Do burned-out and work-engaged employees differ in the functioning of the hypothalamic-pituitary-adrenal axis?

Biomarkers in burnout: A systematic review

“…For this analysis, Proc Mixed of SAS 9.1.3 for multilevel modeling (SAS Institute, Cary, NC, USA) was used [9,10]. In order to select an appropriate covariance matrix for this analysis, we inspected correlation matrices of two data sets of the CAR (Klaassens et al [11]; Langelaan et al [12]). On the basis thereof, and as the number of studies was small, compound symmetry covariance matrix was selected.…”

“…Fourteen reported on cortisol in saliva, 6 on cortisol in blood, and 1 on cortisol in urine [7,[12][13][14][15][16][17][18][19][20][21][22][23][24][25][26][27]31]. In the studies that reported on saliva cortisol, there were 8 case-control studies with a total of 278 cases and 269 controls, whereas 6 studies with a total of 636 people divided participants into groups with high scores and low scores of burnout severity.…”

“…The CAR was analyzed in seven of the studies on saliva [7,12,16,[19][20][21]23]. These studies compared 203 patients with burnout and 195 controls, or 140 subjects [40] with high vs. low scores on burnout severity.…”

“…The CAR was measured after administration of dexamethasone in the evening in five studies [7,12,19,21,23]. Dexamethasone is a cortisol analogue that has difficulty crossing the blood-brain barrier.…”

Indication of attenuated DHEA-s response during acute psychosocial stress in patients with clinical burnout

“…Four publications were found which included a comparison of baseline DHEA-s between burnout subjects and healthy controls. One of these reported higher DHEA-s levels in the burnout subjects [27], and three of them reported no differences in baseline DHEA-s levels between burnout subjects and controls [24,28,29]. Production capacity might however more likely be reflected when investigating the response to a challenge, as in the present study.…”