title: The morning salivary cortisol response in burnout.
abstract: OBJECTIVE
  The aim of the present study was to examine the free salivary cortisol response to awakening in men and women reporting low, moderate, and high levels of burnout.
  
  
  METHODS
  Twenty-two patients on sick leave due to burnout were compared with 22 working participants with low and 20 working participants with intermediate scores on the Shirom-Melamed Burnout Questionnaire (SMBQ), with regard to the free salivary cortisol response to awakening. Saliva samples were collected upon awakening and at +15, +30, and +60 min thereafter.
  
  
  RESULTS
  Female burnout patients had higher cortisol levels than did the females with low burnout at awakening and at +15, +30, and +60 min after awakening. They also had a greater area under the curve (AUC) for salivary cortisol than did the female participants with low burnout. Male participants with moderate levels of burnout had higher cortisol levels at +60 min after awakening compared with males with low burnout.
  
  
  CONCLUSIONS
  The results of the present study indicate a dysregulation in hypothalamic-pituitary-adrenocortical axis (HPA axis) activity, characterised by elevated morning salivary cortisol levels, among female burnout patients. Among males, increased cortisol levels were observed among participants with moderate levels of burnout, but not among patients or healthy controls.
authors.affiliation: The Stress Clinic, National Institute for Psychosocial Factors and Health, Stockholm, Sweden.
authors.forename: Giorgio
authors.initials: G
authors.lastname: Grossi
authors.forename: Aleksander
authors.initials: A
authors.lastname: Perski
authors.forename: Mirjam
authors.initials: M
authors.lastname: Ekstedt
authors.forename: Thorbjörn
authors.initials: T
authors.lastname: Johansson
authors.forename: Morie
authors.initials: M
authors.lastname: Lindström
authors.forename: Karin
authors.initials: K
authors.lastname: Holm
mesh_terms: D000328:Adult; D002055:Burnout, Professional; D003430:Cross-Sectional Studies; D003863:Depression / Q000175:diagnosis / Q000453:epidemiology; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005260:Female; D006801:Humans; D006854:Hydrocortisone / Q000032:analysis*; D007030:Hypothalamo-Hypophyseal System / Q000378:metabolism*; D008297:Male; D010913:Pituitary-Adrenal System / Q000378:metabolism*; D012463:Saliva / Q000737:chemistry*; D011795:Surveys and Questionnaires
chemical_list: D006854:Hydrocortisone