Institute of Stress Medicine, Carl Skottsbergsgata 22B, SE-413 19 Gothenburg, Sweden.
BMC Psychiatry. 2012 Mar 12;12:18. doi: 10.1186/1471-244X-12-18.
Long-term sick leave due to mental health problems, especially among women, is a substantial problem in many countries, and a major reason for this is thought to be psychosocial stress. The recovery period of different patient groups with stress-related mental health problems can differ considerably. We have studied the course of mental health symptoms during 18 months of multimodal treatment in relation to sex and age in a group of patients with stress-related exhaustion.
The study group includes 232 patients (68% women) referred to a stress clinic and who fulfilled the criteria for Exhaustion Disorder (ED). The majority also fulfilled diagnostic criteria for depression and/or anxiety; this was similar among women and men. Symptoms were assessed at baseline, three, six, 12 and 18 months by the Shirom-Melamed Burnout Questionnaire (SMBQ) and the Hospital Anxiety and Depression scale (HAD). A total SMBQ mean score of ≥ 4 was used to indicate clinical burnout, which correlates well with the clinical diagnosis of ED.
There were no statistically significant differences between women and men or between young and old patients in the self-reported symptoms at baseline. The proportion that had high burnout scores decreased over time, but one-third still had symptoms of clinical burnout after 18 months. Symptoms indicating probable depression or anxiety (present in 34% and 65% of the patients at baseline, respectively) declined more rapidly, in most cases within the first three months, and were present only in one out of 10 after 18 months. The course of illness was not related to sex or age. The duration of symptoms before seeking health care, but not the level of education or co-morbid depression, was a predictor of recovery from symptoms of burnout after 18 months.
The course of mental illness in patients seeking specialist care for stress-related exhaustion was not related to sex or age. The burden of mental symptoms is high and similar for men and women, and at the 18 month follow-up, one-third of the study group still showed symptoms of burnout. A long duration of symptoms before consultation was associated with a prolonged time of recovery, which underlines the importance of early detection of stress-related symptoms.
长期因心理健康问题（尤其是女性）而请病假是许多国家的一个重大问题，其主要原因被认为是心理社会压力。不同应激相关心理健康问题患者群体的康复期可能有很大差异。我们研究了一组应激相关衰竭患者接受多模式治疗 18 个月期间心理健康症状的变化情况，并对其与性别和年龄的关系进行了研究。
研究组包括 232 名（68%为女性）被转诊至应激诊所并符合衰竭障碍（ED）标准的患者。大多数患者还符合抑郁和/或焦虑的诊断标准；女性和男性的情况相似。在基线、3 个月、6 个月、12 个月和 18 个月时，使用 Shirom-Melamed 倦怠问卷（SMBQ）和医院焦虑抑郁量表（HAD）评估症状。SMBQ 总分≥4 被用于表示临床倦怠，这与 ED 的临床诊断具有良好相关性。
在基线时，女性和男性之间以及年轻患者和老年患者之间的自我报告症状没有统计学差异。随着时间的推移，具有高倦怠得分的比例下降，但在 18 个月后仍有三分之一的患者存在临床倦怠症状。表明可能存在抑郁或焦虑的症状（分别在基线时存在于 34%和 65%的患者中）下降更快，大多数情况下在头三个月内，18 个月后只有十分之一的患者存在。疾病的病程与性别或年龄无关。在寻求医疗保健之前症状的持续时间，而不是教育程度或合并抑郁，是 18 个月后倦怠症状恢复的预测因素。
寻求专科治疗应激相关衰竭的患者的精神疾病病程与性别或年龄无关。精神症状的负担对男性和女性来说是相似的，在 18 个月的随访中，研究组仍有三分之一的患者存在倦怠症状。在咨询前症状持续时间较长与康复时间延长相关，这强调了早期发现应激相关症状的重要性。
