THE MEDICAL PERSPECTIVE ON BURNOUT AND ITS IMPORTANCE IN HEALTH CARE WORKERS
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Keywords
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Abstract
The aim of this study was to review recent medical findings related to burnout, its diagnosis, treatment, characteristic pathophysiological features, and preventive measures.
Materials and Methods
A systematic review of the scientific literature in PubMed/Medline was performed. The most recent and important findings were reported.
Results
Burnout was found to be a risk factor for myocardial infarction and coronary heart disease. It was also related to reduced fibrinolytic capacity, decreased capacity to cope with stress and hypothalamic-pituitary-adrenal (HPA) axis hypoactivity. Severe burnout symptoms are associated with a lower level or smaller increase of the cortisol awakening response (CAR), higher dehydroepiandrosterone-sulphate (DHEAS) levels, lower cortisol/DHEAS ratios and stronger suppression as measured by the dexamethasone suppression test (DST). More and more literature works suggest that the evaluation of the HPA axis should be brought to the attention of primary care physicians. There is no universal agreement on specific treatment and diagnostic measures to evaluate the wide range of HPA axis disorders. The cost-effective evaluation of adrenal hormones via saliva samples by a primary care physician may significantly alter the course of therapy in numerous chronic disease patients. Psychiatric disorders may have similar symptoms, but they have distinctive hormonal profiles. Having burnout recognized as a medical condition would help in differentiating burnout from similar clinical syndromes, such as depression or anxiety, and provide appropriate treatment to burnout patients. Proper treatment is essential for a fast and full recovery.
Conclusion
Chronic stress-related disorders often fall outside the category of a “true” disease and are often treated as depression or not treated at all. The evaluation of adrenal hormones via saliva samples helps to predict burnout. Burnout screening techniques, dietary and nutritional guidelines and lifestyle changes for supporting the HPA function need to be developed. The presented material includes hormonal, dietary, and pharmaceutical perspectives.
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Abdul Majeed Muhammad Ali Al-Harbi
Public health specialist, General Directorate of Health Affairs Riyadh
Abdul Rahman Salman Al-Ghamdi
Public Health, General Directorate of Health Affairs Riyadh
Rami Ali Al-Zahrani
Public Health, General Directorate of Health Affairs Riyadh
Abdul Majeed Ali Al Shehri
Public Health, General Directorate of Health Affairs Riyadh
Hussain Hassan Al maimouny
Public health, Dhahran Eye Specialist Hospital Dhahran
Ghayah Mohammed Al-Madawisi
Health services and hospitals management, Dhahran eye specialist hospital Dhahran city
Fahad Naji Mustafa Alkhateeb
Puplic Health-promotion, Ministry of Health Riyadh
Nada Kareem Alenazi
Public health, Community health and public health Riyadh