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Brain activation patterns in major depressive disorder and job stress-related long-term sick leave
Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin.
Umeå universitet, Medicinska fakulteten, Institutionen för integrativ medicinsk biologi (IMB), Fysiologi.
Vise andre og tillknytning
(engelsk)Artikkel i tidsskrift (Annet vitenskapelig) Submitted
Identifikatorer
URN: urn:nbn:se:umu:diva-37354OAI: oai:DiVA.org:umu-37354DiVA, id: diva2:359498
Tilgjengelig fra: 2010-10-28 Laget: 2010-10-28 Sist oppdatert: 2018-06-08bibliografisk kontrollert
Inngår i avhandling
1. Neurocognitive and endocrine dysfunction in women with exhaustion syndrome
Åpne denne publikasjonen i ny fane eller vindu >>Neurocognitive and endocrine dysfunction in women with exhaustion syndrome
2010 (engelsk)Doktoravhandling, med artikler (Annet vitenskapelig)
Abstract [en]

Stress has emerged as one of the most important factors to consider in psychiatric diagnoses and has become a common reason for long-term sick leave (LTSL). Roughly 50% of LTSL due to psychiatric diseases are thought to be associated with work-related stress. The demarcation towards major depression is disputed, and no international consensus exists for how to diagnose and rehabilitate these individuals.

The Swedish National Board of Health has suggested the term “exhaustion syndrome” to integrate these individuals into stress-related disorders. Prominent features of this syndrome are fatigue, sleeping disorders, and cognitive dysfunction. The cognitive dysfunction may be due to an interaction between personality features, environmental factors, the biological effects of stress hormones, and dysfunction in key brain areas, notably the hippocampus and prefrontal cortex. A consistent feature of chronic stress is activation of the cortisol, or hypothalamic-pituitary-adrenal, axis, which may be linked to cognitive dysfunction. Increased glucocorticoid levels, mainly cortisol in humans, are known to impair memory performance. The aim of this thesis was to investigate whether patients with exhaustion syndrome exhibit specific alterations in an extensive set of biological, psychological and immunological variables.

Patients in Study 1 had significant cognitive impairment for specific tasks assumed to tap frontal lobe functioning. In Study 2 anxiety prone, worrying, pessimistic individuals with low executive drive and a persistent personality type were more likely to develop exhaustion syndrome. Decreased reactivity was found on the pituitary level after corticotropin releasing hormone (CRH) in exhaustion syndrome patients. The cortisol/adrenocorticotropic hormone response to CRH was slightly higher in patients compared to controls, indicating increased sensitivity at the adrenal cortex level. No differences were found in hippocampal volume. In Study 3, functional imaging revealed a different pattern of brain activation in working memory tests in patients with exhaustion syndrome compared to healthy individuals and patients with depression.

In summary, our data suggests an intimate link between personality and wellbeing, cognitive performance and neuroendocrine dysfunction, in exhaustion syndrome. We thus find similarities with major depression but also distinct differences between the exhaustion syndrome and major depression.

sted, utgiver, år, opplag, sider
Umeå: Umeå university, 2010. s. 76
Serie
Umeå University medical dissertations, ISSN 0346-6612 ; 1379
Emneord
Cognition, attention, working memory, exhaustion syndrome, major depression, cortisol, HPA-axis, proinflammatory cytokines, psychology, neurocognitive, endocrine, fMRI, MRI, prefrontal cortex, multivariate, women, personality, TCI, stress
HSV kategori
Forskningsprogram
medicin; diagnostisk radiologi
Identifikatorer
urn:nbn:se:umu:diva-37280 (URN)978-91-7459-086-9 (ISBN)
Disputas
2010-11-19, Sal B Tandläkarhuset, 901 87 Umeå, Umeå, 09:00 (svensk)
Opponent
Veileder
Tilgjengelig fra: 2010-10-28 Laget: 2010-10-25 Sist oppdatert: 2018-06-08bibliografisk kontrollert

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