Table 2_Factors associated with symptom severity in stress-induced exhaustion disorder: cohort characterization and cross-sectional correlations.xlsx

IntroductionChronic stress-related conditions such as burnout and exhaustion disorder (ED) constitute a significant and growing individual and societal burden. Still, the long-term interactions between symptoms and key risk factors, including brain structure and function, remain poorly understood. To address this knowledge gap, we initiated the PROMUS project, a large-scale longitudinal brain imaging study of 350 participants on sick leave for ED in Sweden.
MethodsHere, we report baseline cohort (n=300) characteristics and cross-sectional associations between symptom severity, primarily measured using the Shirom-Melamed Burnout Questionnaire (SMBQ), and demographic, occupational, psychiatric, psychological, and lifestyle factors assessed using online questionnaires.
ResultsOur findings revealed significant associations between symptom severity and multiple factors, most notably depression, anxiety, sleep disturbances, quality of life, dissociation, psychological inflexibility, intolerance of uncertainty, self-efficacy, alexithymia, trauma, gratitude, educational background, emotional stability, household demands, Attention Deficit/Hyperactivity Disorder symptoms, autistic traits, perfectionism, and physical activity.
DiscussionThese findings support previous research linking persistent stress conditions to a spectrum of demographic, occupational, psychiatric, psychological, and lifestyle measures. The results also add to the understanding of targetable ED symptoms and risk factors and set the direction for brain imaging analyses and longitudinal assessments in this cohort.

引言
与慢性应激相关的疾病（诸如职业倦怠与疲劳障碍（exhaustion disorder, ED））给个体与社会带来了日益沉重的负担。然而，症状与包括脑结构与功能在内的关键风险因素之间的长期相互作用仍未得到充分阐明。为填补这一认知空白，我们启动了PROMUS项目——一项针对瑞典350名因疲劳障碍休病假参与者开展的大规模纵向脑成像研究。

方法
本研究报告了该队列的基线数据（n=300）特征，以及以Shirom-Melamed职业倦怠问卷（Shirom-Melamed Burnout Questionnaire, SMBQ）为主要评估工具的症状严重程度，与通过线上问卷采集的人口统计学、职业相关、精神科、心理学及生活方式因素之间的横断面关联。

结果
本研究发现症状严重程度与多种因素存在显著关联，其中尤为突出的包括抑郁、焦虑、睡眠障碍、生活质量、解离状态、心理僵化、不确定性容忍度、自我效能感、述情障碍、创伤经历、感恩心态、受教育程度、情绪稳定性、家庭负担、注意缺陷/多动障碍（Attention Deficit/Hyperactivity Disorder）症状、自闭症特质、完美主义以及体力活动水平。

讨论
本研究结果佐证了此前关于持续性应激状态与一系列人口统计学、职业相关、精神科、心理学及生活方式指标存在关联的研究结论。此外，本研究进一步加深了对可干预的疲劳障碍症状与风险因素的理解，并为该队列后续的脑成像分析与纵向评估指明了方向。