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Cognitive performance in patients with burnout, in relation to diurnal salivary cortisol.
Stress. 2009 Jan; 12(1):70-81.S

Abstract

This study investigated cognitive performance in patients with burnout, in relation to the flexibility of the hypothalamic-pituitary-adrenal (HPA) axis. Clinical cases with work stress-induced burnout (n = 65), and demographically matched, healthy reference subjects (n = 65), were given six neuropsychological tests and a self-rating scale for cognitive problems. Diurnal salivary cortisol was measured among burnout cases and an external reference group (n = 174), including a dexamethasone suppression test (DST) among burnout cases. Compared with referents, the burnout group under-performed in a cognitive speed test (Wechsler Adult Intelligence Scale-Revised (WAIS-R) Digit Symbol), but not in any other test of sustained attention, episodic memory, or vocabulary. Burnout cases had considerably more subjective cognitive problems, but ratings were unrelated to test performance. Compared with referents, burnout cases had similar morning salivary cortisol levels and similar awakening response, but lower evening cortisol. Among burnout cases, lower diurnal cortisol variability was related to slower performance in several tests. The DST response showed no consistent relationship with any cognitive parameter. Hence, despite considerable subjective cognitive problems, the burnout group showed only a partial, mild deviation in cognitive performance. A flatter diurnal cortisol profile was related to lower cognitive processing speed, but diurnal cortisol pattern and DST response were normal, suggesting a maintained HPA axis flexibility.

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Authors+Show Affiliations

Osterberg K
Division of Occupational and Environmental Medicine, Department of Laboratory Medicine, Lund University, SE-221 85 Lund, Sweden. kai.osterberg@med.lu.se
Karlson B
No affiliation info available
Hansen AM
No affiliation info available

MeSH

AdultAttentionBurnout, ProfessionalCircadian RhythmCognition DisordersDexamethasoneFemaleHumansHydrocortisoneHypothalamo-Hypophyseal SystemMaleMemoryMiddle AgedNeuropsychological TestsPituitary-Adrenal SystemSalivaStress, Psychological

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

18951245

Citation

Osterberg, K, et al. "Cognitive Performance in Patients With Burnout, in Relation to Diurnal Salivary Cortisol." Stress (Amsterdam, Netherlands), vol. 12, no. 1, 2009, pp. 70-81.
Osterberg K, Karlson B, Hansen AM. Cognitive performance in patients with burnout, in relation to diurnal salivary cortisol. Stress. 2009;12(1):70-81.
Osterberg, K., Karlson, B., & Hansen, A. M. (2009). Cognitive performance in patients with burnout, in relation to diurnal salivary cortisol. Stress (Amsterdam, Netherlands), 12(1), 70-81. https://doi.org/10.1080/10253890802049699
Osterberg K, Karlson B, Hansen AM. Cognitive Performance in Patients With Burnout, in Relation to Diurnal Salivary Cortisol. Stress. 2009;12(1):70-81. PubMed PMID: 18951245.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Cognitive performance in patients with burnout, in relation to diurnal salivary cortisol. AU - Osterberg,K, AU - Karlson,B, AU - Hansen,A M, PY - 2008/10/28/pubmed PY - 2009/2/14/medline PY - 2008/10/28/entrez SP - 70 EP - 81 JF - Stress (Amsterdam, Netherlands) JO - Stress VL - 12 IS - 1 N2 - This study investigated cognitive performance in patients with burnout, in relation to the flexibility of the hypothalamic-pituitary-adrenal (HPA) axis. Clinical cases with work stress-induced burnout (n = 65), and demographically matched, healthy reference subjects (n = 65), were given six neuropsychological tests and a self-rating scale for cognitive problems. Diurnal salivary cortisol was measured among burnout cases and an external reference group (n = 174), including a dexamethasone suppression test (DST) among burnout cases. Compared with referents, the burnout group under-performed in a cognitive speed test (Wechsler Adult Intelligence Scale-Revised (WAIS-R) Digit Symbol), but not in any other test of sustained attention, episodic memory, or vocabulary. Burnout cases had considerably more subjective cognitive problems, but ratings were unrelated to test performance. Compared with referents, burnout cases had similar morning salivary cortisol levels and similar awakening response, but lower evening cortisol. Among burnout cases, lower diurnal cortisol variability was related to slower performance in several tests. The DST response showed no consistent relationship with any cognitive parameter. Hence, despite considerable subjective cognitive problems, the burnout group showed only a partial, mild deviation in cognitive performance. A flatter diurnal cortisol profile was related to lower cognitive processing speed, but diurnal cortisol pattern and DST response were normal, suggesting a maintained HPA axis flexibility. SN - 1607-8888 UR - https://www.unboundmedicine.com/medline/citation/18951245/Cognitive_performance_in_patients_with_burnout_in_relation_to_diurnal_salivary_cortisol_ L2 - https://www.tandfonline.com/doi/full/10.1080/10253890802049699 DB - PRIME DP - Unbound Medicine ER -