I’m tired. You’re tired. We’re all tired. Importantly – performance suffers with exhaustion, unhealthy behaviors at work increase, and cognitive errors at work rise. Burnout.
And now there might be a test for it.
This is a small study of resident trainees in Turkey, correlating the levels of neurotrophic factor S100 calcium binding protein B with symptoms of Burnout Syndrome – emotional exhaustion, depersonalization, and personal accomplishment. S100B is a marker of glial activation and brain injury, and seems to fluctuate with stress and depression, although the associations have not been shown to be reliable.
Each resident trainee was asked to complete a questionnaire regarding burnout prior to, and following, a night shift, along with concomitant blood draw. Unfortunately, the results are primarily grim, and not on account of the primary outcome: 37 of 48 participating residents scored in the severe depression category on the burnout questionnaire. The remaining 11 scored in the moderate range.
Looking at the actual purpose of the study, however, they did find S100B levels were significantly different between severe and moderate depression, even accounting for the small sample. The pre- and post-night shift levels were not appreciably different. Overall, S100B seemed to correlate best with the overall burnout score, in particular the subscore for emotional exhaustion.
It’s a little hard to interpret these data, or envision how they might be applied in a real-world situation. It does seem a reasonable biomarker to pursue as an objective measure of the stresses of training, and, frankly, it may be the on-shift changes were not detected as a result of most residents already exhibiting features of high stress and burnout even before starting their night. Then, even assuming S100B were proven valid, the “gold standard” in this case – the burnout inventory – is probably less expensive and certainly less invasive to deploy.
I am not certain the way forward for this line of burnout biomarker research, but it is rather interesting.
“Serum S100B as a surrogate biomarker in the diagnoses of burnout and depression in emergency medicine residents.”