Stress-related disorders and biological aspects of stress

Our research on stress-related disorders has mainly been focused on patients with Exhaustion disorder (ED).

The term “burnout” has been used since the late ´70s to describe fatigue/exhaustion due to work-related stress. During the 21st century, many researchers and clinicians have discussed the poor usability of the term ‘burnout’ in clinical practice and a decision was made to form diagnostic criteria for patients seeking care for symptoms of exhaustion due to long-term stress exposure. The diagnostic criteria for ED were accepted by the Swedish National Board of Health and Welfare in 2005. The ED criteria are being used more frequently by general practitioners in Sweden, and knowledge of clinical manifestations and biological mechanisms is gradually increasing following the publication of various research studies. A recent review by Grossi and co-workers  included a compilation of the physiological manifestations of ED and the diagnosis was suggested as being a valid clinical manifestation of burnout, with the advantage that it follows criteria-based diagnostics and has been shown to be usable in clinical practice. 

Our research group has in several studies described the clinical and biological manifestation of patients fulfilling the diagnostic criteria for ED.

Some of our findings are that ED, depression and anxiety are distinct conditions, that recovery seem to be long-lasting, that only minor difference can be found between women and men with regard to clinical symptoms and that both work-related and non-work-related stress exposure is involved in the development of ED. Cognitive impairments are pronounced in patients with ED and they seem to be long-lasting.

Some of our findings with regard to biological processes are that the Hypothalamic–pituitary–adrenal axis (HPA-axis) is generally not affected in patients with ED, with exception from patients reporting severe exhaustion. However, anabolic processes seems to be affected showing for instance that patients with ED have lower levels of Dehydroepiandrosterone  (DHEA) than healthy controls and that changes in DHEA-S are associated with prognosis for the outcome in burnout patients.

Click here for a list of our publications on ED