Department of Laboratory Medicine, Medical University of Vienna, Vienna, Austria.
Health and Prevention Center, Sanatorium Hera, Vienna, Austria.
Sci Rep. 2018 Jun 14;8(1):9151. doi: 10.1038/s41598-018-27386-1.
Burnout and work-related stress symptoms of anxiety disorder and depression cause prolonged work absenteeism and early retirement. Hence, reliable identification of patients under risk and monitoring of treatment success is highly warranted. We aimed to evaluate stress-specific biomarkers in a population-based, "real-world" cohort (burnouts: n = 40, healthy controls: n = 26), recruited at a preventive care ward, at baseline and after a four-month follow up, during which patients received medical and psychological treatment. At baseline, significantly higher levels of salivary cortisol were observed in the burnout group compared to the control group. This was even more pronounced in midday- (p < 0.001) and nadir samples (p < 0.001) than for total morning cortisol secretion (p < 0.01). The treatment program resulted in a significant reduction of stress, anxiety, and depression scores (all p < 0.001), with 60% of patients showing a clinically relevant improvement. This was accompanied by a ~30% drop in midday cortisol levels (p < 0.001), as well as a ~25% decrease in cortisol nadir (p < 0.05), although not directly correlating with score declines. Our data emphasize the potential usefulness of midday and nadir salivary cortisol as markers in the assessment and biomonitoring of burnout.
倦怠和与工作相关的压力症状，如焦虑障碍和抑郁症，会导致长时间旷工和提前退休。因此，可靠地识别处于风险中的患者并监测治疗效果是非常必要的。我们旨在评估一个基于人群的“真实世界”队列（倦怠：n=40，健康对照组：n=26）中的应激特异性生物标志物，该队列在预防保健病房招募，在基线和四个月的随访期间进行评估，在此期间，患者接受了医学和心理治疗。在基线时，与对照组相比，倦怠组的唾液皮质醇水平明显更高。在中午（p<0.001）和最低点（p<0.001）样本中，这种情况比总晨皮质醇分泌（p<0.01）更为明显。治疗方案导致压力、焦虑和抑郁评分显著降低（均 p<0.001），60%的患者表现出临床相关的改善。这伴随着中午皮质醇水平下降约 30%（p<0.001），以及皮质醇最低点下降约 25%（p<0.05），尽管与评分下降没有直接相关。我们的数据强调了唾液中午和最低点皮质醇作为评估和生物监测倦怠的生物标志物的潜在有用性。
