Cognitive impairment in patients with stress-related exhaustion

Ingibjörg H. Jónsdóttir · Arto Nordlund · Susanne Ellbin · Thomas Ljung · Kristina Glise · Peter Währborg +1 more

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Stress and Burnout Research Sleep and Work-Related Fatigue Healthcare professionals’ stress and burnout

Abstract

Patients who seek medical care for stress-related mental health problems frequently report cognitive impairments as the most pronounced symptom. The purpose of the present study was to compare cognitive function in patients with stress-related exhaustion with that in healthy controls, using a comprehensive battery of cognitive tests. We also explored whether neuropsychological findings were related to severity of illness measured using the Shirom-Melamed burnout questionnaire and hospital anxiety and depression scale. Thirty-three patients (15 males) and 37 healthy controls (11 males), mean age 46 years [standard deviation (SD) 3.9] and 47 years (SD 4.3), respectively, were included in the final analysis. Five cognitive domains were assessed: (1) speed, attention and working memory, (2) learning and episodic memory, (3) executive functions, (4) visuospatial functions and (5) language. The most pronounced difference between patients and controls was seen on executive function, when tested with a multidimensional test, including aspects of speed, control and working memory. The patients also performed poorer on Digit span, measuring attention span and working memory as well as on learning and episodic memory, when measured as delayed recall and the difference between immediate and delayed recall. Delayed recall was the only test that was significantly related to severity of burnout symptoms among the patients. This could reflect poor cognitive sustainability in the patients with the highest burnout scores, as this particular test was the last one performed during the test session. This study clearly shows that cognitive impairment should be considered when evaluating and treating patients who seek medical care for stress-related exhaustion.

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References

2013Diagnostic and Statistical Manual of Mental Disorders 1983The Hospital Anxiety and Depression Scale 2001Job Burnout 2000Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR)1999Validation and Utility of a Self-report Version of PRIME-MD The PHQ Primary Care Study 2002The validity of the Hospital Anxiety and Depression Scale 2001Boston Naming Test 1979Maslach Burnout Inventory

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2021Burnout and job performance: a two-wave study on the mediating role of employee cognitive functioning 2020Severity and prevalence of various types of mental ill-health in a general adult population: age and sex differences 2014Cognitive performance in both clinical and non-clinical burnout 2021A Proposal for a Unifying Set of Definitions of Fatigue 2017Working memory and attention are still impaired after three years in patients with stress‐related exhaustion 2017Executive function and attention in patients with stress-related exhaustion: perceived fatigue and effect of distraction

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