title: Indication of attenuated DHEA-s response during acute psychosocial stress in patients with clinical burnout.
abstract: OBJECTIVE
  Dehydroepiandrosterone sulphate (DHEA-s) is an anabolic protective hormone. We have previously reported that DHEA-s production capacity is attenuated in stressed individuals. The aim of the present study was to investigate the DHEA-s response during acute psychosocial stress in patients with clinical burnout.
  
  
  METHODS
  Seventeen patients with clinical burnout were compared to 13 non-chronically stressed healthy controls, aged 31-50 years (mean age 41 years, SD 6 years), as they underwent the Trier Social Stress Test (TSST). All patients fulfilled diagnostic criteria for stress-related exhaustion disorder, which is a criteria-based diagnosis that has been used in Sweden since 2005 to define patients seeking health-care for clinical burnout. Blood samples were collected before, directly after the stress test, and after 30 min of recovery. DHEA-s levels were measured and delta values (peak levels minus baseline levels) plus area under the curve with respect to increase (AUCI) were calculated.
  
  
  RESULTS
  The patients had 43% smaller AUCI DHEA-s (p=0.041) during the stress test. The delta DHEA-s was 34% lower in the patients, however, this difference was not statistically significant (p=0.054).
  
  
  CONCLUSIONS
  The study indicates that DHEA-s production capacity during acute stress may be attenuated in patients with clinical burnout. Reduced DHEA-s production may constitute one of the links between stress, burnout and the associated adverse health.
authors.affiliation: The Institute of Stress Medicine, Göteborg, Sweden. Electronic address: anna-karin.lennartsson@vgregion.se.
authors.forename: Anna-Karin
authors.initials: AK
authors.lastname: Lennartsson
authors.affiliation: The Institute of Stress Medicine, Göteborg, Sweden.
authors.forename: Anna
authors.initials: A
authors.lastname: Sjörs
authors.affiliation: The Institute of Stress Medicine, Göteborg, Sweden.
authors.forename: Ingibjörg H
authors.initials: IH
authors.lastname: Jonsdottir
mesh_terms: D000324:Adrenocorticotropic Hormone / Q000097:blood; D000328:Adult; D019540:Area Under Curve; D002055:Burnout, Professional / Q000097:blood* / Q000523:psychology*; D019314:Dehydroepiandrosterone Sulfate / Q000097:blood*; D005260:Female; D006304:Health Status; D006801:Humans; D008297:Male; D008603:Mental Health; D008875:Middle Aged; D009483:Neuropsychological Tests; D012727:Sex Characteristics; D012931:Social Environment; D013315:Stress, Psychological / Q000097:blood* / Q000523:psychology*; D013548:Sweden
chemical_list: D019314:Dehydroepiandrosterone Sulfate; D000324:Adrenocorticotropic Hormone
keywords: Acute stress response; Clinical burnout; Dehydroepiandrosterone sulphate; Trier Social Stress Test