Somatic symptoms in burnout in a general adult population 2023 Hammarström et al

Highlights

• Fatigue, pain and gastrointestinal symptoms are particularly common in burnout.
• These symptoms show 2- to 9-fold increased risk when adjusted for negative affect
• The risk of burnout increases 1.52 times with each additional symptom

Abstract

Objective
Burnout results in individual suffering and high societal costs, and is associated with somatic symptoms, anxiety and depression, calling for prevention by early identification. The objectives were to (i) determine prevalence of specific somatic symptoms in burnout, (ii) identify the symptoms, referred to as somatic symptoms of burnout (SS-B), that are particularly associated with burnout, (iii) determine their extent of association with burnout, and (iv) determine how well a certain number of SS-B differentiates participants with and without burnout in a general Swedish adult population.

Methods
Cross-sectional, population-based data were used from 687 participants high on burnout, and 2544 referents based on the Shirom-Melamed Burnout Questionnaire. The Patient Health Questionnaire 15-item Somatic Symptom Severity Scale was used to assess common somatization symptoms, and the Hospital Anxiety and Depression Scale to assess anxiety and depression.

Results
Feeling tired/having low energy, back pain, joint/limb pain, trouble sleeping, headaches, stomach pain, nausea/gas/indigestion, and constipation/loose bowels/diarrhea were most prevalent in burnout (57.2–95.0%). These symptoms, except for joint/limb pain, and dizziness, were also identified as the SS-B, with odds ratios of 2.34–12.74 and 1.95–9.11 when adjusted for background variables, and for anxiety and depression, respectively. Corresponding odds ratios for each additional number of SS-B were 1.69 and 1.52, respectively. The highest balanced accuracy (71.6%) for predicting burnout was found for ≥4 SS-B.

Conclusion
Fatigue, pain and gastrointestinal symptoms are particularly common in burnout. Further studies may show whether clinicians should consider screening for burnout when patients present with SS-B without pathophysiological explanations.

Open access, https://www.sciencedirect.com/science/article/pii/S0022399923000739

 

"Among the 3406 participants, 175 were excluded due to having responded to less than half of the items on the SMBQ, PHQ-15 and/or HADS, resulting in a study sample of 3231 participants. Of these, 687 met the criterion for burnout (global SMBQ score ≥ 3.75), and the remaining 2544 participants constituted referents. The two samples are described in Table 1. The burnout sample was significantly younger than the referents, and consisted to a larger extent of participants who were women, not married/living with a partner, having children, and not exercising ≥2 times/week. The burnout sample also rated their health as poorer, scored higher on the PSS-10, was more likely to have reported being given a diagnosis of SED, generalized anxiety disorder, panic disorder, posttraumatic stress disorder, depression, fibromyalgia, irritable bowel syndrome and chronic fatigue syndrome, and scored higher on all SMBQ subscales and on the HADS-A and HADS-D. The samples did not differ in prevalence of university education, smoking or hypertension."

 

Shirom-Melamed Burnout Measure (SMBM)

How Do You Feel at Work?
1. I feel tired
2. I have no energy for going to work in the morning
3. I feel physically drained
4. I feel fed up
5. I feel like my “batteries” are “dead”
6. I feel burned out
7. My thinking process is slow
8. I have difficulty concentrating
9. I feel I’m not thinking clearly
10.10. I feel I’m not focused in my thinking
11.I have difficulty thinking about complex things
12.I feel I am unable to be sensitive to the needs of coworkers and customers
13.I feel I am not capable of investing emotionally in coworkers and customers
14.I feel I am not capable of being sympathetic to co-workers and customers
physical fatigue; emotional exhaustion; and cognitive weariness
1= Never or almost never‚ 2= Very infrequently‚ 3= Quite infrequently‚ 4= Sometimes Quite‚ 5= frequently Very‚ 6= frequently‚ 7=Always or almost always
physical fatigue (1-5); emotional exhaustion (6-8); and cognitive weariness (9-12)

burned out = BURNED OUT

adj. that which denotes physical, emotional, and mental exhaustion. Historically, it also describes patients who become withdrawn and apathetic, slowly deteriorating in condition and losing their sense of reality to chronic schizophrenia.

BURNED OUT: “It is long-term, non-stop stress which leads to the condition of being burned out.”

 

Exactly.

What are the causal relationships?