, Volume 21, Issue 3, pp 267–272 | Cite as

Longitudinal changes in pituitary-adrenal hormones in south african women with burnout

  • Shirra L. MochEmail author
  • Vanessa R. Panz
  • Barry I. Joffe
  • Ivan Havlik
  • Jonathan D. Moch


The author’ goal was to document baseline pituitaryadrenal hormonal and related metabolic variables in 16 female patients with burnout. Then, following stress management intervention, to compare the changes with an equal number of untreated control subjects. At monthly intervals for 4 mo, 24-h urine samples were obtained for determination of free cortisol excretion. In addition, fasting blood samples were analyzed for levels of cortisol, dehydroepiandrosterone sulfate (DHEAS), ACTH, aldosterone, and catecholamines. Other biochemical measurements included growth hormone, prolactin, insulin, glucose, and lipid components. The Maslach Burnout Inventory, General Health Questionnaire-28, and Zung depression rating scale were completed on each consecutive visit. The most striking finding was the reduction of urine free-cortisol excretion in the patients compared with controls. Initial urinary free cortisol was significantly lower in the patients (mean ± SEM=47.2 ± 11.0 vs 79.0 ± 6.8 nmol/L, P=0.02) and remained significantly reduced at 4 mo (mean ± SEM=44.0 ± 6.1 vs 91.1 ± 8.8 nmol/L, p=0.0001). There were no significant changes in the other hormonal and biochemical data. We conclude that there is functional hypocortisolism in burnout, which is not immediately restored on stress management intervention despite clinical and psychological improvement.

Key Words

Burnout HPA axis cortisol ACTH rating scales depression 


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Copyright information

© Humana Press Inc. 2003

Authors and Affiliations

  • Shirra L. Moch
    • 1
    Email author
  • Vanessa R. Panz
    • 2
  • Barry I. Joffe
    • 2
  • Ivan Havlik
    • 1
  • Jonathan D. Moch
    • 3
  1. 1.Department of Pharmacy and Pharmacology, Faculty of Health SciencesUniversity of the WitwatersrandJohannesburgSouth Africa
  2. 2.Carbohydrate and Lipid Metabolism Research Group, Department of Medicine, Faculty of Health SciencesUniversity of the WitwatersrandJohannesburgSouth Africa
  3. 3.Centre for Stress-Related IllnessesMilpark HospitalJohannesburgSouth Africa

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