Biomarkers of burnout and their relationship with psychological characteristics in healthcare practitioners

Background — The goal of this study was to investigate how biomarkers can be indicators of burnout in healthcare workers and what is the relationship between these biomarkers and psychological characteristics. Material and Methods — A total of 96 doctors and nurses from different clinics in Irkutsk were surveyed. The Maslach Burnout Inventory (MBI), Ware et al. 12-item Short-Form of the Medical Outcomes Study (SF-12), Beck Depression Inventory (BDI), Ways of Coping questionnaire, Mindful Attention Awareness Scale (MAAS) and Five Facet Mindfulness Questionnaire (FFMQ) were employed. Dehydroepiandrosterone sulfate (DHEA-S), thyroid-stimulating hormone (TSH), melatonin, serotonin, dopamine and cortisol were used as biomarkers. Results — We established that doctors and nurses diagnosed with high-level burnout had higher concentrations of DHEA-S and cortisol in their saliva. Salivary cortisol and DHEA-S were associated with levels of depressive symptoms. Relationships were found between various biomarkers (melatonin, DHEA-S) and factors that prevent the development of stress. Such productive coping strategies as Planful Problem-Solving or components of mindfulness capable of reducing stress severity were negatively associated with the circadian rhythm regulator (melatonin) and DHEA-S. Presumably, psychological regulation can reduce objective stress rather than subjectively experienced stress alone. Conclusion — Doctors and nurses with high burnout levels have high concentrations of DHEA-S and cortisol. Accordingly, these biomarkers can be considered as indicators of burnout. In addition, coping strategies and mindfulness components were identified that are associated with stress biomarkers and, presumably, can help reduce not only subjectively experienced stress, but also objective stress.