Wednesday 15 December 2010

Neurobiological and psychological effects of exhaustion syndrome

Exhaustion Syndrome Explored | Psych Central News
<http://psychcentral.com/news/2010/11/23/exhaustion-syndrome-explored/21139.html>

"
A new research paper from Sweden discusses the condition termed
exhaustion syndrome, also called burnout and exhaustion depression.

Investigators believe the condition leaves objectively measurable
changes in the brain — including reduced activity in the frontal lobes
and altered regulation of the stress hormone cortisol.

A research team at Umeå University wanted to study whether this patient
group had any susceptibility factors that could explain the development
of their disorder.

The patient group is distinguished by being anxious and pessimistic,
with a weak sense of self, common in many psychiatric disorders. What
was special about this group was that they stood out as persistent,
ambitious, and pedantic individuals.

Being ambitious, fastidious, and overachieving also appears to make a
person more prone to exhaustion syndrome.

Regulation of the stress hormone cortisol is also impacted in the group,
with altered sensitivity in the hypothalamic-pituitary-adrenal axis (HPA
axis).

According to Agneta Sandström's dissertation, individuals with
exhaustion syndrome show reduced brain activity in parts of the frontal
lobes. Her paper addresses whether it is possible to use
neuropsychological tests to confirm and describe the cognitive problems
reported by patients suffering from exhaustion syndrome.

Above all, patients with exhaustion syndrom demonstrate problems
regarding attention and working memory. Patients were asked to perform
working memory tests while lying in a functional magnetic resonance
imaging machine.

Exhaustion syndrome patients proved to have a different activity pattern
in the brain when they performed a language test of their working
memory, and they also activate parts of the frontal lobe less than
healthy subjects and a group of patients who had recently developed
depression.

The HPA axis in the patient group shows reduced sensitivity in the
pituitary, with less secretion of adrenocorticotropic hormone (ACTH)
following stimulation with corticotropin (CRH), as well as heightened
sensitivity in the adrenal cortex, with increased release of cortisol in
relation to the amount of ACTH secreted.

There is also a difference in the diurnal rhythm of corisol, with the
patients presenting a flatter secretion curve than the other two groups.
The researchers could not detect any reduction in the volume of the
hippocampus, in the patient group.

The proportion of individuals with measurable levels of the
pro-inflammatory cytokine interleukin 1 is higher in the patient group.

In summary, the studies indicate that there is an association between
personality, general health, cognitive ability, and neuroendocrinal
dysfunction in exhaustion syndrome.

Sandström has also found support for there being similarities with
clinical depression, but with well-defined differences.
"

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