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Occupational and Environmental Medicine 2000;57:453-457; doi:10.1136/oem.57.7.453
Copyright © 2000 by the BMJ Publishing Group Ltd.
Occup Environ Med 2000;57:453-457 ( July )

Relation between immune variables and burnout in a sample of physicians

Annalisa Bargellinia, Alberto Barbierib, Sergio Rovestia, Roberto Vivolia, Roberto Roncagliac, Paola Borellaa

a Dipartimento di Scienze Igienistiche, Microbiologiche e Biostatistiche, Via Campi 287, I-41100 Modena, Italy, b Department of Emergency Care, c Department of Immune-haematology and Transfusion, Azienda Policlinico, Modena, Italy

Correspondence to: Professor Paola Borella borella{at}unimo.it

Accepted 25 February 2000

OBJECTIVES---To evaluate in a group of physicians the relation between burnout, demographic or job characteristics, anxiety, and immune variables.
METHODS---Seventy one physicians of all grades were recruited among different departments to a cross sectional survey. The Maslach burnout inventory, scales of emotional exhaustion, depersonalisation, and personal accomplishment, the trait scale of anxiety inventory (STAI-Y2), and a questionnaire on personal and professional characteristics were administered. The immune profile included quantitative (number (%) of lymphocytes and subsets) and functional (natural killer cytotoxicity) measures.
RESULTS---With a model of stepwise multiple regression analysis, emotional exhaustion was significantly affected by both personal (marital, sex) and job characteristics (qualification, working activity), whereas only patient contact explained a portion of variation in depersonalisation. Furthermore, trait anxiety was found to predict the Maslach burnout inventory scores. After correction for potential confounders, physicians who scored high levels of personal accomplishment showed significantly higher numbers of total lymphocytes, T cells (CD3), T helper cells (CD4), and T suppressor cells (CD8) than those who scored low levels. No other correlation was found between burnout and immune variables.
CONCLUSIONS---In our group of relatively young physicians a high degree of personal accomplishment was associated with an increase in the number of peripheral lymphocytes, particularly T subsets. The meaning of this is not clear, although it could be speculated that to evaluate oneself positively, particularly with regard to work with patients in the health services, might help to stimulate the immune system. By contrast, there is no evidence that to work hard, to feel tired from work, and to have a cynical reaction towards patient care is related to immunosuppression.


Keywords: burnout; physicians; immune variables


© 2000 by Occupational and Environmental Medicine

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