A systematic review and meta-analysis of tertiary interventions in clinical burnout.

Clinical burnout is one of the leading causes of work absenteeism in high- and middle-income countries. There is hence a great need for the identification of effective intervention strategies to increase return-to-work (RTW) in this population. This review aimed to assess the effectiveness of tertiary interventions for individuals with clinically significant burnout on RTW and psychological symptoms of exhaustion, depression and anxiety.

Stress-related exhaustion disorder--clinical manifestation of burnout? A review of assessment methods, sleep impairments, cognitive disturbances, and neuro-biological and physiological changes in clinical burnout.

The aim of this paper was to provide an overview of the literature on clinically significant burnout, focusing on its assessment, associations with sleep disturbances, cognitive impairments, as well as neurobiological and physiological correlates. Fifty-nine English language articles and six book chapters were included. The results indicate that exhaustion disorder (ED), as described in the Swedish version of the International Classification of Diseases, seems to be the most valid clinical equivalent of burnout.

Self-reported sleep lengths ≥ 9 hours among Swedish patients with stress-related exhaustion: Associations with depression, quality of sleep and levels of fatigue.

Background: Insomnia-type sleep disturbances are frequent among patients suffering from stress-related exhaustion disorder. However, clinical observations indicate that a subgroup suffer from sleep lengths frequently exceeding 9 hours, coupled with great daytime sleepiness.

Aims: The aim of the present study was to investigate differences in socio-demographic variables, use of medications, sleep parameters, anxiety, depression and fatigue, between individuals with varying sleep lengths, in a sample of 420 Swedish patients (mean age 42 ± 9 years; 77% women) referred to treatment for exhaustion disorder.

The influence of work-related chronic stress on the regulation of emotion and on functional connectivity in the brain.

Despite mounting reports about the negative effects of chronic occupational stress on cognitive and emotional functions, the underlying mechanisms are unknown. Recent findings from structural MRI raise the question whether this condition could be associated with a functional uncoupling of the limbic networks and an impaired modulation of emotional stress. To address this, 40 subjects suffering from burnout symptoms attributed to chronic occupational stress and 70 controls were investigated using resting state functional MRI.

Risk markers of all-cause and diagnosis-specific disability pension--a prospective cohort study of individuals sickness absent due to stress-related mental disorders.

Background: Stress-related mental disorders rank among the leading causes of sickness absence in several European countries. The aim of this study was to investigate predictors of all-cause and diagnosis-specific disability pension in sickness absentees with stress-related mental disorders.

Methods: A cohort of 36304 non-retired individuals aged 16-64 years at 31.

Hyperventilation and exhaustion syndrome.

Chronic stress is among the most common diagnoses in Sweden, most commonly in the form of exhaustion syndrome (ICD-10 classification - F43.8). The majority of patients with this syndrome also have disturbed breathing (hyperventilation).

Long-term occupational stress is associated with regional reductions in brain tissue volumes.

There are increasing reports of cognitive and psychological declines related to occupational stress in subjects without psychiatric premorbidity or major life trauma. The underlying neurobiology is unknown, and many question the notion that the described disabilities represent a medical condition. Using PET we recently found that persons suffering from chronic occupational stress had limbic reductions in the 5-HT1A receptor binding potential.

Validation of Karolinska Exhaustion Scale: psychometric properties of a measure of exhaustion syndrome.

Background: The syndrome of exhaustion is currently a medical diagnosis in Sweden. The description of the syndrome largely corresponds to the suggested core component of burnout, that is exhaustion. Karolinska Exhaustion Scale (KES) has been constructed to provide specific assessment of exhaustion in clinical and research settings.

Sickness absence due to specific mental diagnoses and all-cause and cause-specific mortality: a cohort study of 4.9 million inhabitants of Sweden.

Background: Despite the magnitude and increase of sickness absence due to mental diagnoses, little is known regarding long-term health outcomes. The aim of this nationwide population-based, prospective cohort study was to investigate the association between sickness absence due to specific mental diagnoses and the risk of all-cause and cause-specific mortality.

Methods: A cohort of all 4 857 943 individuals living in Sweden on 31.

Insufficient sleep predicts clinical burnout.

The present prospective study aimed to identify risk factors for subsequent clinical burnout. Three hundred eighty-eight working individuals completed a baseline questionnaire regarding work stress, sleep, mood, health, and so forth. During a 2-year period, 15 subjects (7 women and 8 men) of the total sample were identified as "burnout cases," as they were assessed and referred to treatment for clinical burnout.

Stress symptoms among adolescents: the role of subjective psychosocial conditions, lifestyle, and self-esteem.

Stress-related problems are increasing among Swedish adolescents, especially among females. The aims of this study were to survey the incidence of stress symptoms among 16-year-olds, to investigate the related gender differences, and to understand the factors that may contribute to stress symptoms. The study is questionnaire based, and the sample included 304 first-year high school students from two comparable schools.

Testosterone levels and psychological health status in men from a general population: the Tromsø study.

Aims: To investigate the association between endogenous testosterone levels and psychological health symptoms in men from a general population.

Methods: Total testosterone and sex hormone-binding globulin levels were analysed and free testosterone levels was calculated in 3413 men participating in the fifth Tromsø study in 2001. Self-administered questionnaires including information about education, marital status, smoking habits and the Hopkins Symptom Checklist-10 (SCL-10, a 10-item psychological health questionnaire) were completed.

The effect of short sleep duration on coronary heart disease risk is greatest among those with sleep disturbance: a prospective study from the Whitehall II cohort.

Study Objectives: Short sleep duration is associated with increased CHD (coronary heart disease) mortality and morbidity, although some evidence suggests that sleep disturbance is just as important. We investigated whether a combination of short sleep duration and sleep disturbance is associated with a higher risk of CHD than their additive effects.

Setting: The Whitehall II study.

Self-reported sleep duration and sleep disturbance are independently associated with cortisol secretion in the Whitehall II study.

Context: The association of short sleep duration with cortisol secretion has not been thoroughly examined in large community dwelling populations and the relative importance of short sleep duration and sleep disturbance is unclear.

Objective: The objective of the study was to assess the relationships between self-reported sleep duration, sleep disturbance, and salivary cortisol secretion.

Design: This was a cross-sectional analysis using data from phase 7 (2002-2004) of the Whitehall II study.

Disturbed sleep and fatigue in occupational burnout.

Objectives: The purpose of this study was to investigate sleep with polysomnography and self-ratings and the diurnal pattern of sleepiness and fatigue in a group suffering from severe occupational burnout.

Method: Twelve white-collar workers on long-term sick leave (>3 months) and 12 healthy controls with high and low scores on the Shirom Melamed Burnout Questionnaire (SMBQ) were included. A 1-night polysomnographic recording (after habituation) was carried out at home, and sleepiness and mental fatigue were rated at different times of the day for weekdays and the weekend.

The morning salivary cortisol response in burnout.

Objectives: The aim of the present study was to examine the free salivary cortisol response to awakening in men and women reporting low, moderate, and high levels of burnout.

Methods: Twenty-two patients on sick leave due to burnout were compared with 22 working participants with low and 20 working participants with intermediate scores on the Shirom-Melamed Burnout Questionnaire (SMBQ), with regard to the free salivary cortisol response to awakening. Saliva samples were collected upon awakening and at +15, +30, and +60 min thereafter.

Physiological correlates of burnout among women.

Objectives: The purpose of this study was to investigate the immune, endocrine, and metabolic correlates of burnout among women.

Methods: Forty-three participants with high and 20 participants with low scores for the Shirom-Melamed Burnout Questionnaire were compared in terms of subjective symptoms, job strain, social support, plasma levels of prolactin, tumor necrosis factor alpha (TNF-alpha), transforming growth factor beta (TGF-beta), C-reactive protein (CRP), neopterin, serum levels of dehydroepiandrosterone sulphate (DHEAs), progesterone, estradiol, cortisol, and glycated hemoglobin (HbA1C) in whole blood.

Results: Besides reporting more job strain, less social support at work, and higher levels of anxiety, depression, vital exhaustion (VE), and sleep impairments, participants with high burnout manifested higher levels of TNF-alpha and HbA1C, independent of confounders including depression.

[Emotional exhaustion common among women in the public sector].

This cross-sectional investigation aimed at assessing levels of emotional exhaustion among female employees within the Swedish public sector. Other aims were to study the associations between self-rated emotional exhaustion and psychosocial factors at work, as well as findings from medical examinations. Data was collected by means of questionnaires including the Maslach Burnout Inventory, among 183 women working in geriatric care and 143 employees at the National Social Insurance Office.

Psychosocial correlates of long-term sick-leave among patients with musculoskeletal pain.

We studied the associations between psychosocial variables and sick-leave among patients with musculoskeletal pain. Patients (n = 586) seeking care to relieve their pain at health care and physiotherapy centres, completed a questionnaire about such variables as clinical characteristics (e.g.

Do Older Patients Need a Different Approach to Rehabilitation After Coronary Revascularization?

Despite the increasing size of the population over the age of 65 years and increasing use of coronary revascularization procedures in the elderly population in the developed countries of the world, very limited information is available about the rehabilitative needs of people in this age group. We conducted a study to compare the baseline characteristics, before scheduled coronary revascularization, of patients over and under 65 years of age, in order to determine whether a need exists for a different approach in the rehabilitation of elderly patients. One hundred eighty-two consecutive patients with angina pectoris, who were scheduled to undergo isolated coronary artery bypass grafting or percutaneous transluminal coronary angioplasty for the first time, were examined at the time of coronary angiography with respect to sociodemographic data, extent of coronary artery disease, risk-factor levels, and psychosocial status with the help of self-administered questionnaires, including the Nottingham Health Profile.