Abstract
BackgroundMany patients with stress-related exhaustion seem to struggle with long-term recovery. The primary aim of this study was to explore residual symptoms and perceived recovery in patients previously treated for stress-related exhaustion, 7 years after seeking care.MethodsA total of 217 former patients (74% women) previously treated for exhaustion disorder were asked to participate in follow-ups 2, 3, 5, and 7 years post treatment. Symptoms of depression, and anxiety were measured with questionnaires. Remaining symptoms of extreme fatigue, sleep disturbances, problems with concentration, problems with memory and reduced stress tolerance, were rated with single item questions. A subgroup of patients (n = 163) participated in a clinical assessment to confirm residual stress-related exhaustion not caused by other diseases.ResultsAlmost half of the patients previously treated for stress-related exhaustion perceive fatigue 7 years after initially seeking care, and as many as 73% reported decreased stress tolerance. The clinical assessment confirmed that a third of the patients were clinically judged as still suffering from stress-related exhaustion. Male and female patients showed similar patterns regarding residual symptoms.ConclusionsOne third of patients with exhaustion disorder are clinically judged to have exhaustion, 7 years after seeking care. Further studies are needed to elucidate the reason for such a long-term recovery and ultimately to identify methods for prevention.
Highlights
Many patients with stress-related exhaustion seem to struggle with long-term recovery
We have previously shown that the Shirom-Melamed Burnout Questionnaire (SMBQ) can be used to follow symptoms of exhaustion over time in patients with exhaustion disorder (ED) [1]
Comparisons with non-responders When patients responding to the 7-year follow-up (n = 217) were compared to non-responders eligible to enter the study (n = 117), there were no significant differences regarding the percentage of women/men who participated, severity of burnout at baseline (90% of responders vs. 94% of non-responders scoring above the clinical SMBQ cut-off when initially seeking care; p = 0.197), or severity of burnout at the end of treatment (18-months follow-up; 31% of responders vs. 36% of non-responders scoring above clinical cut-off; p = 0.426)
Summary
Many patients with stress-related exhaustion seem to struggle with long-term recovery. The past decade has seen several descriptions of patients seeking care for severe symptoms of exhaustion and cognitive impairment due to both work-related and privaterelated stress exposure [1,2,3]. In the Netherlands, clinical burnout has been suggested as a diagnosis, using diagnostic criteria such as neurasthenia and adding the component that the problem should be work-related [11]. In Sweden, the increased number of patients seeking care for stress-related exhaustion called for an action of improving diagnostics in cases of stress-related exhaustion/clinical burnout. This resulted in the development of the criteriabased diagnosis exhaustion disorder (ED). The criteria were assigned the code F43.8A of the International Classification of Diseases and Related Health Problems (ICD-10) (Table 1)
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