burnout – American ME and CFS Society

Burnout, Compassion Fatigue, and the Long Haul of Caring for Long COVID

Abstract:

The current landscape of clinician burnout is prompting the need for our health care system to revise its approach toward complex conditions such as long coronavirus disease (COVID), myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS), and other postinfectious fatiguing illnesses (PIFIs). We discuss our efforts here at Family Health Center of San Diego (FHCSD) to help share insight and glean perspective from clinicians who have participated in our Centers for Disease Control and Prevention (CDC)-funded 3-year continuing professional development initiative.

The Long COVID and Fatiguing Illness Recovery Program uses multidisciplinary team-based case consultation and peer-to-peer sharing of emerging best and promising practices (ie, teleECHO [Extension for Community Healthcare Outcomes]) to support the management of complex cases associated with long COVID, ME/CFS, and other PIFIs. We believe that this perspective captures a key moment in the trajectory of postpandemic clinician burnout and prompts further reflection and action from the health care system to improve clinician- and patient-level outcomes related to the care of patients with postinfectious fatiguing illnesses.

Source: Ramers CB, Scott JD, Struminger BB. Burnout, Compassion Fatigue, and the Long Haul of Caring for Long COVID. Open Forum Infect Dis. 2024 Feb 7;11(3):ofae080. doi: 10.1093/ofid/ofae080. PMID: 38449917; PMCID: PMC10917153. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10917153/ (Full text)

The Relationship Between Chronic Fatigue Syndrome, Burnout, Job Satisfaction, Social Support And Age Among Academics At A Tertiary Institution

Abstract:

OBJECTIVES: Over the last 20 years, tertiary institutions have been subjected to several changes. This has resulted in increased workloads for academics. Some academics have started to experience symptoms that are related to chronic fatigue syndrome and burnout. Researchers, however, cannot agree whether the 2 syndromes are two sides of the same coin or actually 2 separate constructs. This study that was conducted at a tertiary institution in South Africa therefore aimed to determine if these constructs accounted for the evidence of the same syndrome within an academic setting or if they were 2 separate, distinguishable constructs. However, since job satisfaction and social support play a role in the poor physical and psychological health experienced by individuals with chronic fatigue syndrome or burnout, it was decided to also include these 2 constructs into the investigation. Age was also incorporated because it had dissimilar relationships with burnout and chronic fatigue syndrome.

MATERIAL AND METHODS: The participants completed the following questionnaires via an online survey: The Centers for Disease Control and Prevention Chronic Fatigue Syndrome Symptom Inventory, the Oldenburg Burnout Inventory, the Overall Job Satisfaction Scale and the Social Support Scale. The data was used for constructing a structural equation model.

RESULTS: Job satisfaction was found to be a strong predictor of burnout. The number of symptoms indicative of chronic fatigue syndrome reported by the participants proved to be a relatively strong significant predictor of burnout. Age did not yield any significant relationship with any of the constructs.

CONCLUSIONS: The results indicated that chronic fatigue and burnout should be perceived as 2 distinguishable constructs in the academic context. It should be noted, however, that some overlap exists between them.

This work is available in Open Access model and licensed under a CC BY-NC 3.0 PL license.

Source: Coetzee N, Maree DJF, Smit BN. The Relationship Between Chronic Fatigue Syndrome, Burnout, Job Satisfaction, Social Support And Age Among Academics At A Tertiary Institution. Int J Occup Med Environ Health. 2019 Feb 27;32(1):75-85. doi: 10.13075/ijomeh.1896.01274. Epub 2019 Feb 20. http://ijomeh.eu/The-relationship-between-chronic-fatigue-syndrome-burnout-job-satisfaction-social,91021,0,2.html (Full article)

EEG findings in burnout patients

Abstract:

The concept of burnout remains enigmatic since it is only determined by behavioral characteristics. Moreover, the differential diagnosis with depression and chronic fatigue syndrome is difficult.

EEG-related variables in 13 patients diagnosed with burnout syndrome were compared with 13 healthy comparison subjects in order to explore the existence of neurobiological markers for burnout.

Burnout patients showed reduced P300 amplitude, a lower alpha peak frequency and reduced beta power. These EEG-related differences in burnout patients differ from those described in the literature in depression and chronic fatigue patients. Our preliminary findings suggest that burnout might be considered as a separate clinical syndrome.

Source: van Luijtelaar G, Verbraak M, van den Bunt M, Keijsers G, Arns M. EEG findings in burnout patients. J Neuropsychiatry Clin Neurosci. 2010 Spring;22(2):208-17. doi: 10.1176/appi.neuropsych.22.2.208. https://www.ncbi.nlm.nih.gov/pubmed/20463115

A new hypothesis of chronic fatigue syndrome: co-conditioning theory

Abstract:

Chronic fatigue syndrome is an illness characterized by a profound, disabling, and unexplained sensation of fatigue lasting at least 6 months, which severely impairs daily functioning and is accompanied by a combination of non-specific symptoms.

Many potential causes of chronic fatigue syndrome have been investigated, including viral infections, immune dysfunctions, abnormal neuroendocrine responses, central nervous system abnormalities, autonomic dysfunctions, impaired exercise capacities, sleep disruptions, genetic backgrounds, psychiatric abnormalities, personality, and abnormal psychological processes. However, no etiology, specific physical signs or laboratory test abnormalities have been found.

It is essential to establish a conceptual theory of chronic fatigue syndrome that can explain its pathophysiology in order to identify the clinical entity and to develop effective treatment methods. In this article, a new conceptual hypothesis about the pathophysiology of chronic fatigue syndrome, the co-conditioning theory, is presented: after repetitive overwork and/or stress, alarm signal to rest and fatigue sensation may cause in response to an unconditioned stimulus (impaired homeostasis and function) that has been paired with a conditioned stimulus (overwork and/or stress).

In the future, a new treatment strategy for patients with chronic fatigue syndrome, re-co-conditioning therapy, may be developed on the basis of the co-conditioning theory. In addition, this theory will likely contribute to a better understanding of the pathophysiology of chronic fatigue syndrome.

Source: Tanaka M, Watanabe Y. A new hypothesis of chronic fatigue syndrome: co-conditioning theory. Med Hypotheses. 2010 Aug;75(2):244-9. doi: 10.1016/j.mehy.2010.02.032. Epub 2010 Mar 24. https://www.ncbi.nlm.nih.gov/pubmed/20338693

Fatigue, burnout, and chronic fatigue syndrome among employees on sick leave: do attributions make the difference?

Abstract:

BACKGROUND: Persistent fatigue among employees, burnout, and chronic fatigue syndrome (CFS) are three fatigue conditions that share some characteristics in theory. However, these conditions have not been compared in empirical research, despite conceptual similarities.

METHODS: This cross sectional study aimed to investigate relations between persistent fatigue, burnout, and CFS by describing the clinical features of a sample of 151 fatigued employees on sick leave. Using validated instruments, subgroups based on research criteria for CFS and burnout within the sample of fatigued employees and a reference group of 97 diagnosed CFS patients were compared. Analyses of covariance were performed.

RESULTS: A total of 66 (43.7%) fatigued employees met research criteria for CFS (except symptom criteria) and 76 (50.3%) met research criteria for burnout. “CFS-like employees” (fatigued employees who met CFS criteria) reported stronger somatic attributions than “non-CFS-like employees”. Burnt out CFS-like employees were more depressed and distressed than CFS-like employees who were not burnt out. Burnout cases among the non-CFS-like employees had stronger psychological attributions than fatigued employees who were not burnt out. Compared to diagnosed CFS patients, CFS-like employees merely had a shorter duration of fatigue complaints. Burnt out CFS-like employees had stronger psychological attributions and were more distressed than CFS patients.

CONCLUSIONS: Fatigued employees shared many important characteristics with CFS patients, regardless of burnout status, and many fatigued employees met CFS criteria and/or burnout criteria. Differences however concerned the causal attributions that were made. This raises questions about the role of causal attributions: are they modified by fatigue complaints or do they determine illness outcome?

Source: Huibers MJ, Beurskens AJ, Prins JB, Kant IJ, Bazelmans E, Van Schayck CP, Knottnerus JA, Bleijenberg G. Fatigue, burnout, and chronic fatigue syndrome among employees on sick leave: do attributions make the difference? Occup Environ Med. 2003 Jun;60 Suppl 1:i26-31. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1765721/ (Full article)