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Strikwerda M, Beulens JW, Remmelzwaal S, Schoonmade LJ, van Straten A, Schram MT, Elders PJ, Rutters F. The Association of Burnout and Vital Exhaustion With Type 2 Diabetes: A Systematic Review and Meta-Analysis. Psychosom Med 2021; 83:1013-1030. [PMID: 34334726 DOI: 10.1097/psy.0000000000000995] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE This study aimed to investigate the association of burnout and vital exhaustion with measures of glycemic control and type 2 diabetes (T2D) in a systematic review and meta-analysis. METHODS PubMed, Embase, and PsycINFO were searched from inception to April 2, 2020. Data extraction and quality assessment were performed using the Effective Public Health Practice Project tool. When possible, results were meta-analyzed using random-effects models and rated using the Grading of Recommendations, Assessment, Development and Evaluation. RESULTS A total of 5317 titles/abstracts were screened, 140 articles were read full text, of which 29 studies were included. Eighteen studies were cross-sectional, three prospective and eight were case-control studies. Burnout and vital exhaustion were significantly associated with T2D, with a pooled odds ratio of 1.8 (95% confidence interval [CI] = 1.4 to 2.4, I2 = 79%; 9 studies). Glycated hemoglobin A1c levels were not significantly higher in people with burnout and vital exhaustion, compared to those without, with a pooled standardized mean difference of 0.35 (95% CI = -0.62 to 1.33, I2 = 98%; 7 studies). In addition, no differences in glucose levels were observed (standardized mean difference = 0.02, 95% CI = -0.26 to 0.30, I2 = 90%; 9 studies). Sensitivity analyses showed no decrease in heterogeneity when excluding studies with low quality (I2glucose = 89%) or studies with a study n < 40 population (I2T2D = 77%). The level of Grading of Recommendations, Assessment, Development and Evaluation evidence was moderate to low quality because of 18 studies having a cross-sectional design. CONCLUSIONS Burnout and vital exhaustion might be associated with a higher risk of T2D, but not with glycemic control. Methodological shortcomings and high heterogeneity of the studies included complicate the interpretation of our results.
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Affiliation(s)
- Marije Strikwerda
- From the Amsterdam UMC, location VUmc, Department of Epidemiology and Data Science (Strikwerda, Beulens, Remmelzwaal, Rutters), Amsterdam Public Health Research Institute (Strikweda, Beulens, Remmelzwaal, Elders); Julius Centre for Health Sciences and Primary Care (Beulens), University Medical Centre Utrecht, Utrecht; the University Library (Schoonmade), VU, Amsterdam; Faculty of Behavioural and Movement Sciences and Amsterdam Public Health Research Institute (van Straten), Vrije Universiteit, HV Amsterdam; Department of Internal Medicine, Cardiovascular Research Institute Maastricht (CARIM), MHeNS School for Mental Health and Neuroscience (Schram), Maastricht University Medical Center+, Maastricht; and Amsterdam UMC, location VUmc, Department of General Practice (Elders), Amsterdam Public Health Research Institute, Amsterdam, the Netherlands
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Brand S, Ebner K, Mikoteit T, Lejri I, Gerber M, Beck J, Holsboer-Trachsler E, Eckert A. Influence of Regular Physical Activity on Mitochondrial Activity and Symptoms of Burnout-An Interventional Pilot Study. J Clin Med 2020; 9:jcm9030667. [PMID: 32131484 PMCID: PMC7141353 DOI: 10.3390/jcm9030667] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2020] [Revised: 02/26/2020] [Accepted: 02/26/2020] [Indexed: 12/20/2022] Open
Abstract
Background: Occupational burnout is both a serious public and individual health concern. Psychopharmacological and psychological interventions are often employed, while interventions involving physical activity have been less frequently studied. The aims of the present study were (1) to investigate the effects of physical activity on mitochondrial activity levels and symptoms of burnout, (2) to compare the mitochondrial activity levels and symptoms of burnout of individuals suffering burnout with those of healthy controls (HCs), and (3) to explore the associations between mitochondrial activity and burnout symptoms. Methods: Twelve males with burnout (mean age: M = 45.8 years) took part in the study. At baseline and after 12 weeks of an intervention involving physical activity, participants completed questionnaires covering symptoms of burnout and depression. In parallel, blood samples were taken to measure changes in mitochondrial functional outcomes, such as ATP levels, oxygen consumption and complex I. For comparison, baseline values of healthy controls (HCs; depression and burnout questionnaires; blood samples) were assessed. Results: Over time, symptoms of burnout (emotional exhaustion and depersonalization) and depression significantly decreased in participants with burnout (large effect sizes) but remained significantly higher than those of HCs (medium to large effect sizes). Personal accomplishment increased over time (medium effect size) but was still lower than for HCs (large effect size). At baseline and compared to HCs, individuals with burnout had significantly lower ATP levels of mitochondrial functional outcomes. Over time, mitochondrial activity levels increased among individuals with burnout. High baseline mitochondrial activity was significantly correlated with lower depression and burnout scores both at baseline and at the end of the study. Conclusions: In individuals with burnout, regular physical activity had positive effects on mitochondrial activity and on symptoms of burnout and depression. However, when compared to healthy controls, full remission was not achieved.
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Affiliation(s)
- Serge Brand
- Psychiatric Clinics (UPK), Center for Affective, Stress and Sleep Disorders, University of Basel, 4001 Basel, Switzerland; (T.M.); (E.H.-T.)
- Department of Sport, Exercise and Health, Division of Sport Science and Psychosocial Health, University of Basel, 4052 Basel, Switzerland;
- Substance Abuse Prevention Research Center, Health Institute, Kermanshah University of Medical Sciences (KUMS), 6719851115 Kermanshah, Iran
- Sleep Disorders Research Center, Kermanshah University of Medical Sciences (KUMS), 6719851115 Kermanshah, Iran
- School of Medicine, Tehran University of Medical Sciences, 1416753955 Tehran, Iran
- Correspondence: ; Tel.: +41-6132-5509-7
| | - Katarina Ebner
- Transfaculty Research Platform, Molecular and Cognitive Neuroscience, Neurobiology Laboratory for Brain Aging and Mental Health, Psychiatric Clinics (UPK), University of Basel, 4001 Basel, Switzerland; (K.E.); (I.L.); (A.E.)
| | - Thorsten Mikoteit
- Psychiatric Clinics (UPK), Center for Affective, Stress and Sleep Disorders, University of Basel, 4001 Basel, Switzerland; (T.M.); (E.H.-T.)
- Psychiatric Services Solothurn and Faculty of Medicine of the University of Basel, 4503 Solothurn, Switzerland
| | - Imane Lejri
- Transfaculty Research Platform, Molecular and Cognitive Neuroscience, Neurobiology Laboratory for Brain Aging and Mental Health, Psychiatric Clinics (UPK), University of Basel, 4001 Basel, Switzerland; (K.E.); (I.L.); (A.E.)
| | - Markus Gerber
- Department of Sport, Exercise and Health, Division of Sport Science and Psychosocial Health, University of Basel, 4052 Basel, Switzerland;
| | - Johannes Beck
- Psychiatric Hospital Sonnenhalde, 4125 Riehen, Switzerland;
| | - Edith Holsboer-Trachsler
- Psychiatric Clinics (UPK), Center for Affective, Stress and Sleep Disorders, University of Basel, 4001 Basel, Switzerland; (T.M.); (E.H.-T.)
| | - Anne Eckert
- Transfaculty Research Platform, Molecular and Cognitive Neuroscience, Neurobiology Laboratory for Brain Aging and Mental Health, Psychiatric Clinics (UPK), University of Basel, 4001 Basel, Switzerland; (K.E.); (I.L.); (A.E.)
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Frenetic, under-Challenged, and Worn-out Burnout Subtypes among Brazilian Primary Care Personnel: Validation of the Brazilian "Burnout Clinical Subtype Questionnaire" (BCSQ-36/BCSQ-12). INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17031081. [PMID: 32046282 PMCID: PMC7036968 DOI: 10.3390/ijerph17031081] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/12/2019] [Revised: 02/03/2020] [Accepted: 02/06/2020] [Indexed: 11/16/2022]
Abstract
Primary healthcare personnel show high levels of burnout. A new model of burnout has been developed to distinguish three subtypes: frenetic, under-challenged, and worn-out, which are characterized as overwhelmed, under-stimulated, and disengaged at work, respectively. The aim of this study was to assess the psychometric properties of the long/short Brazilian versions of the "Burnout Clinical Subtypes Questionnaire" (BCSQ-36/BCSQ-12) among Brazilian primary healthcare staff and its possible associations with other psychological health-related outcomes. An online cross-sectional study conducted among 407 Brazilian primary healthcare personnel was developed. Participants answered a Brazil-specific survey including the BCSQ-36/BCSQ-12, "Maslach Burnout Inventory-General Survey", "Utrecht Work Engagement Scale", "Hospital Anxiety/Depression Scale", "Positive-Negative Affect Schedule", and a Visual Analogue Scale of guilt at work. The bifactor was the model with the best fit to the data using the BCSQ-36, which allowed a general factor for each subtype. The three-correlated factors model fit better to the BCSQ-12. Internal consistence was appropriate, and the convergence between the long-short versions was high. The pattern of relationships between the burnout subtypes and the psychological outcomes suggested a progressive deterioration from the frenetic to the under-challenged and worn-out. In sum, the Brazilian BCSQ-36/BCSQ-12 showed appropriate psychometrics to be used in primary healthcare personnel.
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Nuss P, Tessier C, Masson M, Fossati P, Gaillard R, Lapidus N, Gourion D. Factors Associated With a Higher Score of Burnout in a Population of 860 French Psychiatrists. Front Psychiatry 2020; 11:371. [PMID: 32457663 PMCID: PMC7224256 DOI: 10.3389/fpsyt.2020.00371] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2019] [Accepted: 04/14/2020] [Indexed: 11/13/2022] Open
Abstract
Burnout rates are estimated to be twice as high among healthcare professionals as in the general working population, and studies indicate rising incidence. The present study aimed to identify the contextual factors associated with self-reported burnout rates among French psychiatrists. A total of 860 French or French-speaking psychiatrists completed an online questionnaire when they registered for a major psychiatric conference. The Copenhagen Burnout Inventory, a validated scale that independently appraises personal, work- and patient-related dimensions, was used to assess the degree of perceived burnout. Respondents were divided into lower risk and higher risk groups. The latter contained the 25% of individuals who scored the highest on each of the three dimensions of the CBI scale. Univariate analysis showed that private practice was associated with lower levels of risk on the personal and work-related dimensions. Working for the public sector and long hours were both associated with a higher score on the work-related dimension. Interestingly, none of the variables we investigated, except from poor atmosphere at work, correlated with the patient-related dimension. Among public-sector psychiatrists, female gender, longer hours, and more consultations per week were associated with a higher score on the work-related dimension. Working four or more night shifts per month was significantly associated with a higher score of burnout risk on all three dimensions. Private- and public-sector practitioners who mainly treated patients with schizophrenia had a higher score of burnout risk. Multivariate analysis showed that a poor atmosphere at work, longer hours, and working four or more night shifts were significantly associated with higher score of burnout risk. A nonreassuring working environment and more stressors while treating patients each had a possibly negative impact. Although this study only examined the factors that distinguish between clinicians with the lowest versus highest CBI burnout risk scores, it opens up important avenues for research and development of programs to reduce burnout risk within the French healthcare system.
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Affiliation(s)
- Philippe Nuss
- AP-HP, Service de Psychiatrie et de Psychologie Médicale, Paris, France.,Sorbonne Université, INSERM, Centre de Recherche Saint-Antoine, CRSA, UMRS 938, Paris, France
| | - Cedric Tessier
- AP-HP, Service de Psychiatrie et de Psychologie Médicale, Paris, France
| | - Marc Masson
- Nightingale Hospitals, Château de Garches Clinic, Garches, France.,Department of Psychiatry, Sainte-Anne Hospital, Paris, France
| | - Philippe Fossati
- Institut du cerveau et de la moelle epiniere, INSERM U 1127, Paris, France.,Sorbonne Université, CNRS UMR 7225, Paris, France.,AP-HP, Department of Adult Psychiatry, Pitie Salpetriere Hospital, Paris, France
| | - Raphaël Gaillard
- Centre Hospitalier Sainte Anne, Service Hospitalo-universitaire de Psychiatrie, Paris, France
| | - Nathanaël Lapidus
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique IPLESP, AP-HP.Sorbonne Université, Public Health Department, Saint-Antoine Hospital, Paris, France
| | - David Gourion
- Department of Psychiatry, Sainte-Anne Hospital, Paris, France.,Hautes etudes de commerce (HEC) Paris Business School, Jouy-en-Josas, France
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Jahangard L, Hedayati M, Abbasalipourkabir R, Haghighi M, Ahmadpanah M, Faryadras M, Mikoteit T, Sadeghi Bahmani D, Brand S. Omega-3-polyunsatured fatty acids (O3PUFAs), compared to placebo, reduced symptoms of occupational burnout and lowered morning cortisol secretion. Psychoneuroendocrinology 2019; 109:104384. [PMID: 31382171 DOI: 10.1016/j.psyneuen.2019.104384] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2019] [Revised: 07/11/2019] [Accepted: 07/17/2019] [Indexed: 01/06/2023]
Abstract
BACKGROUND Occupational burnout is both a serious health concern at both public and individual levels. Treatment options are psychopharmacological, psychological and physical activity-related interventions. Here, we tested whether, compared to placebo, omega-3-polyunsaturated fatty acids (O3PUFAs) have a positive impact on burnout and morning cortisol secretion. METHOD A total of 43 individuals (mean age: 38.4 years, 76.7% females) took part in the present double-blind and placebo-controlled intervention. Participants were randomly assigned either to the O3PUFA or to the placebo condition. At baseline and again eight weeks later, participants completed the Maslach Burnout Inventory and collected morning saliva samples for analysis of the cortisol awakening response (CAR). RESULTS Emotional exhaustion and depersonalization decreased, and sense of personal accomplishment increased over time, but more so in the O3PUFA condition than in the placebo condition. Likewise, CAR decreased over time, but again more so in the O3PUFA condition than in the placebo condition. CONCLUSIONS The present pattern of results suggests that, compared to placebo, administration of daily omega-3-polyunsaturated fatty acids for eight consecutive weeks positively influences both psychological and physiological markers of occupational burnout.
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Affiliation(s)
- Leila Jahangard
- Research Center for Behavioral Disorders and Substance Abuse, Hamadan University of Medical sciences, Hamadan, Iran
| | - Mahmoud Hedayati
- Research Center for Behavioral Disorders and Substance Abuse, Hamadan University of Medical sciences, Hamadan, Iran
| | | | - Mohammad Haghighi
- Research Center for Behavioral Disorders and Substance Abuse, Hamadan University of Medical sciences, Hamadan, Iran
| | - Mohammad Ahmadpanah
- Research Center for Behavioral Disorders and Substance Abuse, Hamadan University of Medical sciences, Hamadan, Iran
| | - Mohammad Faryadras
- Department of Biostatistics and Epidemiology, School of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Thorsten Mikoteit
- University of Basel, Psychiatric Clinics, Center for Affective, Stress and Sleep Disorders, Basel, Switzerland; University of Basel, Psychiatric Hospital Solothurn, Solothurn, Switzerland
| | - Dena Sadeghi Bahmani
- University of Basel, Psychiatric Clinics, Center for Affective, Stress and Sleep Disorders, Basel, Switzerland; Kermanshah University of Medical Sciences (KUMS), Substance Abuse Prevention Research Center, Kermanshah, Iran; Kermanshah University of Medical Sciences (KUMS), Sleep Disorders Research Center, Kermanshah, Iran; Isfahan University of Medical Sciences, Neurosciences Research Center, Alzahra Research Institute, Isfahan, Iran
| | - Serge Brand
- University of Basel, Psychiatric Clinics, Center for Affective, Stress and Sleep Disorders, Basel, Switzerland; Kermanshah University of Medical Sciences (KUMS), Substance Abuse Prevention Research Center, Kermanshah, Iran; Kermanshah University of Medical Sciences (KUMS), Sleep Disorders Research Center, Kermanshah, Iran; University of Basel, Department of Sport, Exercise and Health, Division of Sport Science and Psychosocial Health, Basel, Switzerland.
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Schilling R, Colledge F, Brand S, Ludyga S, Gerber M. Psychometric Properties and Convergent Validity of the Shirom-Melamed Burnout Measure in Two German-Speaking Samples of Adult Workers and Police Officers. Front Psychiatry 2019; 10:536. [PMID: 31427997 PMCID: PMC6688652 DOI: 10.3389/fpsyt.2019.00536] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2019] [Accepted: 07/10/2019] [Indexed: 01/05/2023] Open
Abstract
Burnout is considered an occupation-related psychological syndrome consisting of emotional, physical, and cognitive exhaustion. To assess dimensions of burnout, the Shirom-Melamed Burnout Measure (SMBM) is widely used, but its validity and reliability have rarely been examined in adult samples. The aim of this study is to examine the psychometric properties of the German version of the SMBM in two independent samples of adults. In total, 311 adult workers and 201 police officers completed the SMBM, and questionnaires related to perceived stress and mental well-being. Descriptive statistics, internal consistency, convergent validity, and factorial validity were assessed for both samples, separately for male and female participants. The German SMBM had adequate psychometric properties and sufficient convergent validity. In confirmatory factor analyses, we found a good fit for both the first- and second-order model. Furthermore, measurement invariance across gender was observed in both samples. Although the SMBM is a popular instrument among burnout researchers, this study demonstrates for the first time that the SMBM can be considered a valid and reliable tool to assess burnout symptoms in both male and female adults and across different professional groups. Furthermore, with its 14 items, the SMBM is a succinct and economic self-assessment tool for symptoms of burnout.
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Affiliation(s)
- René Schilling
- Department of Sport, Exercise and Health at the University of Basel, Basel, Switzerland
| | - Flora Colledge
- Department of Sport, Exercise and Health at the University of Basel, Basel, Switzerland
| | - Serge Brand
- Department of Sport, Exercise and Health at the University of Basel, Basel, Switzerland.,Center for Affective, Stress and Sleep Disorders, Psychiatric Clinics of the University of Basel, Basel, Switzerland.,Department of Psychiatry, Kermanshah University of Medical Sciences (KUMS), Substance Abuse Prevention Research Center and Sleep Disorders Research Center Kermanshah, Kermanshah, Iran
| | - Sebastian Ludyga
- Department of Sport, Exercise and Health at the University of Basel, Basel, Switzerland
| | - Markus Gerber
- Department of Sport, Exercise and Health at the University of Basel, Basel, Switzerland
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Volden S, Wimmelmann CL, Flensborg-Madsen T. Reply to the letter "Does vital exhaustion enhance our ability to predict type 2 diabetes?" written by Dr. Renzo Bianchi and Dr. Eric Laurent. J Psychosom Res 2017; 101:138-139. [PMID: 28843378 DOI: 10.1016/j.jpsychores.2017.08.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2017] [Accepted: 08/16/2017] [Indexed: 10/19/2022]
Affiliation(s)
- Sasia Volden
- The Copenhagen City Heart Study, Hovedvejen, Entrance 5, 1st floor, Frederiksberg Hospital, 2000 Frederiksberg, Denmark.
| | - Cathrine Lawaetz Wimmelmann
- Department of Public Health, University of Copenhagen, Øster Farimagsgade 5, Building, 05, 1353 Copenhagen, Denmark; Center for Healthy Aging, University of Copenhagen, Blegdamsvej 3B, 2200 Copenhagen, Denmark
| | - Trine Flensborg-Madsen
- Department of Public Health, University of Copenhagen, Øster Farimagsgade 5, Building, 05, 1353 Copenhagen, Denmark; Center for Healthy Aging, University of Copenhagen, Blegdamsvej 3B, 2200 Copenhagen, Denmark
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Does vital exhaustion enhance our ability to predict type 2 diabetes? J Psychosom Res 2017; 101:137. [PMID: 28802739 DOI: 10.1016/j.jpsychores.2017.08.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2017] [Accepted: 08/01/2017] [Indexed: 11/24/2022]
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