title: Clinical burnout is not reflected in the cortisol awakening response, the day-curve or the response to a low-dose dexamethasone suppression test.
abstract: Burnout is presumed to be the result of chronic stress, and chronic stress is known to affect the HPA-axis. To date, studies on HPA-axis functioning in burnout have showed inconsistent results. In the present study, a large sample (n=74) of clinically diagnosed burnout individuals, mostly on sick-leave, were included and compared with 35 healthy controls. Salivary cortisol was sampled on 2 days to determine the cortisol awakening response (CAR) and the day-curve. In addition, the dexamethasone suppression test (DST) was applied to assess the feedback efficacy of the HPA-axis. There were no differences observed in the CAR, day-curve or CAR after DST in the burnout group as compared to a healthy control group. Burnout shows overlap in symptoms with chronic fatigue syndrome (CFS) and depression. Therefore, differential changes in HPA-axis functioning that resemble the hypo-functioning of the HPA-axis in CFS, or rather the hyper-functioning of the HPA-axis in depression, might have obscured the findings. However, no effect of fatigue or depressive mood on HPA-axis functioning was found in the burnout group. We concluded that HPA-axis functioning in clinically diagnosed burnout participants as tested in the present study, seems to be normal.
authors.affiliation: Department of Health Psychology, Utrecht University, P.O. Box 80.140, 3508 TC Utrecht, The Netherlands. p.mommersteeg@fss.uu.nl
authors.forename: Paula M C
authors.initials: PM
authors.lastname: Mommersteeg
authors.forename: Cobi J
authors.initials: CJ
authors.lastname: Heijnen
authors.forename: Marc J P M
authors.initials: MJ
authors.lastname: Verbraak
authors.forename: Lorenz J P
authors.initials: LJ
authors.lastname: van Doornen
mesh_terms: D000328:Adult; D000704:Analysis of Variance; D019540:Area Under Curve; D002055:Burnout, Professional / Q000175:diagnosis / Q000378:metabolism* / Q000503:physiopathology; D016009:Chi-Square Distribution; D002940:Circadian Rhythm / Q000502:physiology*; D003907:Dexamethasone; D025461:Feedback, Physiological; D005260:Female; D006801:Humans; D006854:Hydrocortisone / Q000378:metabolism*; D007030:Hypothalamo-Hypophyseal System / Q000502:physiology / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D010913:Pituitary-Adrenal System / Q000502:physiology / Q000503:physiopathology*; D012016:Reference Values; D012463:Saliva / Q000378:metabolism; D018709:Statistics, Nonparametric; D014851:Wakefulness / Q000502:physiology*
chemical_list: D003907:Dexamethasone; D006854:Hydrocortisone