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      Associations of fatigue to work-related stress, mental and physical health in an employed community sample

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          Abstract

          Background

          While work-related fatigue has become an issue of concern among European employees, the relationship between fatigue, depression and work-related stressors is far from clear. The purposes of this study were (1) to determine the associations of fatigue with work-related stressors, severe medical disease, health behavior and depression in the working population and (2) to determine the unique impact of work-related stressors on fatigue.

          Methods

          We used cross-sectional data of N = 7,930 working participants enrolled in the Gutenberg Health Study (GHS) from 2007 to 2012 filled out the Personal Burnout Scale (PBS) of the Copenhagen Psychosocial Questionnaire (COPSOQ), the PHQ-9, and a list of work-related stressors.

          Results

          A total of 27.5% reported increased fatigue, esp. women, younger persons with a lower social status and income, smokers, severely medically ill, previously and currently depressed participants. Fatigue was consistently associated with severe medical disease, health behavior and depression, which need to be taken into account as potential confounders when analyzing its relationship to work-related strains. Depression was consistently associated with work-related stressors. However, after statistically partialling out depression, fatigue was still significantly associated with work-related stress.

          Conclusions

          Fatigue as an indicator of allostatic load is consistently associated with work-related stressors such as work overload after controlling for depression. The brief Personal Burn-out Scale is suitable for assessing work-related fatigue in the general population.

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          Most cited references33

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          Tests for comparing elements of a correlation matrix.

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            Protective and Damaging Effects of Mediators of Stress: Elaborating and Testing the Concepts of Allostasis and Allostatic Load

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              Mood disorders and allostatic load.

              The brain controls both the physiologic and the behavioral coping responses to daily events as well as major stressors, and the nervous system is itself a target of the mediators of those responses through circulating hormones. The amygdala and hippocampus interpret what is stressful and regulate appropriate responses. The amygdala becomes hyperactive in posttraumatic stress disorder (PTSD) and depressive illness, and hypertrophy of amygdala nerve cells is reported after repeated stress in an animal model. The hippocampus expresses adrenal steroid receptors. It undergoes atrophy in several psychiatric disorders and responds to repeated stressors with decreased dendritic branching and reduction in number of neurons in the dentate gyrus. Stress promotes adaptation ("allostasis"), but a perturbed diurnal rhythm or failed shutoff of mediators after stress ("allostatic state") leads, over time, to wear and tear on the body ("allostatic load"). Neural changes mirror the pattern seen in the cardiovascular, metabolic, and immune systems, that is, short-term adaptation versus long-term damage. Allostatic load leads to impaired immunity, atherosclerosis, obesity, bone demineralization, and atrophy of nerve cells in brain. Allostatic load is seen in major depressive illness and may also be expressed in other chronic anxiety disorders such as PTSD and should be documented.
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                Author and article information

                Contributors
                dirk-matthias.rose@unimedizin-mainz.de
                andreas.seidler@mailbox.tu-dresden.de
                nuebling@ffaw.de
                latza.ute@baua.bund.de
                Elmar.braehler@medizin.uni-leipzig.de
                eva.klein@unimedizin-mainz.de
                joerg.wiltink@unimedizin-mainz.de
                matthias.michal@unimedizin-mainz.de
                stefan.nickels@unimedizin-mainz.de
                philipp.wild@unimedizin-mainz.de
                koenigjo@uni-mainz.de
                matthias.claus@unimedizin-mainz.de
                letzel@uni-mainz.de
                manfred.beutel@psycho.med.uni-giessen.de
                Journal
                BMC Psychiatry
                BMC Psychiatry
                BMC Psychiatry
                BioMed Central (London )
                1471-244X
                5 May 2017
                5 May 2017
                2017
                : 17
                : 167
                Affiliations
                [1 ]GRID grid.410607.4, Institute of Teachers’ Health, , University Medical Center of the Johannes Gutenberg University of Mainz, ; Mainz, Germany
                [2 ]ISNI 0000 0001 2111 7257, GRID grid.4488.0, Institute and Policlinic of Occupational and Social Medicine, Faculty of Medicine, , TU Dresden, ; Dresden, Germany
                [3 ]FFAW, Freiburg Research Centre for Occupational Sciences, Freiburg, Germany
                [4 ]ISNI 0000 0001 2220 0888, GRID grid.432860.b, , Federal Institute for Occupational Safety and Health (BAuA), ; Berlin, Germany
                [5 ]GRID grid.410607.4, Department of Psychosomatic Medicine and Psychotherapy, , University Medical Center of the Johannes Gutenberg University of Mainz, ; Mainz, Germany
                [6 ]GRID grid.410607.4, Department of Ophthalmology, , University Medical Center of the Johannes Gutenberg University of Mainz, ; Mainz, Germany
                [7 ]GRID grid.410607.4, Department of Medicine 2, Preventive Cardiology and Preventive Medicine, , University Medical Center of the Johannes Gutenberg University of Mainz, ; Mainz, Germany
                [8 ]GRID grid.452396.f, , German Center for Cardiovascular Research (DZHK), partner site RhineMain, ; Berlin, Germany
                [9 ]GRID grid.410607.4, Center for Thrombosis and Hemostasis (CTH), , University Medical Center of the Johannes Gutenberg University of Mainz, ; Mainz, Germany
                [10 ]GRID grid.410607.4, Institute of Medical Biostatistics, Epidemiology and Informatics (IMBEI), , University Medical Center of the Johannes Gutenberg University of Mainz, ; Mainz, Germany
                [11 ]GRID grid.410607.4, Institute of Occupational, Social and Environmental Health, , University Medical Center of the Johannes Gutenberg University of Mainz, ; Mainz, Germany
                Article
                1237
                10.1186/s12888-017-1237-y
                5420158
                28476149
                fe822a47-f87e-4a46-b190-1cad1aa82a33
                © The Author(s). 2017

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

                History
                : 22 October 2016
                : 10 February 2017
                Categories
                Research Article
                Custom metadata
                © The Author(s) 2017

                Clinical Psychology & Psychiatry
                fatigue,depression,work-related stressors,allostatic load,health behavior

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