Risk of burnout can be estimated by analysing saliva samples

June 15, 2018, Medical University of Vienna
Risk of burnout can be estimated by analysing saliva samples. Credit: Medical University of Vienna

According to calculations from the World Health Organisation, depression occupies first place in the global "disease burden" and, by 2030, experts estimate that there will be three mental illnesses in the Top 5: depression, Alzheimer's and other forms of dementia and alcohol addiction. Even Austria is seeing an increase in mental problems such as burnout and, since 2010, these have been the main reason for invalidity retirement. Researchers from MedUni Vienna and the Health Insurance Agency's Health and Prevention Center have now shown that burnout can be identified by means of a simple saliva test. The hormone cortisol is the marker used for this.

Cortisol is actually an anti- hormone, which activates metabolic break-down processes, thereby making energy-rich compounds available to the human body. Its damping effect on the immune system is also used to prevent over-reactions and to suppress inflammation. Cortisol is predominantly produced in the early morning on waking, to crank up the circulation, as it were.

In healthy people, the cortisol level then falls again over the course of the day – until there is practically no measurable cortisol left by the evening. The picture is very different for people who are under constant stress: the body keeps the within the measurable range for much longer, in order to cope with the prevailing stress – if the stress then becomes "chronic", cortisol levels remain high without any normal daily pattern.

The three lead investigators, Helmuth Haslacher and Alexander Pilger from the Division of Medical-Chemical Laboratory Diagnostics (KILM) of MedUni Vienna and Robert Winker from the stress clinic at the Health and Prevention Center of the KFA (Health Insurance Agency) have now shown that elevated cortisol levels can be detected by means of a single saliva sample, taken either at midday or in the evening, so that the risk of can be measured.

The study involved comparing the work-related stress and cortisol levels of burnout patients with those of healthy employees. "It was found that people who were identified as having a high level of work-related stress using psychological methods had noticeably higher cortisol values at midday and also in the evening. We also observed an improvement in the clinical course and levels of patients receiving treatment in the special stress clinic set up by the KFA. This means that we can use these markers for preventively identifying people who are at greater risk of burnout," say the experts. Follow-on studies are therefore to be conducted to evaluate this result and to develop a valid biochemical testing system for use in everyday clinical practice to identify high-risk candidates for burnout.

According to the researchers, compared with the previously used early-morning samples – taken three times after waking at fifteen-minute intervals – the midday and evening saliva samples also provided a much better and more reliable result: "Our current data indicate that people at risk of burnout can be identified from a single saliva sample with almost 100 percent accuracy, whereas the multiple early-morning sampling involved more laborious methods and produced a much larger range of variation." Reliable analysis is now possible just four hours after providing the sample and this method even produced better results than analysing stress-related blood parameters. "We will use these results to further reinforce our efforts to prevent stress-related illnesses in collaboration with the stress clinic of the KFA Health and Prevention Center.

Explore further: Stress hormones spike as the temperature rises

More information: Alexander Pilger et al. Midday and nadir salivary cortisol appear superior to cortisol awakening response in burnout assessment and monitoring, Scientific Reports (2018). DOI: 10.1038/s41598-018-27386-1

Related Stories

Stress hormones spike as the temperature rises

April 25, 2018
A new study in medical students finds that summer, not winter, is the season when people are most likely to have higher levels of circulating stress hormones. These non-intuitive findings contradict traditional concepts of ...

When stress hormone falters, your health may suffer

August 11, 2017
(HealthDay)— Steady daytime levels of the stress hormone cortisol are associated with serious health problems, such as inflammation, obesity and cancer, researchers say.

Stress contagion possible amongst students and teachers

June 27, 2016
Teacher burnout and student stress may be linked, according to a University of British Columbia study.

Saliva test for stress hormone levels may identify healthy older people with thinking problems

August 19, 2015
Testing the saliva of healthy older people for the level of the stress hormone cortisol may help identify individuals who should be screened for problems with thinking skills, according to a study published in the August ...

Low cortisol levels may increase risk of depression in bipolar disorder

June 18, 2014
Depression is almost twice as common, and poor quality of life almost five times as common, in people with bipolar disorder who have elevated or low levels of the stress hormone cortisol in the blood. Researchers at Umeå ...

Animal welfare: Potential new indicator of chronic stress in horses

September 8, 2017
Cortisol, deemed the quintessential stress hormone, allows us to cope with important events and imminent threats. A spike in cortisol levels mobilizes necessary resources—such as by tapping into our body's reserves to produce ...

Recommended for you

WHO recognises 'compulsive sexual behaviour' as mental disorder

July 15, 2018
The World Health Organization has recognised "compulsive sexual behaviour" as a mental disorder, but said Saturday it remained unclear if it was an addiction on a par with gambling or drug abuse.

How looking at the big picture can lead to better decisions

July 13, 2018
New research suggests how distancing yourself from a decision may help you make the choice that produces the most benefit for you and others affected.

Nature is proving to be awesome medicine for PTSD

July 13, 2018
The awe we feel in nature can dramatically reduce symptoms of post-traumatic stress disorder, according to UC Berkeley research that tracked psychological and physiological changes in war veterans and at-risk inner-city youth ...

Is depression during pregnancy on the rise?

July 13, 2018
(HealthDay)—Today's young mothers-to-be may be more likely to develop depression while pregnant than their own mothers were, a new study suggests.

Machine learning helps to predict the treatment outcomes of schizophrenia

July 12, 2018
Could the diagnosis and treatment of mental health disorders one day be aided through the help of machine learning? New research from the University of Alberta is bringing us closer to that future through a study published ...

Mental illness study to explore patients' self-assessments

July 12, 2018
As the mental health community pursues new ways to improve the lives of the severely ill, a University of Texas at Dallas researcher is focusing on what can be learned from patients' answers to a simple question: "How do ...

1 comment

Adjust slider to filter visible comments by rank

Display comments: newest first

LaPortaMA
not rated yet Jun 15, 2018
All about ignorance.

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.