Reduced interleukin-6 stress reactivity in male physicians with occupational burnout

Occupational burnout is associated with an elevated risk of cardiovascular events, but the mechanisms underlying this connection have rarely been studied. Low grade inflammation with interleukin (IL)-6 as a key player has been postulated as a possible link between low-grade inflammation and cardiovascular events. Another possibility could be attenuated inflammatory responses to stress reflecting a dysregulated innate immune response. The aim of this study was to examine the relationship between burnout and IL-6 reactivity to acute stress in physicians with burnout. Sixty male physicians were recruited, 30 with burnout, assessed with the Maslach Burnout Inventory, and 30 without burnout. Participants underwent the Trier Social Stress Test, inflicting uncontrollability, and social evaluative threat. Blood samples for IL-6 measurements were taken five times at predefined intervals during stress. Repeated measures analysis of covariance was conducted across the five time points, adjusting for age. IL-6 reactivity over time was significantly lower in physicians with burnout compared to their matched healthy counterparts (F(1.90, 108.10) = 4.88, p = 0.010) during stress. Confirming these results, there was also a significantly lower area under the curve with respect to increase in physicians with burnout compared to those without burnout (F(1, 57) = 4.99, p = 0.029). This study suggests that burnout is associated with lowered IL-6 reactivity in male physicians with burnout. An attenuated innate immune response in burnout complies with increased allostatic load such that dysfunctional stress responses might increase the risk of cardiovascular events in the long term.