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Background: Physician burnout, characterized by chronic job-related stress leading to emotional exhaustion, depersonalization, and reduced personal accomplishment. This cross-sectional study investigates cortisol reactivity in male physicians with burnout compared to healthy controls during an acute psychosocial stress test., Methods: Sixty male physicians (30 burnout, 30 healthy controls) participated between September 2019 and December 2021 to investigate the impact of burnout on cardiovascular health. Salivary cortisol levels were measured before and after a Trier Social Stress Test (TSST). Burnout was assessed with the Maslach Burnout Inventory-Human Services Survey (MBI-HSS). Covariates included age, BMI, and physical activity. Data were analyzed using repeated measures analysis and area under the curve analysis., Results: Male physicians with burnout exhibited significantly greater cortisol reactivity during the TSST, notably post-stress to 15 min post-stress. Emotional exhaustion correlated with reduced cortisol increase from pre-stress and smaller post-stress to 15- and 45-min declines., Discussion: Findings suggest heightened cortisol reactivity in male physicians with burnout, possibly reflecting initial chronic stress stages. This study highlights the necessity for long-term research on cortisol's influence on cardiovascular health and stress responses across diverse groups., Conclusions: The findings contribute to comprehending physiological responses in burnout-afflicted physicians, emphasizing cortisol reactivity's pivotal role in stress-related research and its potential health implications, particularly within the burnout context.

Background: As a professional group, physicians are at increased risk of burnout and job stress, both of which are associated with an increased risk of coronary heart disease that is at least as high as that of other professionals. This study aimed to examine the association of burnout and job stress with coronary microvascular function, a predictor of major adverse cardiovascular events., Methods: Thirty male physicians with clinical burnout and 30 controls without burnout were included. Burnout was assessed with the Maslach Burnout Inventory and job stress with the effort-reward imbalance and overcommitment questionnaire. All participants underwent myocardial perfusion positron emission tomography to quantify endothelium-dependent (cold pressor test) and endothelium-independent (adenosine challenge) coronary microvascular function. Burnout and job stress were regressed on coronary flow reserve (primary outcome) and two additional measures of coronary microvascular function in the same model while adjusting for age and body mass index., Results: Burnout and job stress were significantly and independently associated with endothelium-dependent microvascular function. Burnout was positively associated with coronary flow reserve, myocardial blood flow response, and hyperemic myocardial blood flow (r partial = 0.28 to 0.35; p-value = 0.008 to 0.035). Effort-reward ratio (r partial =  - 0.32 to - 0.38; p-value = 0.004 to 0.015) and overcommitment (r partial =  - 0.30 to - 0.37; p-value = 0.005 to 0.022) showed inverse associations with these measures., Conclusions: In male physicians, burnout and high job stress showed opposite associations with coronary microvascular endothelial function. Longitudinal studies are needed to show potential clinical implications and temporal relationships between work-related variables and coronary microvascular function. Future studies should include burnout and job stress for a more nuanced understanding of their potential role in cardiovascular health., (© 2023. The Author(s).)

Ineffective coping is a risk factor for burnout among physicians, in whom the prevalence of burnout is high and has also increased in recent years. We examined in a cross-sectional study whether physicians with burnout show different coping styles compared with healthy controls. Male physicians (n = 60) were recruited into two groups (burnout vs. healthy). The Coping Inventory for Stressful Situations (CISS) and the Maslach Burnout Inventory (MBI) were applied. Wilcoxon rank-sum test showed group differences in two of the three coping styles, task-oriented and emotion-oriented, and also in one of the two subscales of the avoidance-oriented coping: social-diversion-oriented coping. Multiple binomial logistic regression, controlling for age, showed that lower task-oriented coping (OR = 0.38 (0.13 - 0.93), p = 0.048, d = 0.534) and lower social-diversion-oriented coping (OR = 0.33 (0.11 - 0.80), p = 0.024, d = 0.611) significantly predicted the burnout group. The findings suggest that male physicians with burnout differ from healthy controls in terms of less frequent utilization of effective coping styles. These findings could be explored for their utility in preventing burnout in future studies., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2023 Holzgang et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Background: Retirement is a central transition in late adulthood and requires adjustment. These processes not only affect the retired individuals but also their romantic partners. The aim of this study is to investigate the interplay of intrapersonal emotion regulation (rumination) with interpersonal regulation processes (disclosure quality). Furthermore, the associations of daily retirement-related disclosure with adjustment symptoms in disclosing and the listening partner will be investigated. It is expected that the effects of disclosure alter after providing the couples with a self-applied solitary written disclosure task in order to support their intrapersonal emotion regulation. Methods: In this dyadic online-diary study, 45 couples ( N = 45) with one partner perceiving the adjustment to a recent retirement as challenging reported rumination, perceived disclosure quality (repetitive, focused on negative content, hard to follow, disclosing partner open for common/authentic), retirement-related disclosure, and ICD-11 adjustment symptoms preoccupation and failure to adapt were assessed at the end of the day over 14 days. In the middle of this assessment period, couples performed a modified online-expressive writing about their thoughts and feelings regarding the transition to retirement. Results: The double-intercept multilevel Actor-Partner Interdependence Models (APIM) reveal that on days with more daily rumination, the spouse perceived that disclosure of the retiree is more difficult to follow, more negative, and repetitive. In contrast, the retiree perceived less authenticity and openness to comments during disclosure on days when the spouse reports more rumination. Retirement-related disclosure showed no within-couple association with failure to adapt but actor effects on preoccupation. Moreover, a partner effect of disclosure of the retirees on the preoccupation of spouses could be observed. This contagious effect of the retiree disclosure, however, disappeared during the week after writing. Conclusion: Our results support the notion that disclosure processes are altered during maladaptive intrapersonal emotion regulation processes. This in turn seems to lead to less effective interpersonal regulation and contagious spilling over of symptoms. Supporting intrapersonal emotion regulation seems to have the potential to allow more favorable interpersonal regulation processes and to free interpersonal resources for an individual adjustment. This has implications for further planning of support for couples facing life transitions and aging-related changes., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2021 Horn, Holzgang and Rosenberger.)

Job burnout, characterized by feelings of exhaustion, cynicism and reduced personal efficacy, has been defined as a risk state for the development of diseases, but its association with somatic diseases is underexplored. Study participants were 5671 respondents (mean age 44.1 years, range 18-70; 38.6% men) to an online survey of job burnout, using a mobile health web application. Respondents provided data on sociodemographic characteristics, symptoms of burnout, measured with the Maslach Burnout Inventory-General Survey, depressive symptoms, measured with the Profile of Mood States, and 11 categories of somatic diseases. Adjusting for age, sex, educational level, depressive symptoms, and all disease categories included, network analysis showed a significant association of high exhaustion with "high blood pressure" and a category of "other chronic somatic diseases". Low personal efficacy showed a significant association with "chronic lung diseases". In network analysis, clinically relevant depressive symptoms were also significantly associated with "high blood pressure", "other chronic somatic diseases" and "skin diseases". Logistic regression analysis confirmed these associations. Burnout dimensions were significantly associated with an increased risk for somatic diseases, independently of sociodemographic factors and clinically relevant depressive symptoms. This relationship seems particularly evident for the exhaustion dimension of job burnout.