title: The psychobiology of burnout: are there two different syndromes?
abstract: BACKGROUND
  Plasma prolactin levels are sensitive to dopamine and serotonin function, and fatigue. Low cortisol, dopamine and/or serotonin may be involved in burnout and detachment.
  
  
  METHODS
  In this double-blind within-subject study, we treated 9 female burnout subjects and 9 controls with 35 mg cortisol and placebo orally. We measured state affect and plasma prolactin, oxytocin, cortisol and adrenocorticotropic hormone levels, and administered an attachment questionnaire.
  
  
  RESULTS
  The burnout subjects displayed an extreme distribution of basal prolactin levels, displaying higher or lower levels compared to the controls. The low prolactin burnouts had profoundly low attachment scores and tended to have low oxytocin levels. The high prolactin burnout subjects tended to show cortisol-induced decreased prolactin and fatigue, and increased vigor.
  
  
  CONCLUSIONS
  Results are consistent with the hypothesis that burnout subjects are either characterized by low serotonergic function or by low dopaminergic function, and that the latter group benefits from cortisol replacement. These preliminary results suggest that differentiating between two syndromes may resolve inconsistencies in research on burnout, and be necessary for selecting the right treatment strategy.
authors.affiliation: Department of Experimental and Work Psychology, University of Groningen, Groningen, The Netherlands. mtops@fsw.leidenuniv.nl
authors.forename: Mattie
authors.initials: M
authors.lastname: Tops
authors.forename: Maarten A S
authors.initials: MA
authors.lastname: Boksem
authors.forename: Albertus A
authors.initials: AA
authors.lastname: Wijers
authors.forename: Hiske
authors.initials: H
authors.lastname: van Duinen
authors.forename: Johan A
authors.initials: JA
authors.lastname: Den Boer
authors.forename: Theo F
authors.initials: TF
authors.lastname: Meijman
authors.forename: Jakob
authors.initials: J
authors.lastname: Korf
mesh_terms: D000324:Adrenocorticotropic Hormone / Q000097:blood; D000328:Adult; D000893:Anti-Inflammatory Agents / Q000097:blood / Q000627:therapeutic use*; D002055:Burnout, Professional / Q000097:blood / Q000188:drug therapy* / Q000523:psychology; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D006854:Hydrocortisone / Q000097:blood / Q000627:therapeutic use*; D015999:Multivariate Analysis; D010121:Oxytocin / Q000097:blood; D011388:Prolactin / Q000097:blood; D011795:Surveys and Questionnaires; D013577:Syndrome
chemical_list: D000893:Anti-Inflammatory Agents; D010121:Oxytocin; D000324:Adrenocorticotropic Hormone; D011388:Prolactin; D006854:Hydrocortisone