The Association of Burnout and Vital Exhaustion With Type 2 Diabetes: A Systematic Review and Meta-Analysis

Study of glucose homeostasis in burnout cases using an oral glucose tolerance test

Burnout is caused by long term psychosocial stress and has, besides the fatigue and mental health burden, been associated with increased risk of adverse physical health, such as for example type 2 diabetes. This study aims to investigate the glucose and insulin levels in individuals with stress related burnout, by assessing these metabolic markers in response to a standard oral glucose tolerance test (OGTT). 38 cases with burnout (13 men and 25 women) and 35 healthy controls (13 men and 22 women) in the age 24-55 were included in the study. The burnout group overall did not differ from healthy controls in glucose or insulin levels during the OGTT. However, the burnout cases who reported more severe burnout symptoms exhibited significantly higher levels of both glucose and insulin levels during the OGTT compared to burnout cases reporting lower severity of symptoms. Furthermore, the group of burnout cases who reported symptoms of depression exhibited higher insulin levels during OGTT compared to the burnout cases without depressive symptoms. The observed higher levels in the burnout cases with most severe symptoms indicate an increased diabetic risk in these patients and it may be of importance to follow glucose and insulin levels in individuals with more severe symptoms of burnout i.e. to perform an OGTT.

Is vital exhaustion distinct? A meta-analytic investigation on the immediate nomological network of vital exhaustion

A multitude of studies have supported that vital exhaustion is an important predictor of physical and psychological well-being, especially in the aftermath of adverse medical events; however, some authors have expressed that vital exhaustion may be repetitive with other popular constructs, namely burnout, fatigue, and depression. We resolve this tension by performing a meta-analysis of 74 sources on the immediate nomological network of vital exhaustion. Our results support that the relations of vital exhaustion with emotional exhaustion (r ¯  = 0.71, ρ ¯  = 0.82, k = 4, n = 1152) and depression (r ¯  = 0.70, ρ ¯  = 0.83, k = 59, n = 30,963) approached the magnitude of its convergent validity correlation (r ¯  = 0.75, ρ ¯  = 0.88, k = 4, n = 1445), suggesting that these constructs share most of their variance. Researchers should reinvestigate whether vital exhaustion relates to outcomes when accounting for these two constructs.

The Short Version of the Italian Maastricht Vital Exhaustion Questionnaire (MVEQ): Psychometric Properties and Relationships with Anxiety, Depression, and Stress in a Community Sample of Older Adults

Vital Exhaustion (VE) refers to a physical and mental state of excessive fatigue, feelings of demoralization, hopelessness, and increased irritability. The short form of the Maastricht Vital Exhaustion Questionnaire (MVEQ) is a widely used measure to assess VE. Despite its utility is broadly recognized, the validity and reliability of the scale have yet to be examined in the Italian context. The present study aimed to evaluate the psychometric properties of the shortened MVEQ in a community sample of Italian older adults. A total of 722 older adults (Mage = 72.97, SD = 7.71; 60.4% females) completed the MVEQ, as well as other self-report questionnaires assessing anxiety, depression and stress in order to evaluate the criterion-related validity of the scale. A confirmatory factor analysis (CFA) was conducted to examine the original MVEQ latent structure. Internal consistency was assessed through model-based omega coefficient. Test-retest reliability was examined by re-administering the MVEQ after three months to a subsample of 568 participants. Factorial invariance tests across gender were conducted by means of multi-group CFAs. The one-factor model showed an acceptable fit to the data. The MVEQ yielded a reliable total score (ω = 0.822) and showed moderate-to-large correlations with measures of anxiety, depression, and stress (r range 0.30 to 0.75, ps < 0.001). Test-retest reliability was supported by an Intraclass Correlation Coefficient (ICC) of 0.661. Lastly, the scale was factorially invariant across gender. Overall, the MVEQ provided evidence of reliability and criterion-related validity in a sample of Italian older adults and may be useful for both clinical and research practices.

Relationship between Marriage and Prediabetes among Healthcare Workers: Mediating Effect of Triglycerides

Background and Objectives: In the literature, relationships between being married and having prediabetes or diabetes are inconsistent. We aimed to investigate whether marriage is a protective or risk factor for prediabetes and to uncover new insights into its impact on prediabetes. Materials and Methods: In this cross-sectional observational study, questionnaires were distributed by email to 1039 staff members who participated in an employee health check from a hospital affiliated with a medical university in Taiwan. Fasting blood glucose and triglyceride (TG) levels were checked and the questionnaires elicited basic demographic characteristics and included the Copenhagen Burnout Inventory and Nordic Musculoskeletal Questionnaire. The chi-square test or Fisher's exact test, logistic regression, and mediation analysis were conducted for statistical analysis. Results: Among the group aged 20-37 years, married (OR = 1.89, 95%CI: 1.08, 3.33), obesity (OR = 2.95, 95%CI: 1.49, 5.83), neck and shoulder pain (OR = 1.31, 95%CI: 1.01, 1.69), and elevated TG levels (OR = 1.01, 95%CI: 1.00, 1.01) were independent risk factors for prediabetes (impaired fasting glucose). For those >38 years old, overweight (OR = 2.08, 95%CI: 1.27, 3.43), obesity (OR = 4.30, 95%CI: 2.38, 7.79), and elevated triglyceride (TG) (OR = 1.003, 95%CI: 1.00, 1.01) were the independent risk factors for impaired fasting glucose. Increased TG levels serve as a mediating factor (Zm = 2.64, p < 0.01) linking marriage to an increased risk of prediabetes for the group aged 20-37 years. Conclusions: TGs play a significant role in the association between marriage and prediabetes among the group aged 20-37 years. Therefore, dietary habits, especially those of young adult couples should be considered. Our findings connect marital status to prediabetes, facilitating advances in diabetes prevention.

Effects of environmental and genetic interactions on job burnout in coal miners: interactions between occupational stress, coping styles, and NR3C2 gene polymorphisms

Objectives

To investigate the current situation regarding occupational burnout among coal miners, explore the relationship between NR3C2 gene polymorphism and occupational burnout, and analyze the influence of the interaction between environment and gene on occupational burnout. This study provides a scientific basis for formulating health strategies to combat job burnout.

Methods

A total of 1,500 first-line coal mine workers were selected by cluster random sampling, and the job burnout scale, job content questionnaire (JCQ), and simplified coping style questionnaire (SCSQ) were used for the questionnaire survey. A total of 150 workers were randomly selected from the high burnout group and the low burnout group, and a total of 300 workers were selected as the research objects to examine the relationship between gene polymorphism, environment-gene interactions and burnout. This study employed iMLDRTM genotyping technology for NR3C2 gene (rs5522, rs2070950) polymorphism analysis. The relationship between the occurrence of job burnout, occupational stress, coping styles and the NR3C2 gene was analyzed.

Results

Finally, a total of 1,282 valid questionnaires were retrieved, with an effective recovery rate of 85.5%. The study included 128 participants (10%) with zero burnout, 400 (31.2%) with mild burnout, 649 (50.6%) with moderate burnout and 105 (8.2%) with severe burnout. There were significant differences in the rate of burnout among miners with respect to sex, age, working years, educational level, shifts, and marital status (P < 0.05). The difference in occupational stress between the different job burnout groups was statistically significant (P < 0.05). Compared with the GG genotype of rs2070950 of the NR3C2 gene, the CC genotype was identified as a susceptibility gene for occupational burnout (P < 0.05). In respect to rs5522, rs2070950, occupational stress, positive coping, and negative coping, the low-risk group was unlikely to suffer from job burnout compared with the high-risk group (OR = 0.103, 95%CI: 0.058-0.182).

Conclusion

In addition to demographic characteristics, occupational stress and negative coping styles were also identified as risk factors for job burnout. The interaction between locus rs5522, locus rs2070950, occupational stress, positive response, and negative response were found to affect the incidence of occupational burnout.

Towards a new approach to job-related distress: A three-sample study of the Occupational Depression Inventory

The Occupational Depression Inventory (ODI) was recently developed to assess depressive symptoms that individuals specifically attribute to their work. One purpose of the ODI is to respond to limitations of current assessments of job-related distress, most notably, assessments relying on the burnout construct. In this study, we conducted a thorough examination of the psychometric and structural properties of the ODI using exploratory structural equation modelling bifactor analysis and Mokken scale analysis. The study involved three samples of employed individuals, recruited in France (N = 3454), Switzerland (N = 1971), and Australia (N = 1485). Results were consistent across the three samples. The ODI exhibited essential unidimensionality and excellent total-score reliability-as indexed by McDonald's omega, Cronbach's alpha, Guttman's lambda-2, and the Molenaar-Sijtsma statistic. We found evidence for measurement invariance across sexes, age groups, and samples. Mokken scale analysis revealed that the ODI's scalability was strong. No monotonicity violation was detected. Invariant item ordering showed sufficient accuracy. In all three samples, suicidal ideation was the least commonly endorsed item-thus acting as a sentinel item-and fatigue/loss of energy was the most commonly endorsed item. The ODI exhibits excellent psychometric and structural properties, suggesting that occupational health specialists can effectively employ the instrument.

Diabetes distress in adult patients with type 1 and type 2 diabetes

Background: Diabetes is a chronic and demanding condition, exposing patients to complex physical and mental challenges, and making them particularly vulnerable to distress. Diabetes distress related to disease in diabetic patients is a term encompassing challenges associated with the psychosocial adaptation required of these individuals. Aim of the study: To assess distress in patients with diabetes mellitus. Material and methods: This study was conducted among 107 patients with type 1 and 2 diabetes mellitus reporting for follow-up at a diabetes clinic. The Diabetes Distress Scale (DDS) was used for data collection. Results: Moderate and severe diabetes distress was found in 36.4% and 15% of respondents in the study group, respectively. The total mean score for the DDS was 2.19. The largest percentages of respondents with high levels of distress were observed in patients with a financial situation rated lower than good (30.6%), those having less than secondary education (28.0%), and those under 30 years of age (27.8%). Patients with type 1 diabetes (26.9%), a disease duration > 30 years (30.8%), those using insulin pump therapy (30%) or CGM (Continuous Glucose Monitoring) and FGM (Flash Glucose Monitoring) systems (50%), and those showing ≥ 3 chronic diabetic complications (37.5%) experienced severe distress. Conclusions: Overall, diabetic patients showed a moderate level of distress. The greatest inconveniences caused by the disorder were associated with regimen-related distress and emotional burden. Rural patients with a lower level of education and a lower financial status showed higher levels of distress. Patients experiencing chronic complications from diabetes and those with higher levels of glycated hemoglobin also presented with more severe distress.

The role of mental disorders in precision medicine for diabetes: a narrative review

This narrative review aims to examine the value of addressing mental disorders as part of the care of people with type 1 and type 2 diabetes in terms of four components of precision medicine. First, we review the empirical literature on the role of common mental disorders in the development and outcomes of diabetes (precision prevention and prognostics). We then review interventions that can address mental disorders in individuals with diabetes or at risk of diabetes (precision treatment) and highlight recent studies that have used novel methods to individualise interventions, in person and through applications, based on mental disorders. Additionally, we discuss the use of detailed assessment of mental disorders using, for example, mobile health technologies (precision monitoring). Finally, we discuss future directions in research and practice and challenges to addressing mental disorders as a factor in precision medicine for diabetes. This review shows that several mental disorders are associated with a higher risk of type 2 diabetes and its complications, while there is suggestive evidence indicating that treating some mental disorders could contribute to the prevention of diabetes and improve diabetes outcomes. Using technologically enabled solutions to identify mental disorders could help individuals who stand to benefit from particular treatments. However, there are considerable gaps in knowledge and several challenges to be met before we can stratify treatment recommendations based on mental disorders. Overall, this review demonstrates that addressing mental disorders as a facet of precision medicine could have considerable value for routine diabetes care and has the potential to improve diabetes outcomes.

Mediation Effect of Musculoskeletal Pain on Burnout: Sex-Related Differences

Burnout occurs when people are exposed to emotionally demanding work situations over an extended period, resulting in physical, emotional, and mental exhaustion. This study adopted the personal burnout (PB) and work-related burnout (WB) scales of the Copenhagen Burnout Inventory to measure burnout levels. Musculoskeletal (MS) pain is one factor influencing burnout. Previous studies have demonstrated that male and female hormones may contribute to sex-related differences in MS pain. This was an observational and cross-sectional study conducted at a medical-university-affiliated hospital in Taichung, Taiwan, in 2021. Data were collected for demographic characteristics, family structure, living habits, occupation, physical health, Nordic Musculoskeletal Questionnaire score, and Copenhagen Burnout Inventory score. Of the 2531 questionnaires that were distributed, 1615 (63.81%) valid questionnaires remained after those with missing data were excluded. The results demonstrated neck and shoulder pain (NBSP) is commonly associated with burnout among healthcare workers, with a higher prevalence among women than among men. With confounders being controlled for, women were found to experience substantially higher levels of personal and work-related burnout than men did. NBSP is a mediating factor; therefore, it is a key reason why women are more likely than men to experience burnout.