Chmiel James, Malinowska Agnieszka
Faculty of Physical Culture and Health, Institute of Physical Culture Sciences, University of Szczecin, Al. Piastów 40B Block 6, 71-065 Szczecin, Poland.
Institute of Psychology, University of Szczecin, 71-017 Szczecin, Poland.
J Clin Med. 2025 Jul 29;14(15):5357. doi: 10.3390/jcm14155357.
Burnout syndrome, long described as an "occupational phenomenon", now affects 15-20% of the general workforce and more than 50% of clinicians, teachers, social-care staff and first responders. Its precise nosological standing remains disputed. We conducted a mechanistic review of electroencephalography (EEG) studies to determine whether burnout is accompanied by reproducible brain-function alterations that justify disease-level classification. Following PRISMA-adapted guidelines, two independent reviewers searched PubMed/MEDLINE, Scopus, Google Scholar, Cochrane Library and reference lists (January 1980-May 2025) using combinations of "burnout," "EEG", "electroencephalography" and "event-related potential." Only English-language clinical investigations were eligible. Eighteen studies (n = 2194 participants) met the inclusion criteria. Data were synthesised across three domains: resting-state spectra/connectivity, event-related potentials (ERPs) and longitudinal change. Resting EEG consistently showed (i) a 0.4-0.6 Hz slowing of individual-alpha frequency, (ii) 20-35% global alpha-power reduction and (iii) fragmentation of high-alpha (11-13 Hz) fronto-parietal coherence, with stage- and sex-dependent modulation. ERP paradigms revealed a distinctive "alarm-heavy/evaluation-poor" profile; enlarged N2 and ERN components signalled hyper-reactive conflict and error detection, whereas P3b, Pe, reward-P3 and late CNV amplitudes were attenuated by 25-50%, indicating depleted evaluative and preparatory resources. Feedback processing showed intact or heightened FRN but blunted FRP, and affective tasks demonstrated threat-biassed P3a latency shifts alongside dampened VPP/EPN to positive cues. These alterations persisted in longitudinal cohorts yet normalised after recovery, supporting trait-plus-state dynamics. The electrophysiological fingerprint differed from major depression (no frontal-alpha asymmetry, opposite connectivity pattern). Across paradigms, burnout exhibits a coherent neurophysiological signature comparable in magnitude to established psychiatric disorders, refuting its current classification as a non-disease. Objective EEG markers can complement symptom scales for earlier diagnosis, treatment monitoring and public-health surveillance. Recognising burnout as a clinical disorder-and funding prevention and care accordingly-is medically justified and economically imperative.
职业倦怠综合征长期以来被描述为一种“职业现象”，目前影响着15%至20%的普通劳动者，以及超过50%的临床医生、教师、社会护理人员和急救人员。其确切的疾病分类地位仍存在争议。我们对脑电图（EEG）研究进行了一项机制性综述，以确定职业倦怠是否伴随着可重复的脑功能改变，从而证明其疾病层面的分类是合理的。按照改编后的PRISMA指南，两名独立评审员在PubMed/MEDLINE、Scopus、谷歌学术、Cochrane图书馆及参考文献列表（1980年1月至2025年5月）中检索，使用了“职业倦怠”“EEG”“脑电图”和“事件相关电位”的组合。仅符合英文临床研究。18项研究（n = 2194名参与者）符合纳入标准。数据在三个领域进行了综合：静息态频谱/连接性、事件相关电位（ERP）和纵向变化。静息EEG始终显示：（i）个体α频率减慢0.4至0.6Hz；（ii）整体α功率降低20%至35%；（iii）高α（11至13Hz）额顶叶连贯性碎片化，并存在阶段和性别依赖性调节。ERP范式显示出一种独特的“警报重/评估差”特征；N2和ERN成分增大表明冲突和错误检测反应过度，而P3b、Pe、奖励P3和晚期CNV振幅衰减25%至50%，表明评估和准备资源耗尽。反馈处理显示FRN完整或增强，但FRP减弱，情感任务显示威胁偏向的P3a潜伏期变化以及对积极线索的VPP/EPN减弱。这些改变在纵向队列中持续存在，但恢复后恢复正常，支持特质加状态动态。这种电生理特征与重度抑郁症不同（无额叶α不对称，连接模式相反）。在所有范式中，职业倦怠表现出与已确诊的精神疾病相当的连贯神经生理特征，反驳了其目前作为非疾病的分类。客观的EEG标记物可以补充症状量表，用于早期诊断、治疗监测和公共卫生监测。将职业倦怠视为一种临床疾病并相应地为预防和护理提供资金，在医学上是合理的，在经济上也是必要的。
