نبذة مختصرة : Background. Stress-related disorders including clinical burnout (CB) are one of the main causes of sickness absenteeism in many Western countries. Little is known about the situation of CB patients, and objective markers are not used as an aid in clinical work with these patients. Moreover, evidence-based treatments are scarce to date. Yoga has shown an effect on stress, depression and anxiety, and might be an interesting treatment alternative. Aims. To understand the situation of patients with CB on sick leave (CBG), to investigate the effect of traditional yoga (TY) on patients with CB, and whether there are subjective and objective measures that can be used for screening, to diagnose CB, to follow the course and evaluate treatment effects. Subjective measures: 1. To describe health-related quality of life (HRQoL) in the CBG at baseline and compare to a healthy control group experiencing stress (HCG). 2. To explore the effect of psychological treatment with TY, mindfulness-based cognitive therapy (MBCT) and cognitive behavioural therapy (CBT) on HRQoL in the CBG. Objective measures: 1. To evaluate potential biomarkers for screening, diagnosis, to follow the course and to evaluate treatment effects in patients with CB on sick leave. 2. To compare the concentration of biomarkers in the CBG at baseline with that of biomarkers in the HCG at baseline. 3. To evaluate whether the 1 μg ACTH test can be used as a stress test. Material and methods. This thesis comprises 4 publications, derived from two randomized clinical trials (RCTs). Study population 1: The CBG, primary care patients (n=94, 12 men). Randomized to TY, MBCT or CBT. They received 20 weeks of group treatment, three hours per week, with additional homework for a minimum 4.5 hours per week. HRQoL was measured using SWED-QUAL questionnaire (S-Q). S-Q and biomarkers in blood and urine were sampled before and after treatment. Study population 2: The HCG, health care personnel (n = 88, 16 men). The HRQoL and biomarker baseline measurements for the HCG were ...
Relation: I. Astrid Grensman, Bikash Dev Acharya, Per Wändell, Gunnar Nilsson & Sigbritt Werner. Health-related quality of life in patients with Burnout on sick-leave: Descriptive and comparative results from a clinical study. International Archives of Occupational and Environmental Health. 2016 Feb;89(2):319–29. ::doi::10.1007/s00420-015-1075-5 ::pmid::26198803 ::isi::000368806500014; II. Grensman A, Acharya BD, Wändell P, Nilsson GH, Falkenberg T, Sundin Ö, Werner S. Effect of traditional yoga, mindfulness-based cognitive therapy, and cognitive behavioral therapy, on health related quality of life: a randomized controlled trial on patients on sick leave because of burnout. BMC Complement Altern Med. 2018 Mar 6;18(1):80. ::doi::10.1186/s12906-018-2141-9 ::pmid::29510704 ::isi::000427044900001; III. Astrid Grensman, Bikash Dev Acharya, Per Wändell, Gunnar H Nilsson, Torkel Falkenberg, Sigbritt Werner. Potential biomarkers for screening, diagnosis and evaluation of treatment effect on clinical burnout: Descriptive and comparative results from a randomized control trial using psychological treatment. [Submitted]; IV. Astrid Grensman, Bikash Dev Acharya, Per Wändell, Jan Sundquist & Sigbritt Werner. Salivary cortisol measurements for reliable numerical maximum concentration after the low dose 1 μg ACTH intravenously in healthy individuals. [Submitted]; http://hdl.handle.net/10616/46884
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