Physiological differences between burnout patients and healthy controls: blood pressure, heart rate, and cortisol responses

W De Vente¹, M Olff², J G C Van Amsterdam³, J H Kamphuis¹, P M G Emmelkamp¹

¹ Department of Clinical Psychology, University of Amsterdam, The Netherlands
² Speciality Programme Psychotrauma, Academic Medical Centre/De Meren, Department of Psychiatry, The Netherlands
³ Laboratory of Health Effects Research, National Institute of Public Health and the Environment, The Netherlands

Correspondence to:
Correspondence to:
W De Vente, Department of Clinical Psychology, University of Amsterdam, Roetersstraat 15, 1018 WB Amsterdam, The Netherlands;
devente{at}psy.uva.nl

Objectives: To investigate differences between burnout patients and healthy controls regarding basal physiological values and physiological stress responses. Measures of the sympathetic-adrenergic-medullary (SAM) axis and the hypothalamic-pituitary-adrenal (HPA) axis were examined.

Methods: SAM axis and HPA axis activity was compared between 22 burnout patients and 23 healthy controls. SAM axis activity was measured by means of heart rate (HR) and blood pressure (BP). HPA axis activity was investigated by means of salivary cortisol levels. Resting levels of HR, BP, and cortisol were determined as well as reactivity and recovery of these measures during a laboratory session involving mental arithmetic and speech tasks. In addition, morning levels of cortisol were determined.

Results: Burnout patients showed higher resting HR than healthy controls. BP resting values did not differ between burnout patients and healthy controls, nor did cardiovascular reactivity and recovery measurements during the laboratory session. Basal cortisol levels and cortisol reactivity and recovery measures were similar for burnout patients and healthy controls. However, burnout patients showed elevated cortisol levels during the first hour after awakening in comparison to healthy controls.

Conclusions: The findings provided limited proof that SAM axis and HPA axis are disturbed among burnout patients. Elevated HR and elevated early morning cortisol levels may be indicative of sustained activation.

Keywords: burnout; stress; SAM axis; HPA axis; stress test; cortisol; heart rate; blood pressure

Abbreviations: BDI, Beck Depression Inventory; BP, blood pressure; CFS, chronic fatigue syndrome; CIDI, Composite International Diagnostic Interview; CIS, checklist individual strength; HPA, hypothalamic-pituitary-adrenal; HR, heart rate; MA, mental arithmetic; POMS, Profile of Mood Scale; PTSD, post traumatic stress disorder; REC1, first recovery phase; REC2, second recovery phase; SAM, sympathetic-adrenergic-medullary

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