Biomarkers in burnout: A systematic review

Danhof-Pont, Marie Bernardine; Veen, Tineke van; Zitman, Frans G.

doi:10.1016/j.jpsychores.2010.10.012

Cited by 177 publications

(150 citation statements)

References 42 publications

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“…Many attempts have been made to find physiological correlates or biomarkers for burnout, but absolute consensus has not yet been reached [7]. Nevertheless, substantial evidence exists that stress-induced dysregulations of the main stress axes, i.e., the hypothalamo-pituitary-adrenocortical axis (HPA-axis) and the autonomic nervous system (ANS), are present in burnout [2,5,7,8].…”

Section: Introductionmentioning

confidence: 99%

“…Nevertheless, substantial evidence exists that stress-induced dysregulations of the main stress axes, i.e., the hypothalamo-pituitary-adrenocortical axis (HPA-axis) and the autonomic nervous system (ANS), are present in burnout [2,5,7,8].…”

Section: Introductionmentioning

confidence: 99%

“…With most of the biological correlates described for burnout [7] directly or indirectly relating to exhaustion, it is tempting to agree with the "exhaustion/fatigue only" view [6] of what burnout constitutes. However, burnout is by definition not a context free phenomenon, but job stress-related and marked by emotional disengagement from (cynicism towards) the work situation and feelings of reduced professional efficacy [1,19].…”

Section: Introductionmentioning

confidence: 99%

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Cynicism as subscale of burnout

Viljoen

Claassen

2017

WOR

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Background: Cynicism, as a personality trait, has adverse effects on health. The question was asked whether cynical attitudes that develop due to work-related stress correlate with stress levels and whether it has a negative influence on health.Objectives: To investigate associations of the cynicism subscale scores of the Maslach Burnout Inventory-General Survey (MBI-GS) with levels of stress, anxiety, questionnaire-based physical health and with a number of physiological health risk indicators.Methods: Cynicism, anxiety, questionnaire-based physical health scores, as well as allostatic load, heart rate variability and C-reactive protein, were assessed in 27 males working between 40 and 80 irregular hours per week. Results:Cynicism scores related to stress levels (r=0.411, p=0.030). Effects of work-related cynicism on physical health were suggested by negative associations with questionnaire-based scores on physical health (r=-0.383, p=0.044) and heart rate variability indicators (r=-0.379, p=0.047 to r=-0.496, p=0.007), and by positive associations with anxiety levels (r=0.408, p=0.031), heart rate (r=0.449, p=0.017), BMI (r=0.426, p=0.024) allostatic load (r=0.360, p=0.065) and levels of the inflammatory marker C-reactive protein (r= 0.407, p=0.035).Conclusions: Cynicism, as reflected by the MBI-GS, increases with increases in stress levels and could contribute to the decline in the health reported for burnout.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Cynicism as subscale of burnout

Viljoen

Claassen

2017

WOR

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“…Nevertheless, cortisol samples seem to be frequently taken in primary and occupational health care as a rather unspecific measure of 'stress level.' A recent meta-analysis has found 14 studies on salivary cortisol and burnout, of which 8 were case-control studies and 6 were studies that divided subjects into subgroups based on high or low burnout scores [4]. They have concluded that there was no difference in the cortisol awakening response (CAR) between the patients with burnout and the controls.…”

Section: Materials and Methods Participantsmentioning

confidence: 99%

No alterations in diurnal cortisol profiles before and during the treatment in patients with stress-related exhaustion

Sjörs¹,

Jonsdottir²

2015

Int J Occup Med Environ Health

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Objectives: Several theories have emerged in recent years suggesting that neuroendocrinological alterations, mainly changes in cortisol, could be of importance with respect to the link between chronic stress and disease. This study investigated possible deviations in the diurnal cortisol profiles of patients with clinically diagnosed stress-related exhaustion (exhaustion disorder -ED) compared with healthy controls. Material and Methods: Salivary cortisol samples taken at home in the morning directly after waking up, 30 min later, and in the evening were compared between ED patients (N = 122; 25% men) and healthy controls (N = 98; 44% men). Follow-up measurements were performed after 6 months (79 patients) and 12 months (68 patients) of the treatment. Results: There were no clear differences in diurnal salivary cortisol profiles between the patients and healthy controls. Moreover, salivary cortisol levels and diurnal profiles did not change significantly during the treatment in the patient group. There was some indication of a smaller cortisol awakening response in the male patients compared to the male controls, but the difference appeared to be mainly related to the antidepressant use. Conclusions: Diurnal salivary cortisol profiles, at least as measured in this study, give a rather poor reflection of the prolonged stress exposure experienced by patients with ED. Such basal salivary cortisol measurements do not seem suitable as biomarkers for stress-related conditions such as ED or burnout, or as an aid to assess the effects of prolonged stress load in a routine clinical practice.

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“…Burnout takes a steep toll on physicians and has negative effects on patients and health care systems. 1 Research advances detailing the detrimental effects of chronic stress, including impaired immune function, inflammation, elevation of cardiovascular risk factors, and depression, [2][3][4][5][6][7][8][9] are directly relevant to pediatric practitioners and create a need for organized efforts to address physician health and well-being in the pediatric community. The purpose of this report is to provide an update on the issue of physician health and wellness with regard to how they relate to pediatricians.…”

Section: Introductionmentioning

confidence: 99%

Physician Health and Wellness

McClafferty¹,

Brown²,

Vohra³

et al. 2014

Pediatrics

136

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Physician health and wellness is a critical issue gaining national attention because of the high prevalence of physician burnout. Pediatricians and pediatric trainees experience burnout at levels equivalent to other medical specialties, highlighting a need for more effective efforts to promote health and well-being in the pediatric community. This report will provide an overview of physician burnout, an update on work in the field of preventive physician health and wellness, and a discussion of emerging initiatives that have potential to promote health at all levels of pediatric training.Pediatricians are uniquely positioned to lead this movement nationally, in part because of the emphasis placed on wellness in the Pediatric Milestone Project, a joint collaboration between the Accreditation Council for Graduate Medical Education and the American Board of Pediatrics. Updated core competencies calling for a balanced approach to health, including focus on nutrition, exercise, mindfulness, and effective stress management, signal a paradigm shift and send the message that it is time for pediatricians to cultivate a culture of wellness better aligned with their responsibilities as role models and congruent with advances in pediatric training.Rather than reviewing programs in place to address substance abuse and other serious conditions in distressed physicians, this article focuses on forward progress in the field, with an emphasis on the need for prevention and anticipation of predictable stressors related to burnout in medical training and practice. Examples of positive progress and several programs designed to promote physician health and wellness are reviewed. Areas where more research is needed are highlighted. Pediatrics 2014;134:830-835 INTRODUCTIONPhysician health and wellness is an issue garnering national interest because of the high prevalence of burnout in medical practitioners and trainees. Burnout takes a steep toll on physicians and has negative effects on patients and health care systems. 1 Research advances detailing the detrimental effects of chronic stress, including impaired immune function, inflammation, elevation of cardiovascular risk factors, and depression, 2-9 are directly relevant to pediatric practitioners and create a need for organized efforts to address physician health and well-being in the pediatric community. The purpose of this report is to provide an update on the issue of physician health and wellness with regard to how they relate to pediatricians. Rather than reviewing programs already in place to address substance abuse and other serious conditions in distressed physicians, this report focuses on forward progress in the field, with an emphasis on the need for prevention and anticipation of predictable stressors related to burnout in medical training and practice. Although specific recommendations are beyond the parameters of this report, examples of positive progress and national programs to promote physician health and wellness will be reviewed. BURNOUT: THE ANTITHESIS ...

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Biomarkers in burnout: A systematic review

Cited by 177 publications

References 42 publications

Cynicism as subscale of burnout

Cynicism as subscale of burnout

No alterations in diurnal cortisol profiles before and during the treatment in patients with stress-related exhaustion

Physician Health and Wellness

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