes based on burnout profiles in clinically diagnosed burnout patients enrolled in an employee rehabilitation program, and to investigate whether the subtypes differ in depression, recovery/resources-stress balance, and sociodemographic characteristics. METHODS One hundred three patients (66 women, 37 men) with a clinical burnout diagnosis, who were enrolled in a 5 week employee rehabilitation program in two specialized psychosomatic clinics in Austria, completed a series of questionnaires including the Maslach Burnout Inventory - General Survey (MBI-GS), the Beck Depression Inventory, and the Recovery-Stress-Questionnaire for Work. Cluster analyses with the three MBI-GS subscales as clustering variables were used to identify the burnout subtypes. Subsequent multivariate/univariate analysis of variance and Pearson chi-square tests were performed to investigate differences in depression, recovery/resources-stress balance, and sociodemographic characteristics. RESULTS Three different burnout subtypes were discovered: the exhausted subtype, the exhausted/cynical subtype, and the burned-out subtype. The burned-out subtype and the exhausted/cynical subtype showed both more severe depression symptoms and a worse recovery/resources-stress balance than the exhausted subtype. Furthermore, the burned-out subtype was more depressed than the exhausted/cynical subtype, but no difference was observed between these two subtypes with regard to perceived stress, recovery, and resources. Sociodemographic characteristics were not associated with the subtypes. CONCLUSIONS The present study indicates that there are different subtypes in clinical burnout patients (exhausted, exhausted/cynical, and burned-out), which might represent patients at different developmental stages in the burnout cycle. Future studies need to replicate the current findings, investigate the stability of the symptom patterns, and examine the efficacy of rehabilitation interventions in different subtypes.
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Affiliation(s)
- Kathrin Bauernhofer
- Department of Psychology, University of Graz, Universitätsplatz 2/DG, 8010, Graz, Austria.
| | - Daniela Bassa
- 0000000121539003grid.5110.5Department of Psychology, University of Graz, Universitätsplatz 2/DG, 8010 Graz, Austria
| | - Markus Canazei
- 0000 0001 2151 8122grid.5771.4Department of Psychology, University of Innsbruck, Bruno-Sander-Haus Innrain 52f, 6020 Innsbruck, Austria
| | - Paulino Jiménez
- 0000000121539003grid.5110.5Department of Psychology, University of Graz, Universitätsplatz 2/DG, 8010 Graz, Austria
| | - Manuela Paechter
- 0000000121539003grid.5110.5Department of Psychology, University of Graz, Universitätsplatz 2/DG, 8010 Graz, Austria
| | - Ilona Papousek
- 0000000121539003grid.5110.5Department of Psychology, University of Graz, Universitätsplatz 2/DG, 8010 Graz, Austria
| | - Andreas Fink
- 0000000121539003grid.5110.5Department of Psychology, University of Graz, Universitätsplatz 2/DG, 8010 Graz, Austria
| | - Elisabeth M. Weiss
- 0000000121539003grid.5110.5Department of Psychology, University of Graz, Universitätsplatz 2/DG, 8010 Graz, Austria
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Golonka K, Mojsa-Kaja J, Popiel K, Marek T, Gawlowska M. Neurophysiological Markers of Emotion Processing in Burnout Syndrome. Front Psychol 2018; 8:2155. [PMID: 29326619 PMCID: PMC5736989 DOI: 10.3389/fpsyg.2017.02155] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2017] [Accepted: 11/27/2017] [Indexed: 01/16/2023] Open
Abstract
The substantial body of research employing subjective measures indicates that burnout syndrome is associated with cognitive and emotional dysfunctions. The growing amount of neurophysiological and neuroimaging research helps in broadening existing knowledge of the neural mechanisms underlying core burnout components (emotional exhaustion and depersonalization/cynicism) that are inextricably associated with emotional processing. In the presented EEG study, a group of 93 participants (55 women; mean age = 35.8) were selected for the burnout group or the demographically matched control group on the basis of the results of the Maslach Burnout Inventory – General Survey (MBI-GS) and the Areas of Worklife Survey (AWS). Subjects then participated in an EEG experiment using two experimental procedures: a facial recognition task and viewing of passive pictures. The study focuses on analyzing event-related potentials (ERPs): N170, VPP, EPN, and LPP, as indicators of emotional information processing. Our results show that burnout subjects, as compared to the control group, demonstrate significantly weaker response to affect-evoking stimuli, indexed by a decline in VPP amplitude to emotional faces and decreased EPN amplitude in processing emotional scenes. The analysis of N170 and LPP showed no significant between-group difference. The correlation analyses revealed that VPP and EPN, which are ERP components related to emotional processing, are associated with two core burnout symptoms: emotional exhaustion and cynicism. To our knowledge, we are one of the first research groups to use ERPs to demonstrate such a relationship between neurophysiological activity and burnout syndrome in the context of emotional processing. Thus, in conclusion we emphasized that the decreased amplitude of VPP and EPN components in the burnout group may be a neurophysiological manifestation of emotional blunting and may be considered as neurophysiological markers of emotional exhaustion and cynicism. Additionally, we did not observe a decrease in LPP, which may be considered as a marker that significantly differentiates burnout from depression.
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Affiliation(s)
- Krystyna Golonka
- Institute of Applied Psychology, Jagiellonian University, Krakow, Poland
| | - Justyna Mojsa-Kaja
- Institute of Applied Psychology, Jagiellonian University, Krakow, Poland
| | - Katarzyna Popiel
- Institute of Applied Psychology, Jagiellonian University, Krakow, Poland
| | - Tadeusz Marek
- Department of Cognitive Neuroscience and Neuroergonomics, Institute of Applied Psychology, Jagiellonian University, Krakow, Poland.,Neurobiology Department, The Malopolska Centre of Biotechnology, Jagiellonian University, Krakow, Poland
| | - Magda Gawlowska
- Institute of Applied Psychology, Jagiellonian University, Krakow, Poland
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Gajewski PD, Boden S, Freude G, Potter GG, Claus M, Bröde P, Watzl C, Getzmann S, Falkenstein M. Executive control, ERP and pro-inflammatory activity in emotionally exhausted middle-aged employees. Comparison between subclinical burnout and mild to moderate depression. Psychoneuroendocrinology 2017; 86:176-186. [PMID: 28972891 DOI: 10.1016/j.psyneuen.2017.09.017] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2017] [Revised: 09/01/2017] [Accepted: 09/14/2017] [Indexed: 01/11/2023]
Abstract
Burnout is a syndrome occurring mainly in individuals with long-term stressful work. The main complaints are emotional exhaustion and reduced performance. Burnout also largely overlaps with depression. Both are characterized by increased incidence of infections due to dysregulation of the immune system, overexpression of pro-inflammatory cytokines and cognitive deficits, particularly related to executive functions. To distinguish between burnout and depression already at the pre-clinical stage, the present double-blinded study compared immunological and cognitive parameters in seventy-six employees from emotionally demanding occupations who were post-hoc subdivided into two groups scoring low (EE-) and high (EE+) in emotional exhaustion and low (DE-) and high (DE+) in depression. Immunological parameters were measured from blood samples. Executive functions were studied by analyzing event-related brain potentials (ERPs) and performance during a task switching paradigm. Psychosocial job parameters were measured with standardized questionnaires. Burnout and mild to moderate depression largely overlapped. However, several subjects showed burnout without depressive symptoms. Higher levels of the pro-inflammatory cytokines IL-6 and IL-12 were correlated with burnout severity and depressive symptoms in male individuals. In the switch task a trend for lower performance in the EE+ vs. EE- group and no difference between DE+ and DE- groups were found. In the ERPs, however, differences were observed which distinguished between subclinical burnout and depression: the terminal contingent negative variation (CNV), indicating preparatory activity and the P3b, related to allocation of cognitive resources were generally reduced in EE+ vs. EE-, whereas no differences were found in the DE+ vs. DE- groups. The frontal P3a was selectively reduced in switch trials in the EE+ vs. EE- group and showed only a trend in DE+ vs. DE-, indicating impairment of executive control in subclinical burnout. Taken together, the results unveil specific immunological changes and declines in brain functions in employees with subclinical burnout that are not apparent in persons with moderate depression. Hence, the combination of immunological, behavioral and ERP methods renders a promising method for distinguishing both syndromes and for improving an early diagnosis of burnout before a clinical stage is reached.
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Affiliation(s)
- Patrick D Gajewski
- Leibniz Research Centre for Working Environment and Human Factors (IfADo) at TU Dortmund, Dortmund, Germany1.
| | - Sylvia Boden
- Leibniz Research Centre for Working Environment and Human Factors (IfADo) at TU Dortmund, Dortmund, Germany1
| | - Gabriele Freude
- Federal Institute for Occupational Safety and Health (BAuA), Berlin, Germany
| | - Guy G Potter
- Department of Psychiatry and Behavioral Sciences, Duke University, Durham, NC, USA
| | - Maren Claus
- Leibniz Research Centre for Working Environment and Human Factors (IfADo) at TU Dortmund, Dortmund, Germany1
| | - Peter Bröde
- Leibniz Research Centre for Working Environment and Human Factors (IfADo) at TU Dortmund, Dortmund, Germany1
| | - Carsten Watzl
- Leibniz Research Centre for Working Environment and Human Factors (IfADo) at TU Dortmund, Dortmund, Germany1
| | - Stephan Getzmann
- Leibniz Research Centre for Working Environment and Human Factors (IfADo) at TU Dortmund, Dortmund, Germany1
| | - Michael Falkenstein
- Leibniz Research Centre for Working Environment and Human Factors (IfADo) at TU Dortmund, Dortmund, Germany1; Institute for Working, Learning and Aging, Bochum, Germany
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Alcantara J, Ohm J, Alcantara J. The quality of life of chiropractors using PROMIS: Results from a practice-based research network. Complement Ther Clin Pract 2017; 29:142-146. [PMID: 29122252 DOI: 10.1016/j.ctcp.2017.09.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2017] [Accepted: 09/12/2017] [Indexed: 11/24/2022]
Affiliation(s)
- Joel Alcantara
- The International Chiropractic Pediatric Association, Media, PA, USA; Life Chiropractic College West, 25001 Industrial Blvd, Hayward, CA, 94545, USA.
| | - Jeanne Ohm
- The International Chiropractic Pediatric Association, Media, PA, USA; Private Practice of Chiropractic Media, 327 N Middletown Rd, Media, PA, 19063, USA.
| | - Junjoe Alcantara
- Private Practice of Chiropractic, 25 San Miguel Avenue, Suite 2615 Medical Plaza Ortigas, Ortigas Business Center, Pasig City, Manila, Philippines.
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Tuithof M, Ten Have M, Beekman A, van Dorsselaer S, Kleinjan M, Schaufeli W, de Graaf R. The interplay between emotional exhaustion, common mental disorders, functioning and health care use in the working population. J Psychosom Res 2017; 100:8-14. [PMID: 28789797 DOI: 10.1016/j.jpsychores.2017.06.018] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2017] [Revised: 06/27/2017] [Accepted: 06/28/2017] [Indexed: 11/30/2022]
Abstract
OBJECTIVES Previous research established that emotional exhaustion - the often assumed core dimension of burnout - diminishes job-related functioning, but knowledge of its association with functioning and health care utilization is largely lacking. Moreover, as exhaustion frequently co-occurs with mood and anxiety disorders (i.e. common mental disorders (CMD)), the question should be addressed whether these associations hold after adjustment for CMD, and whether CMD intensifies the burden of exhaustion. METHODS Cross-sectional data was used from 2902 workers included in the third wave of the Netherlands Mental Health Survey and Incidence Study-2, a nationally representative face-to-face survey. Exhaustion was assessed with the exhaustion scale of the Maslach Burnout Inventory; work loss (including presenteeism and absenteeism) with the WHO Disability Assessment Schedule; and general functioning with the 36-item Short Form. Health care use is defined as ≥1 general or mental health care contact for mental health problems. Confounders included sociodemographics, job characteristics, CMD, and physical health. The Composite International Diagnostic Interview assessed CMD. RESULTS Mild and severe exhaustion occurred in 14.9% and 2.3% of the workers, respectively, and was significantly associated with work loss, impaired emotional, physical and social functioning, and health care use, even after adjustment for confounders. Co-occurrence of CMD strengthened the association between exhaustion and work loss as well as impaired emotional and social functioning. CONCLUSIONS Exhaustion is uniquely associated with work loss, impaired functioning and health care use. Moreover, co-occurring CMD intensified impairments in functioning. This stresses the need for clinical attention to the exhaustion dimension of burnout.
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Affiliation(s)
- Marlous Tuithof
- Netherlands Institute of Mental Health and Addiction, Utrecht, The Netherlands.
| | - Margreet Ten Have
- Netherlands Institute of Mental Health and Addiction, Utrecht, The Netherlands.
| | | | | | - Marloes Kleinjan
- Netherlands Institute of Mental Health and Addiction, Utrecht, The Netherlands.
| | - Wilmar Schaufeli
- Utrecht University, Utrecht, The Netherlands; KU Leuven, Leuven, Belgium.
| | - Ron de Graaf
- Netherlands Institute of Mental Health and Addiction, Utrecht, The Netherlands.
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Balayssac D, Pereira B, Virot J, Collin A, Alapini D, Cuny D, Gagnaire JM, Authier N, Vennat B. Burnout, associated comorbidities and coping strategies in French community pharmacies-BOP study: A nationwide cross-sectional study. PLoS One 2017; 12:e0182956. [PMID: 28800612 PMCID: PMC5553933 DOI: 10.1371/journal.pone.0182956] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2016] [Accepted: 07/26/2017] [Indexed: 11/19/2022] Open
Abstract
Background Work-related stress and burnout syndromes are unfortunately common comorbidities found in health professionals. However, burnout syndrome has only been partly and episodically assessed for community pharmacists whereas these professionals are exposed to patients’ demands and difficulties every day. Prevalence of burnout, associated comorbidities and coping strategies were assessed in pharmacy teams (pharmacists and pharmacy technicians) in French community pharmacies. Methods This online survey was performed by emails sent to all French community pharmacies over 3 months. The survey assessed the prevalence of burnout (Maslach Burnout Inventory—MBI—questionnaire), anxiety, depression and strategies for coping with work-related stress. Results Of the 1,339 questionnaires received, 1,322 were completed and useable for the analysis. Burnout syndrome was detected in 56.2% of respondents and 10.5% of them presented severe burnout syndrome. Severe burnout syndrome was significantly associated with men, large urban areas and the number of hours worked. Depression and anxiety were found in 15.7% and 42.4% of respondents, respectively. These co-morbidities were significantly associated with severe burnout syndrome. Higher MBI scores were significantly associated with medical consultations and medicinal drug use. Conversely, respondents suffering from burnout syndrome declared they resorted less to non-medical strategies to manage their work-related stress (leisure, psychotherapy, holidays and time off). Conclusion This study demonstrated that community pharmacists and pharmacy technicians presented high prevalence of burnout syndrome, such as many healthcare professionals. Unfortunately, burnout syndrome was associated with several comorbidities (anxiety, depression and alcohol abuse) and the consumption of health resources. The psychological suffering of these healthcare professionals underlines the necessity to deploy a strategy to detect and manage burnout in community pharmacy.
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Affiliation(s)
- David Balayssac
- Université Clermont Auvergne, Inserm U1107, NEURO-DOL, UFR de Pharmacie, CHU Clermont-Ferrand, Clermont-Ferrand, France
- * E-mail:
| | | | - Julie Virot
- Université Clermont Auvergne, UFR de Pharmacie, Clermont-Ferrand, France
| | - Aurore Collin
- Université Clermont Auvergne, Inserm U1107, NEURO-DOL, UFR de Pharmacie, Clermont-Ferrand, France
| | - David Alapini
- Ordre des Pharmaciens—Conseil Régional Nord Pas de Calais, Lille, France
| | - Damien Cuny
- Univ. Lille, CHU Lille, Institut Pasteur de Lille, EA 4483—IMPECS—IMPact de l’Environnement Chimique sur la Santé humaine, Lille, France
| | - Jean-Marc Gagnaire
- Ordre des Pharmaciens—Conseil Régional Auvergne, Clermont-Ferrand, France
| | - Nicolas Authier
- Université Clermont Auvergne, Inserm U1107, NEURO-DOL, UFR de Médecine, CHU Clermont-Ferrand, Clermont-Ferrand, France
| | - Brigitte Vennat
- Université Clermont Auvergne, UFR de Pharmacie, unité ACCePPT, Clermont-Ferrand, France
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Cai S, Lin H, Hu X, Cai YX, Chen K, Cai WZ. High fatigue and its associations with health and work related factors among female medical personnel at 54 hospitals in Zhuhai, China. PSYCHOL HEALTH MED 2017; 23:304-316. [PMID: 28778141 DOI: 10.1080/13548506.2017.1361038] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
The present study aimed to investigate the prevalence of fatigue and determine factors associated with fatigue in female medical personnel. Based on a cross-sectional study, a total of 1608 female medical personnel at 54 hospitals in Zhuhai, China were recruited by a multistage stratified cluster sampling method. The Symptoms Checklist-90-Revised and Chalder Fatigue Scale were used to assess psychiatric symptoms and fatigue, respectively. Data regarding demographic, health, and work related variables were also collected. Multivariate logistic regression model was constructed to determine the influencing factors of fatigue. Approximately 83% of participants had experienced fatigue in the past week. The risk of fatigue was higher in aged 30-39 years old than older or younger participants; Longer sleeping time predicted a lower prevalence of fatigue (OR = .35), while tense physician-patient relationship predicted a higher prevalence of fatigue (OR = 1.77). Depression (OR = 1.76) and anxiety (OR = 1.96) were found related to fatigue. Additionally, fatigue was associated with marital status, occupation, health related factors (exercise, regular diet, and health status), and work related factors (hospital rank and turnover intention). These study findings might facilitate development and implementation of targeted interventions and preventive measures.
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Affiliation(s)
- Shu Cai
- a Shenzhen Hospital of Southern Medical University , Shenzhen , China.,b School of Nursing , Guangdong Pharmaceutical University , Guangzhou , China
| | - Hong Lin
- c Phoenix International Medical Center , The Fifth Affiliated Hospital of SUN YAT-SEN University , Zhu Hai , China
| | - Xuan Hu
- a Shenzhen Hospital of Southern Medical University , Shenzhen , China
| | | | - Ken Chen
- b School of Nursing , Guangdong Pharmaceutical University , Guangzhou , China
| | - Wen-Zhi Cai
- a Shenzhen Hospital of Southern Medical University , Shenzhen , China
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Golonka K, Mojsa-Kaja J, Gawlowska M, Popiel K. Cognitive Impairments in Occupational Burnout - Error Processing and Its Indices of Reactive and Proactive Control. Front Psychol 2017; 8:676. [PMID: 28507528 PMCID: PMC5410591 DOI: 10.3389/fpsyg.2017.00676] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2017] [Accepted: 04/13/2017] [Indexed: 11/17/2022] Open
Abstract
The presented study refers to cognitive aspects of burnout as the effects of long-term work-related stress. The purpose of the study was to investigate electrophysiological correlates of burnout to explain the mechanisms of the core burnout symptoms: exhaustion and depersonalization/cynicism. The analyzed error-related electrophysiological markers shed light on impaired cognitive mechanisms and the specific changes in information-processing in burnout. In the EEG study design (N = 80), two components of error-related potential (ERP), error-related negativity (ERN), and error positivity (Pe), were analyzed. In the non-clinical burnout group (N = 40), a significant increase in ERN amplitude and a decrease in Pe amplitude were observed compared to controls (N = 40). Enhanced error detection, indexed by increased ERN amplitude, and diminished response monitoring, indexed by decreased Pe amplitude, reveal emerging cognitive problems in the non-clinical burnout group. Cognitive impairments in burnout subjects relate to both reactive and unconscious (ERN) and proactive and conscious (Pe) aspects of error processing. The results indicate a stronger ‘reactive control mode’ that can deplete resources for proactive control and the ability to actively maintain goals. The analysis refers to error processing and specific task demands, thus should not be extended to cognitive processes in general. The characteristics of ERP patterns in burnout resemble psychophysiological indexes of anxiety (increased ERN) and depressive symptoms (decreased Pe), showing to some extent an overlapping effect of burnout and related symptoms and disorders. The results support the scarce existing data on the psychobiological nature of burnout, while extending and specifying its cognitive characteristics.
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Affiliation(s)
- Krystyna Golonka
- Institute of Applied Psychology, Jagiellonian UniversityKrakow, Poland
| | | | - Magda Gawlowska
- Institute of Applied Psychology, Jagiellonian UniversityKrakow, Poland
| | - Katarzyna Popiel
- Institute of Applied Psychology, Jagiellonian UniversityKrakow, Poland
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He SC, Zhang YY, Zhan JY, Wang C, Du XD, Yin GZ, Cao B, Ning YP, Soares JC, Zhang XY. Burnout and cognitive impairment: Associated with serum BDNF in a Chinese Han population. Psychoneuroendocrinology 2017; 77:236-243. [PMID: 28119229 DOI: 10.1016/j.psyneuen.2017.01.002] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2016] [Revised: 12/08/2016] [Accepted: 01/04/2017] [Indexed: 12/20/2022]
Abstract
BACKGROUND Some studies have demonstrated that subjects with chronic burnout showed cognitive impairments; however, cognitive performance in burnout has been under-investigated. Increasing evidence show that brain-derived neurotrophic factor (BDNF) plays a critical role in cognitive function. We hypothesized that decreased BDNF may be associated with cognitive impairments in burnout, which has not been investigated yet. The aim of the present study was to examine the association of BDNF with cognitive impairment in burnout. METHOD Using a cross-sectional design, 712 healthy subjects were recruited from a general hospital and they were all measured with the Maslach Burnout Inventory (MBI). We assessed part of subjects on the repeatable battery for the assessment of neuropsychological status (RBANS) (n=192) and serum BDNF levels (n=127). RESULTS 30.5% of the subjects had burnout. Compared to those non-burnout subjects, the burnout subjects were younger, had significant lower BDNF levels (p=0.003) and scored lower on immediate memory, RBANS total score and attention (all p<0.05). Interestingly, after the Bonferroni correction, there were negative correlations between BDNF and MBI total score or reduced professional accomplishment (PA). Moreover, BDNF was positively associated with immediate memory, attention and RBANS total score. Further multiple regression analysis showed that BDNF was an independent contributor to the RBANS total score and attention, and BDNF and MBI depersonalization (DP) were independent contributors to immediate memory. In addition, there was mediating effect of BDNF in the relation between burnout and cognitive impairments. CONCLUSIONS Our results suggest that burnout is associated with significant cognitive impairments and decreased BDNF. Moreover, decreased BDNF is associated with cognitive impairments in burnout.
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Affiliation(s)
- S C He
- School of Psychological and Cognitive Sciences, Peking University, Beijing, China.
| | - Y Y Zhang
- Suzhou Psychiatric Hospital, The Affiliated Guangji Hospital of Soochow University, Suzhou, Jiangsu, China
| | - J Y Zhan
- School of Psychological and Cognitive Sciences, Peking University, Beijing, China
| | - C Wang
- School of Psychological and Cognitive Sciences, Peking University, Beijing, China
| | - X D Du
- Suzhou Psychiatric Hospital, The Affiliated Guangji Hospital of Soochow University, Suzhou, Jiangsu, China
| | - G Z Yin
- Suzhou Psychiatric Hospital, The Affiliated Guangji Hospital of Soochow University, Suzhou, Jiangsu, China
| | - B Cao
- Department of Psychiatry and Behavioral Sciences, The University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Y P Ning
- The Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), Guangzhou, China
| | - J C Soares
- Department of Psychiatry and Behavioral Sciences, The University of Texas Health Science Center at Houston, Houston, TX, USA
| | - X Y Zhang
- Department of Psychiatry and Behavioral Sciences, The University of Texas Health Science Center at Houston, Houston, TX, USA; Psychiatry Research Center, Beijing HuiLongGuan hospital, Peking University, Beijing, China.
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