Lennartsson Anna-Karin, Sjörs Anna, Währborg Peter, Ljung Thomas, Jonsdottir Ingibjörg H
The Institute of Stress Medicine , Gothenburg , Sweden.
Sahlgrenska Academy, University of Gothenburg , Gothenburg , Sweden.
Front Psychiatry. 2015 Feb 2;6:8. doi: 10.3389/fpsyt.2015.00008. eCollection 2015.
Common consequences of long-term psychosocial stress are fatigue and burnout. It has been suggested that burnout could be associated with hypocortisolism, thus, inability to produce sufficient amounts of cortisol. This study aimed to investigate whether patients with clinical burnout exhibit aberrant ACTH and cortisol responses under acute psychosocial stress compared with healthy individuals.
Nineteen patients (9 men and 10 women) and 37 healthy subjects (20 men and 17 women), underwent the Trier Social Stress Test. Blood samples and saliva samples were collected before, after, and during the stress test for measurements of plasma ACTH, serum cortisol, and salivary cortisol. Several statistical analyses were conducted to compare the responses between patients and controls. In addition, in order to investigate the possibility that burnout patients with more severe symptoms would respond differently, sub-groups of patients reporting higher and lower burnout scores were compared.
In both patients and healthy controls, we observed elevated levels of ACTH and cortisol after exposure to the stressor. There were no differences in responses of ACTH, serum cortisol, or salivary cortisol between patients and controls. Patients reporting higher burnout scores had lower salivary cortisol responses than controls, indicating that patients with more severe burnout symptoms may be suffering from hypocortisolism. In addition, patients with more severe burnout symptoms tended to have smaller ACTH responses than the other patients. However, there was no corresponding difference in serum cortisol.
This study indicates that hypocortisolism is not present in a clinical burnout patient group as a whole but may be present in the patients with more severe burnout symptoms.
长期心理社会压力的常见后果是疲劳和倦怠。有人提出，倦怠可能与皮质醇分泌不足有关，即无法产生足够量的皮质醇。本研究旨在调查与健康个体相比，临床倦怠患者在急性心理社会压力下是否表现出促肾上腺皮质激素（ACTH）和皮质醇反应异常。
19例患者（9例男性和10例女性）和37名健康受试者（20例男性和17例女性）接受了特里尔社会压力测试。在压力测试前、测试后和测试期间采集血样和唾液样本，用于测量血浆ACTH、血清皮质醇和唾液皮质醇。进行了多项统计分析以比较患者和对照组之间的反应。此外，为了研究症状更严重的倦怠患者反应不同的可能性，对报告倦怠得分较高和较低的患者亚组进行了比较。
在患者和健康对照组中，我们都观察到暴露于应激源后ACTH和皮质醇水平升高。患者和对照组在ACTH、血清皮质醇或唾液皮质醇的反应上没有差异。报告倦怠得分较高的患者唾液皮质醇反应低于对照组，表明症状更严重的倦怠患者可能存在皮质醇分泌不足。此外，症状更严重的倦怠患者的ACTH反应往往比其他患者小。然而，血清皮质醇没有相应差异。
本研究表明，临床倦怠患者群体整体不存在皮质醇分泌不足，但症状更严重的倦怠患者可能存在。
