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Review
. 2019 Mar 1;180(3):R147-R158.
doi: 10.1530/EJE-18-0741.

MECHANISMS IN ENDOCRINOLOGY: Endocrine and immunological aspects of burnout: a narrative review

Ingibjörg H Jonsdottir  1   2 , Anna Sjörs Dahlman  1
Affiliations
Review

MECHANISMS IN ENDOCRINOLOGY: Endocrine and immunological aspects of burnout: a narrative review

Ingibjörg H Jonsdottir et al. Eur J Endocrinol. .

Abstract

Burnout has several different definitions, and attempts have been made to discriminate between burnout as a psychological construct and burnout as a clinical entity. A large body of research has focused on elucidating the biological link between stress exposure and burnout and/or finding a clinically usable biomarker for burnout. The objective of this narrative review is to summarize the main endocrine and immune findings in relation to burnout. The literature has primarily focused on dysregulation of the hypothalamus-pituitary-adrenal (HPA) axis. However, albeit the large body of studies, it cannot be concluded that clear effects are seen on HPA axis function in people with burnout. The HPA axis and anabolic acute reactivity to stress might be affected in clinical burnout. Plausible, effects of chronic stress might rather be seen when measuring responses to acute stress rather than resting state hormonal levels. Studies on other hormones, including thyroid hormones, prolactin and growth hormone in burnout subjects are inconclusive. It is important to note that this field is faced with many methodological challenges, one being the diurnal and pulsatile nature of many of the hormones of interest, including cortisol, which is not always considered. Another challenge is the heterogeneity regarding definitions and measurements of stress and burnout. Existing studies on burnout and immune function are heterogeneous regarding the results and no firm conclusion can be made if clinically relevant immune changes are present in burnout subjects. An overall conclusion is that existing research cannot confirm any homogenous reliable endocrinological or immunological changes related to burnout.

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Figures

Figure 1
Figure 1
Major endocrine systems studied in relation to burnout.
See this image and copyright information in PMC

References

    1. Selye H. The Stress of Life, 2nd ed. New York: McGraw-Hill, 1978.
    1. Lazarus RS, Folkman S. Stress, Appriasal and Coping. New York: Springer Publishing, 1984.
    1. Ursin H, Eriksen HR. The cognitive activation theory of stress. Psychoneuroendocrinology 2004. 29 567–592. ( 10.1016/S0306-4530(03)00091-X) - DOI - PubMed
    1. Dhabhar FS. The short-term stress response – mother nature’s mechanism for enhancing protection and performance under conditions of threat, challenge, and opportunity. Frontiers in Neuroendocrinology 2018. 49 175–192. ( 10.1016/j.yfrne.2018.03.004) - DOI - PMC - PubMed
    1. Biondi M, Picardi A. Psychological stress and neuroendocrine function in humans: the last two decades of research. Psychotherapy and Psychosomatics 1999. 68 114–150. ( 10.1159/000012323) - DOI - PubMed

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