The association between burnout and physical illness in the general population--results from the Finnish Health 2000 Study.

OBJECTIVE The association between burnout and physical diseases has been studied very little. The purpose of this study was to examine the relationship between burnout and physical illness in a representative nationwide population health study. METHODS As a part of the "Health 2000 Study" in Finland, 3368 employees aged 30-64 years were studied. Burnout was assessed with the Maslach Burnout Inventory-General Survey. Physical diseases were diagnosed in a comprehensive health examination by research physicians. RESULTS Physical illness was more common among subjects with burnout than others (64% vs. 54%, P<.0001), and the prevalence of diseases increased with the severity of burnout (P<.0001). Burnout was an important correlate of cardiovascular diseases among men (OR=1.35; 95% CI, 1.13-1.61) and musculoskeletal disorders among women (OR=1.22, 95% CI, 1.07-1.38) when adjusted for age, marital status, education, socioeconomic status, physical strenuousness of work, smoking, physical activity, alcohol consumption, body mass index, and depressive symptoms. The prevalence of musculoskeletal disorders and cardiovascular diseases increased with the severity of all three dimensions of burnout, that is, exhaustion (P<.0001 and P<.001, respectively), cynicism (P=.0001 and P<.001, respectively), and lack of professional efficacy (P<.01 and P<.0001, respectively). CONCLUSIONS Burnout is associated with musculoskeletal diseases among women and with cardiovascular diseases among men. These associations are not explained by sociodemographic factors, health behavior, or depression. Physical illnesses are associated with all three dimensions of burnout and not only with the exhaustion dimension. In the future, the causal relationships between burnout and physical diseases need to be investigated in prospective studies.

[1]  W. Schaufeli,et al.  Consistency of the burnout construct across occupations , 1996 .

[2]  A. Shirom,et al.  Association between burnout at work and leukocyte adhesiveness/aggregation. , 1999, Psychosomatic medicine.

[3]  S. Rovesti,et al.  Relation between immune variables and burnout in a sample of physicians , 2000, Occupational and environmental medicine.

[4]  A. Shirom,et al.  Burnout and risk factors for cardiovascular diseases. , 1992, Behavioral medicine.

[5]  C. Nemeroff,et al.  The relationship of depression to cardiovascular disease: epidemiology, biology, and treatment. , 1998, Archives of general psychiatry.

[6]  N. Vanyperen,et al.  How to conduct research on burnout: advantages and disadvantages of a unidimensional approach in burnout research , 2003, Occupational and environmental medicine.

[7]  C. Bombardier,et al.  Osteoarthritis of the hip and knee and mechanical occupational exposure--a systematic overview of the evidence. , 1997, The Journal of rheumatology.

[8]  C. Shapiro Chronic fatigue--chronically confusing but growing information. , 2004, Journal of psychosomatic research.

[9]  P. Leino,et al.  Depressive and distress symptoms as predictors of low back pain, neck-shoulder pain, and other musculoskeletal morbidity: a 10-year follow-up of metal industry employees , 1993, Pain.

[10]  J. Suvisaari,et al.  DSM-IV mood-, anxiety- and alcohol use disorders and their comorbidity in the Finnish general population , 2005, Social Psychiatry and Psychiatric Epidemiology.

[11]  Birgitta Evengård,et al.  Physiological correlates of burnout among women. , 2003, Journal of psychosomatic research.

[12]  A. Beck,et al.  Psychometric properties of the Beck Depression Inventory: Twenty-five years of evaluation , 1988 .

[13]  E. Schouten,et al.  Vital exhaustion as risk indicator for myocardial infarction in women. , 1993, Journal of psychosomatic research.

[14]  Depressive symptoms and disability in acute and chronic back pain patients , 1996, International journal of behavioral medicine.

[15]  Harry Hemingway,et al.  Evidence based cardiology: psychosocial factors in the aetiology and prognosis of coronary heart disease. Systematic review of prospective cohort studies. , 1999, BMJ.

[16]  I. Kant,et al.  The association between chronic diseases and fatigue in the working population. , 2003, Journal of psychosomatic research.

[17]  Seppo Koskinen,et al.  HEALTH AND FUNCTIONAL CAPACITY IN FINLAND Baseline Results of the Health 2000 Health Examination Survey , 2004 .

[18]  J. Soares,et al.  Psychosocial experiences among primary care patients with and without musculoskeletal pain , 2004, European journal of pain.

[19]  S. Jackson,et al.  Maslach burnout inventory manual , 1996 .

[20]  M. Sullivan,et al.  The treatment of depression in chronic low back pain: review and recommendations , 1992, Pain.

[21]  A. Silman,et al.  Psychologic Distress and Low Back Pain: Evidence From a Prospective Study in the General Population , 1995, Spine.

[22]  A. Bakker,et al.  The job demands-resources model of burnout. , 2001, The Journal of applied psychology.

[23]  A. Bakker,et al.  Job demands, job resources, and their relationship with burnout and engagement: a multi‐sample study , 2004 .

[24]  P. Landsbergis,et al.  Is job strain a major source of cardiovascular disease risk? , 2004, Scandinavian journal of work, environment & health.

[25]  I. Niedhammer,et al.  Psychosocial factors at work, personality traits and depressive symptoms , 2002, British Journal of Psychiatry.

[26]  S. Wessely,et al.  A systematic review and critical evaluation of the immunology of chronic fatigue syndrome. , 2003, Journal of psychosomatic research.

[27]  T. Lewis,et al.  Psychosocial factors and cardiovascular diseases. , 2005, Annual review of public health.

[28]  Wilmar B. Schaufeli,et al.  The Burnout Companion to Study and Practice: A Critical Analysis , 1998 .

[29]  J Siegrist,et al.  Two alternative job stress models and the risk of coronary heart disease. , 1998, American journal of public health.

[30]  I. Kant,et al.  Common infections and the role of burnout in a Dutch working population. , 2003, Journal of psychosomatic research.

[31]  Wilmar B. Schaufeli,et al.  Using Equity Theory to Examine the Difference Between Burnout and Depression , 2000 .

[32]  Wilmar B. Schaufeli,et al.  The factorial validity of the Maslach Burnout Inventory‐General Survey (MBI‐GS) across occupational groups and nations , 2000 .

[33]  Ritva Luukkonen,et al.  Work stress and risk of cardiovascular mortality: prospective cohort study of industrial employees , 2002, BMJ : British Medical Journal.

[34]  E. Schouten,et al.  Burnout as a risk factor for coronary heart disease. , 1991, Behavioral medicine.

[35]  Toon W. Taris,et al.  Construct validity of the Maslach Burnout Inventory-General Survey: A two-sample examination of its factor structure and correlates , 1999 .

[36]  A. Beck,et al.  An inventory for measuring depression. , 1961, Archives of general psychiatry.

[37]  J. Lisspers,et al.  Stress, Burnout and Coping: Differences between Women with Coronary Heart Disease and Healthy Matched Women , 2003, Journal of health psychology.

[38]  S. Jackson,et al.  The Measurement of experienced burnout , 1981 .

[39]  K. Ogino,et al.  Natural killer (NK) cell activity and NK cell subsets in workers with a tendency of burnout. , 1999, Journal of psychosomatic research.

[40]  S. Melamed,et al.  The Gulf War and its impact on burnout and well-being of working civilians , 1992, Psychological Medicine.

[41]  I. Hickie,et al.  Fatigue and psychiatric disorder: different or the same? , 1999, Psychological Medicine.

[42]  Anneli Ojajärvi,et al.  Burnout as a Predictor of Medically Certified Sick-Leave Absences and Their Diagnosed Causes , 2005, Behavioral medicine.

[43]  E. Viikari-Juntura,et al.  A prospective study on knee pain and its risk factors. , 2002, Osteoarthritis and cartilage.

[44]  R. Brown,et al.  The assessment of fatigue: a practical guide for clinicians and researchers. , 2004, Journal of psychosomatic research.

[45]  P. Mutanen,et al.  Staying well or burning out at work: Work characteristics and personal resources as long-term predictors , 2003 .

[46]  Toon W. Taris,et al.  Construct validity of the demand-control model: A double cross-validation approach , 1998 .