Change search
ReferencesLink to record
Permanent link

Direct link
Brain activation patterns in major depressive disorder and job stress-related long-term sick leave
Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine.
Umeå University, Faculty of Medicine, Department of Integrative Medical Biology (IMB), Physiology.
Show others and affiliations
(English)Article in journal (Other academic) Submitted
URN: urn:nbn:se:umu:diva-37354OAI: diva2:359498
Available from: 2010-10-28 Created: 2010-10-28 Last updated: 2010-11-02Bibliographically approved
In thesis
1. Neurocognitive and endocrine dysfunction in women with exhaustion syndrome
Open this publication in new window or tab >>Neurocognitive and endocrine dysfunction in women with exhaustion syndrome
2010 (English)Doctoral thesis, comprehensive summary (Other academic)
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.

Place, publisher, year, edition, pages
Umeå: Umeå university, 2010. 76 p.
Umeå University medical dissertations, ISSN 0346-6612 ; 1379
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
National Category
Public Health, Global Health, Social Medicine and Epidemiology Radiology, Nuclear Medicine and Medical Imaging
Research subject
Medicine; Diagnostic Radiology
urn:nbn:se:umu:diva-37280 (URN)978-91-7459-086-9 (ISBN)
Public defence
2010-11-19, Sal B Tandläkarhuset, 901 87 Umeå, Umeå, 09:00 (Swedish)
Available from: 2010-10-28 Created: 2010-10-25 Last updated: 2010-10-28Bibliographically approved

Open Access in DiVA

No full text

Search in DiVA

By author/editor
Sandström, AgnetaSalami, AlirezaOlsson, TommyNyberg, Lars
By organisation
Department of Public Health and Clinical MedicinePhysiologyMedicineDiagnostic Radiology

Search outside of DiVA

GoogleGoogle Scholar
The number of downloads is the sum of all downloads of full texts. It may include eg previous versions that are now no longer available

Total: 343 hits
ReferencesLink to record
Permanent link

Direct link