title: Burnout Is Associated with Reduced Parasympathetic Activity and Reduced HPA Axis Responsiveness, Predominantly in Males.
abstract: There is mounting evidence that burnout is a risk factor for cardiovascular disease (CVD). Stress-related dysregulation of the sympathetic and parasympathetic system and the hypothalamic pituitary adrenal (HPA) axis may explain the enhanced risk for CVD. To test this hypothesis, 55 patients (34 males and 21 females) with burnout on sickness absence and 40 healthy participants (16 males and 24 females) were exposed to a psychosocial stressor consisting of mental arithmetic and public speech. Physiological variables (i.e., blood pressure, heart rate, cardiac output, vascular resistance, cortisol, and alpha-amylase) were measured. Basal levels, reactivity, and recovery were compared between groups. In male patients, baseline systolic blood pressure was higher, whereas basal alpha-amylase and cortisol reactivity were lower than in healthy males. In female patients, a tendency for lower basal cortisol was found as compared to healthy females. Furthermore, reduced basal heart rate variability and a trend for elevated basal cardiac output were observed in both male and female patients. Burnout is characterised by dysregulation of the sympathetic and parasympathetic system and the HPA axis, which was more pronounced in males than in females. This study further supports burnout as being a risk factor for CVD through dysregulation of the sympathetic and parasympathetic system and the HPA axis.
authors.affiliation: Department of Clinical Psychology, University of Amsterdam, Weesperplein 4, 1018 XA Amsterdam, Netherlands ; Research Institute Child Development and Education, University of Amsterdam, P.O. Box 15776, 1001 NG Amsterdam, Netherlands.
authors.forename: Wieke
authors.initials: W
authors.lastname: de Vente
authors.affiliation: Amsterdam Institute for Addiction Research, Academic Medical Center, P.O. Box 75867, 1070 AW Amsterdam, Netherlands.
authors.forename: Jan G C
authors.initials: JG
authors.lastname: van Amsterdam
authors.affiliation: Center for Psychological Trauma, Department of Psychiatry, Academic Medical Center, P.O. Box 22660, 1100 DD Amsterdam, Netherlands.
authors.forename: Miranda
authors.initials: M
authors.lastname: Olff
authors.affiliation: Department of Clinical Psychology, University of Amsterdam, Weesperplein 4, 1018 XA Amsterdam, Netherlands.
authors.forename: Jan H
authors.initials: JH
authors.lastname: Kamphuis
authors.affiliation: Department of Clinical Psychology, University of Amsterdam, Weesperplein 4, 1018 XA Amsterdam, Netherlands ; Netherlands Institute for Advanced Study, Meijboomlaan 1, 2242 PR Wassenaar, Netherlands ; The Center for Social and Humanities Research, King Abdulaziz University, P.O. Box 80 202, Jeddah 21589, Saudi Arabia.
authors.forename: Paul M G
authors.initials: PM
authors.lastname: Emmelkamp
mesh_terms: D000328:Adult; D001794:Blood Pressure / Q000502:physiology; D005260:Female; D006339:Heart Rate / Q000502:physiology; D006801:Humans; D006854:Hydrocortisone / Q000378:metabolism; D007030:Hypothalamo-Hypophyseal System / Q000503:physiopathology*; D008297:Male; D010275:Parasympathetic Nervous System / Q000503:physiopathology*; D010913:Pituitary-Adrenal System / Q000503:physiopathology*; D013315:Stress, Psychological / Q000150:complications* / Q000503:physiopathology*; D000516:alpha-Amylases / Q000378:metabolism
chemical_list: D000516:alpha-Amylases; D006854:Hydrocortisone