title: Stressful and traumatic life events are associated with burnout-a cross-sectional twin study.
abstract: BACKGROUND
  Most burnout studies focus on symptoms of burnout in relation to work-related stress. However, recent studies have found that familial factors and stress in the personal life may also be of importance. Stressful and traumatic life events influence how individuals cope with stress over the life course and may therefore be associated with burnout symptoms.
  
  
  OBJECTIVE
  This study aims to assess the associations between stressful and traumatic life events and burnout symptoms in a population-based sample of twins, adjusting for familial confounding.
  
  
  METHODS
  In this cross-sectional questionnaire-based study of 25,378 Swedish twins, odds ratios (OR) with 95% confidence intervals (CI) were calculated using logistic regression analysis. First, the whole sample was analysed. Secondly, a matched co-twin analysis was conducted of the same-sex twin pairs discordant on burnout, in order to adjust for familial factors.
  
  
  RESULTS
  A history of traumatic life events was independently associated with burnout symptoms, with a cumulative effect with increasing number of events. ORs adjusted for familial confounding: 1-3 events OR 1.58 (CI = 1.21-2.07) 4 or more events OR 2.00 (CI = 1.45-2.75). Independent associations between the stressful life events: serious family problems OR 1.71 (CI = 1.36-2.15), physical illness OR 1.44 (CI = 1.17-1.77), divorce or separation OR 1.40 (CI = 1.15-1.70), and burnout symptoms were also found.
  
  
  CONCLUSIONS
  The results indicate that stressful and traumatic life events are of importance in the burnout process. This finding may have implications in efforts to prevent burnout.
authors.affiliation: Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, 17177, Stockholm, Sweden, lisa.mather@ki.se.
authors.forename: Lisa
authors.initials: L
authors.lastname: Mather
authors.forename: Victoria
authors.initials: V
authors.lastname: Blom
authors.forename: Pia
authors.initials: P
authors.lastname: Svedberg
mesh_terms: D000328:Adult; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008016:Life Change Events; D008297:Male; D013315:Stress, Psychological / Q000453:epidemiology*; D013548:Sweden / Q000453:epidemiology; D014427:Twins / Q000706:statistics & numerical data*; D055815:Young Adult