Extended Long-Term Effects of Cognitive and Aerobic Training on Cognitive Function in Patients With Stress-Related Exhaustion Disorder: 2026 Aronsson+

Andy

Senior Member (Voting rights)
Full title: Extended Long-Term Effects of Cognitive and Aerobic Training on Cognitive Function in Patients With Stress-Related Exhaustion Disorder: A 4.5-Year Follow-Up of a Randomized Controlled Trial

Stress-related conditions like clinical burnout and exhaustion disorder (ED) are associated with enduring cognitive problems. We have previously demonstrated that the addition of computerised cognitive training (CCT) and aerobic training (AT) to a multimodal rehabilitation programme (MMR) yielded greater improvements in cognitive function compared to MMR alone in patients with ED. These effects were maintained at the 1-year follow-up for CCT, but not for AT. Building on these findings, the present study examined the extended long-term effects of CCT and AT on cognitive function, psychological health, and work ability, 4.5 years after the interventions.

Participants were recruited from a stress-rehabilitation clinic and 56 of the initial 132 participants returned for the 4.5-year follow-up. Assessments were conducted before (T1), immediately after (T2), 1-year after (T3) and 4.5-years after (T4) the interventions. Mixed model analyses assessed changes in the intervention groups relative to the control group from T1 to T4, with follow-up comparisons examining within-group stability of outcomes between T3 to T4.

The primary outcome was cognitive performance on a global cognitive score. Secondary outcomes included domain-specific cognitive functioning, self-reported cognitive function, psychological health (burnout, depression, anxiety, and fatigue), and work ability. The analysis revealed sustained long-term effects on the global cognitive score, a trained updating task and episodic memory in the CCT group, with stable performance between one- and 4.5-year follow-up. The addition of AT did not yield any extended long-term effects on cognitive performance.

Both groups showed extended long-term improvements in self-reported memory problems, although findings were mixed. Extended long-term improvements were observed on burnout for both groups, with additional effects on anxiety and work ability in the AT group. Notably, these effects were not present at the 1-year follow-up and are more plausibly explained by selective attrition rather than a delayed intervention effect. In conclusion, the result indicates that cognitive interventions such as CCT can have lasting positive effects on cognitive function in patients with ED, whereas the long-term psychological effects should be interpreted with caution.

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Diagnostic Criteria for Exhaustion Disorder According to the Swedish National Board of Health and Welfare

A. Physical and mental symptoms of exhaustion with minimum of 2 weeks duration. The symptoms have developed in response to one or more identifiable stressors which have been present for at least 6 months.
B. Markedly reduced mental energy, which is manifested by reduced initiative, lack of endurance or increase of time needed for recovery after mental efforts.
C. At least four of the following symptoms have been present most of the day, nearly every day, during the same 2-week period:
1. Persistent complaints of impaired memory or concentration
2. Markedly reduced capacity to tolerate demands or to work under time pressure
3. Emotionally instability or irritability
4. Disturbed sleep
5. Persistent complaints of physical weakness or fatigue
6. Physical symptoms such as muscular pain, chest pain, palpitations, gastrointestinal problems, vertigo or increased sensitivity to sounds
D. The symptoms cause clinically significant distress or impairment in occupational, social or other important areas of functioning.
E. The symptoms are not due to the direct physiological effects of a substance (e.g. drug abuse, medication) or a general medical condition (e.g. hypothyroidism, diabetes, infectious disease).
F. If criteria for major depressive disorder, dysthymic disorder or generalised anxiety disorder are met, ED is set as co-morbid condition.

Note: All capital letters must be fulfiled for the diagnosis.
 
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