Introduction Stress-related exhaustion is characterized by both physical and mental symptoms of exhaustion and for many patients the prognosis seems to be long lasting. Little is known what factors may influence such long-term prognosis. One plausible explanation could be differences in exposure to certain stressors, or vulnerability related to previous life events.

Objectives The purpose of this study was to examine if work and private related stress-exposure, as well as adverse childhood experiences differ between patients that are still exhausted at a long-term follow-up, with a group of patients that have recovered from their exhaustion.

Methods Patient records from 150 patients diagnosed with Exhaustion Disorder (ED) at a specialist outpatient stress clinic was analysed regarding work- and private-related stressors, and adverse childhood experiences. The first part of data analysis consisted of a qualitative text analysis, creating a coding scheme. Frequency statistics regarding each stressor was calculated to compare the two groups. At the 7–10 year follow-up, 34% of the patients still fulfilled the criteria for ED, compared to 66% that had recovered.

Results Compared to the patients that had recovered, significantly more patients with long-term exhaustion, reported managerial responsibilities (8% versus 0%) and caregiver stress related to children (24% versus 6%) at follow-up. Significantly more recovered patients reported work related quantitative demands (73% versus 53%) and managerial responsibilities (14% versus 2%) at first visit, and experienced more caregiver stress related to parents at follow-up (6% versus 0%). There were no differences regarding adverse childhood experiences.

Conclusions The main conclusion is that neither adverse childhood experiences nor any of the stressors at the onset of exhaustion seem to be associated with a lack of recovery. However, stressors at folllow-up relating to having responsibility for other people, such as managerial responsibilities or caring for a child with a chronic disease or psychiatric disorder, may be associated with prolonged recovery.