Orosz Ariane, Federspiel Andrea, Eckert Anne, Seeher Christian, Dierks Thomas, Tschitsaz Armita, Cattapan Katja
Centre for Stress-Related Illnesses, Sanatorium Kilchberg, Private Clinic for Psychiatry and Psychotherapy, Kilchberg, Switzerland.
University Hospital of Psychiatry and Psychotherapy, Division of Systems Neuroscience of Psychopathology, Translational Research Center, University Bern Psychiatric Services (UPD), Bern, Switzerland.
Clin Psychol Psychother. 2021 Jul;28(4):852-861. doi: 10.1002/cpp.2539. Epub 2020 Dec 15.
The increasing prevalence of stress-related disorders such as burnout urges the need for specialized treatment approaches. Programmes combining psychotherapy and regenerative interventions emerge to be the most successful. However, evaluated therapy programmes are scarce and usually involve subjective symptom quantification without consideration of physiologic parameters. The aim of the present exploratory, single-group study was the multimodal investigation of the effectiveness of a specialized holistic therapy programme by assessing symptoms and biological markers of chronic stress. Seventy-one in-patients (39 men/32 women; age 46.8 ± 9.9 years) of a specialized burnout ward with the additional diagnosis of burnout (Z73.0) in conjunction with a main diagnosis of depressive disorder (F32 or F33) according to the International Classification of Diseases (ICD)-10 were included in the study. In addition to symptomatology, the stress-responsive biomarkers heart rate variability (HRV) and serum brain-derived neurotrophic factor (BDNF) were measured in patients at admittance to and discharge from the burnout ward applying a 6-week specialized treatment programme. At discharge, patients showed a significant reduction of symptom burden and a significant increase in serum BDNF, while HRV remained unchanged. The findings implicate that the therapy programme may have beneficial effects on symptomatology and neuroplasticity of patients with burnout. As therapy was often supplemented by psychopharmacological treatment, a relevant influence of antidepressant medication especially on BDNF has to be considered.
与压力相关的疾病（如职业倦怠）的患病率不断上升，促使人们需要专门的治疗方法。结合心理治疗和再生干预的方案似乎是最成功的。然而，经过评估的治疗方案很少，而且通常涉及主观症状量化，而没有考虑生理参数。本探索性单组研究的目的是通过评估慢性压力的症状和生物标志物，对一种专门的整体治疗方案的有效性进行多模式调查。根据国际疾病分类（ICD）-10，71名住院患者（39名男性/32名女性；年龄46.8±9.9岁）被纳入研究，这些患者来自一个专门的职业倦怠病房，除了职业倦怠（Z73.0）的额外诊断外，还伴有抑郁症（F32或F33）的主要诊断。除了症状学，在患者进入和离开职业倦怠病房时，应用为期6周的专门治疗方案，测量了应激反应生物标志物心率变异性（HRV）和血清脑源性神经营养因子（BDNF）。出院时，患者的症状负担显著减轻，血清BDNF显著增加，而HRV保持不变。研究结果表明，该治疗方案可能对职业倦怠患者的症状学和神经可塑性有有益影响。由于治疗经常辅以心理药物治疗，必须考虑抗抑郁药物尤其是对BDNF的相关影响。
