Institute of Psychology, University of Regensburg, Regensburg, Germany.
Institute of Psychology, University of Regensburg, Regensburg, Germany.
Psychoneuroendocrinology. 2022 Sep;143:105853. doi: 10.1016/j.psyneuen.2022.105853. Epub 2022 Jun 27.
Burnout and chronic work stress have been linked to various negative health outcomes. While the mechanisms underlying this interplay are still unclear, the allostatic load (AL) model was suggested to demonstrate a possible biological pathway. However, previous studies provided divergent results regarding the association between burnout and AL, probably also due to the heterogeneity of selected samples. Therefore, the aim of the present study was to examine differences in AL between a conceptually strictly specified group of individuals suffering from burnout (BO group) and a healthy comparison group (HC group).
After a multi-stage recruitment procedure with strict inclusion criteria based on burnout symptomatology and pathogenesis, the BO group (n = 56) was compared to the HC group (n = 65) regarding an index of AL. The AL-index included 14 parameters: high-sensitivity c-reactive protein (hsCRP), tumor necrosis factor-alpha (TNF-α), interleukin 6 (IL-6), fibrinogen, d-dimer, plasminogen activator inhibitor 1 (PAI-1), glycosylated hemoglobin (HbA1c), high-density lipoprotein (HDL) cholesterol, total cholesterol to HDL cholesterol ratio (TC/HDL), dehydroepiandrosterone-sulphate (DHEA-S), systolic blood pressure (SBP), diastolic blood pressure (DBP), waist-hip ratio (WHR), and body fat percentage.
The BO group showed significantly higher AL-scores in comparison to the HC group. This effect remained significant after adjusting for sex, age, and smoking status. Additionally, burnout symptoms (assessed with the Maslach Burnout Inventory; MBI), MBI-subscales emotional exhaustion and depersonalization as well as chronic work stress (assessed with the effort-reward imbalance questionnaire) were significantly associated with higher AL-scores.
Consistent with our hypothesis, we detected higher AL-scores in the BO compared to the HC group, indicating a greater cumulative physiological burden in individuals suffering from burnout. Given the high heterogeneity in individuals experiencing burnout symptoms, future studies may focus on well-specified subgroups, when examining the association between burnout and psychophysiological dysregulations.
倦怠和慢性工作压力与各种负面健康结果有关。虽然这种相互作用的机制尚不清楚，但应激反应（allostatic load，AL）模型被认为可以展示一种可能的生物学途径。然而，以前的研究对于倦怠和 AL 之间的关联提供了不同的结果，这可能也是由于所选样本的异质性所致。因此，本研究的目的是检查在严格定义的倦怠患者（BO 组）和健康对照组（HC 组）之间，AL 之间的差异。
在基于倦怠症状和发病机制的多阶段招募程序后，根据严格的纳入标准，BO 组（n=56）与 HC 组（n=65）进行了 AL 指数比较。AL 指数包括 14 个参数：高敏 C 反应蛋白（hsCRP）、肿瘤坏死因子-α（TNF-α）、白细胞介素 6（IL-6）、纤维蛋白原、D-二聚体、纤溶酶原激活物抑制剂 1（PAI-1）、糖化血红蛋白（HbA1c）、高密度脂蛋白（HDL）胆固醇、总胆固醇与高密度脂蛋白胆固醇比值（TC/HDL）、脱氢表雄酮硫酸盐（DHEA-S）、收缩压（SBP）、舒张压（DBP）、腰臀比（WHR）和体脂百分比。
与 HC 组相比，BO 组的 AL 评分显著更高。调整性别、年龄和吸烟状况后，这种影响仍然显著。此外，倦怠症状（使用 Maslach 倦怠量表评估；MBI）、MBI 子量表情感衰竭和去人性化以及慢性工作压力（使用努力-回报失衡问卷评估）与更高的 AL 评分显著相关。
与我们的假设一致，我们在 BO 组中检测到比 HC 组更高的 AL 评分，这表明倦怠患者的累积生理负担更大。鉴于经历倦怠症状的个体存在高度异质性，未来的研究可能会在检查倦怠和心理生理失调之间的关联时，重点关注特定的亚组。
