OBJECTIVE: The effects of burnout and perceived stress on
early morning free cortisol levels after awakening were
investigated in a group of teachers. Previous studies revealed
that cortisol levels show a significant increase after
awakening, with high intraindividual stability.
Sixty-six teachers from local public schools (42 women and 24
men, mean age 42+/-5 years) were asked to sample saliva for
cortisol analysis on 3 consecutive days. On each day, cortisol
levels were measured at the time of awakening and 15, 30, and
60 minutes thereafter. On the night before the third day,
subjects took 0.5 mg dexamethasone orally for testing
glucocorticoid feedback inhibition. Burnout and perceived
stress were measured by three different questionnaires.
RESULTS: Perceived stress correlated with increases of
cortisol levels during the first hour after awakening after
dexamethasone pretreatment. In addition, teachers scoring high
on burnout showed lower overall cortisol secretion on all
sampling days, and a higher suppression of cortisol secretion
after dexamethasone administration. In the subgroup of
teachers with both high levels of perceived stress and high
levels of burnout, a lower overall cortisol secretion was
observed on the first 2 days, with stronger increases during
the first hour after awakening after dexamethasone
suppression. This subgroup also showed the lowest self-esteem,
the highest external locus of control, and the highest number
of somatic complaints.
CONCLUSIONS: These results demonstrate
differential effects of burnout and perceived stress on
hypothalamic-pituitary-adrenal axis regulation.
Pruessner JC, Hellhammer DH, Kirschbaum C