Abstract
BackgroundStress-related exhaustion is associated with cognitive impairment as measured by both subjective cognitive complaints (SCCs) and objective cognitive test performance. This study aimed to examine how patients diagnosed with exhaustion disorder differ from healthy control participants in regard to levels and type of SCCs, and if SCCs are associated with cognitive test performance and psychological distress.MethodsWe compared a group of patients with stress-related exhaustion disorder (n = 103, female = 88) with matched healthy controls (n = 58, female = 47) cross-sectionally, concerning the type and magnitude of self-reported SCCs. We furthermore explored the association between SCCs and cognitive test performance as well as with self-reported depression, anxiety and burnout levels, in the patient and the control group, respectively.ResultsPatients reported considerably more cognitive failures and were more likely than controls to express memory failures in situations providing few external cues and reminders in the environment. In both groups, SCCs were associated with demographic and psychological factors, and not with cognitive test performance.ConclusionOur findings underline the high burden of cognitive problems experienced by patients with exhaustion disorder, particularly in executively demanding tasks without external cognitive support. From a clinical perspective, SCCs and objective cognitive test performance may measure different aspects of cognitive functioning, and external cognitive aids could be of value in stress rehabilitation.Trial registrationParticipants were recruited as part of the Rehabilitation for Improved Cognition (RECO) study (ClinicalTrials.gov: NCT03073772). Date of registration: 8 March 2017
Highlights
Stress-related illness is one of the main reasons for sickleave in Europe today [1, 2]
The aims of this study were to investigate the level and type of subjective cognitive complaints (SCCs) in patients with exhaustion disorder (ED) compared to healthy control participants, and if SCCs were associated with cognitive test performance and psychological distress in patients with ED and in a healthy control group, respectively
A subjective experience of failure in executively demanding tasks harmonize with the cognitive profile suggested by the existing literature on stress-related exhaustion [10] and with the cognitive test results of this study, as we found that patients showed impaired cognitive performance on individual tasks assessing executive function and working memory, as well as reasoning ability, which is associated with executive functioning [42]
Summary
Stress-related illness is one of the main reasons for sickleave in Europe today [1, 2]. In several populations, SCCs have been found highly correlated with psychological and demographic factors such as anxiety, depression, age and sex and it has been suggested that SCCs reflect these phenomena rather than objective cognitive dysfunction [19,20,21] While this question is less studied in the context of stress-related exhaustion, SCCs have been associated with increased levels of depression in this group [9, 13, 14]. Previous studies on stress-related exhaustion have operationalized SCCs using single items [11, 12] or total scores on questionnaires targeting everyday memory or cognitive functioning [7,8,9, 22, 23] These measures indicate a general experience of cognitive deficit, they do not provide information on the specific type of complaints experienced by ED patients. This study aimed to examine how patients diagnosed with exhaustion disorder differ from healthy control participants in regard to levels and type of SCCs, and if SCCs are associated with cognitive test performance and psychological distress
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