Stress-related exhaustion disorder--clinical manifestation of burnout? A review of assessment methods, sleep impairments, cognitive disturbances, and neuro-biological and physiological changes in clinical burnout.
The aim of this paper was to provide an overview of the literature on clinically significant burnout, focusing on its assessment, associations with sleep disturbances, cognitive impairments, as well as neurobiological and physiological correlates. Fifty-nine English language articles and six book chapters were included. The results indicate that exhaustion disorder (ED), as described in the Swedish version of the International Classification of Diseases, seems to be the most valid clinical equivalent of burnout. The data supports the notion that sleep impairments are causative and maintaining factors for this condition. Patients with clinical burnout/ED suffer from cognitive impairments in the areas of memory and executive functioning. The studies on neuro-biological mechanisms have reported functional uncoupling of networks relating the limbic system to the pre-frontal cortex, and decreased volumes of structures within the basal ganglia. Although there is a growing body of literature on the physiological correlates of clinical burnout/ED, there is to date no biomarker for this condition. More studies on the role of sleep disturbances, cognitive impairments, and neurobiological and physiological correlates in clinical burnout/ED are warranted.
Stress Research Institute, Stockholm University, Stockholm, Sweden.|The Stress Clinic Foundation, Stockholm, Sweden.|Center for Social Sustainability, Department of Neurobiology, Care Sciences and Society, Karolinska institute, Stockholm, Sweden.
Giorgio
G
Grossi
Stress Research Institute, Stockholm University, Stockholm, Sweden.|The Stress Clinic Foundation, Stockholm, Sweden.
Aleksander
A
Perski
Center for Social Sustainability, Department of Neurobiology, Care Sciences and Society, Karolinska institute, Stockholm, Sweden.
Walter
W
Osika
Department of Women's and Children's Health, and Neurology Clinic, Karolinska Institute and Hospital, Stockholm, Sweden.
Ivanka
I
Savic
D002055:Burnout, Professional / Q000175:diagnosis* / Q000523:psychology; D003071:Cognition / Q000502:physiology; D003072:Cognition Disorders / Q000175:diagnosis* / Q000523:psychology; D056344:Executive Function / Q000502:physiology; D006801:Humans; D008568:Memory / Q000502:physiology; D009483:Neuropsychological Tests; D012893:Sleep Wake Disorders / Q000175:diagnosis* / Q000523:psychology; D013315:Stress, Psychological / Q000175:diagnosis* / Q000523:psychology
Clinical burnout; assessment; brain; cognition; exhaustion disorder; physiology; sleep; stress