1. Longitudinal changes in pituitary-adrenal hormones in South African women with burnout.
- Author
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Moch SL, Panz VR, Joffe BI, Havlik I, and Moch JD
- Subjects
- Adrenocorticotropic Hormone blood, Adult, Aldosterone blood, Blood Glucose metabolism, Burnout, Professional blood, Burnout, Professional urine, Catecholamines blood, Dehydroepiandrosterone Sulfate blood, Fasting, Female, Growth Hormone blood, Humans, Insulin metabolism, Lipids blood, Longitudinal Studies, Middle Aged, South Africa, Treatment Outcome, Adrenal Cortex Hormones blood, Burnout, Professional metabolism, Burnout, Professional therapy, Hydrocortisone urine, Pituitary Hormones blood, Pituitary-Adrenal System metabolism
- Abstract
The authors' goal was to document baseline pituitary-adrenal hormonal and related metabolic variables in 16 female patients with burnout. Then, following stress management intervention, to compare the changes with an equal number of untreated control subjects. At monthly intervals for 4 mo, 24-h urine samples were obtained for determination of free cortisol excretion. In addition, fasting blood samples were analyzed for levels of cortisol, dehydroepiandrosterone sulfate (DHEAS), ACTH, aldosterone, and catecholamines. Other biochemical measurements included growth hormone, prolactin, insulin, glucose, and lipid components. The Maslach Burnout Inventory, General Health Questionnaire- 28, and Zung depression rating scale were completed on each consecutive visit. The most striking finding was the reduction of urine free-cortisol excretion in the patients compared with controls. Initial urinary free cortisol was significantly lower in the patients (mean +/- SEM = 47.2 +/- 11.0 vs 79.0 +/- 6.8 nmol/L, p = 0.02) and remained significantly reduced at 4 mo (mean +/- SEM = 44.0 +/- 6.1 vs 91.1 +/- 8.8 nmol/L, p = 0.0001). There were no significant changes in the other hormonal and biochemical data. We conclude that there is functional hypocortisolism in burnout, which is not immediately restored on stress management intervention despite clinical and psychological improvement.
- Published
- 2003
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