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Burnout: a reality among physicians and other health professionals
- P. Perestrelo Passos, M. J. Amorim, F. Araújo
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- Journal:
- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, p. S959
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- Article
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Introduction
Burnout is a syndrome that results from chronic stress at work, with several consequences to workers’ well-being and health. It is included in the 11th Revision of the International Classification of Diseases (ICD-11) as an occupational phenomenon and is described in the chapter «Factors influencing health status or contact with health services», which includes reasons for which people contact health services but that are not classed as illnesses or health conditions. Burnout isn’t classified as a medical condition.
ObjectivesTo assess the consequences of health professionals’ burnout: it’s impact at personal and professional level.
MethodsNon-systematic literature review, available in English, using the PubMed database. Key search terms included burnout; physician; psychiatrist; healthcare; depression; suicide.
ResultsBurnout is a syndrome conceptualized as resulting from chronic workplace stress that has not been successfully managed. It is characterized by three dimensions: feelings of energy depletion or exhaustion; increased mental distance from one’s job, or feelings of negativism or cynicism related to one’s job; and reduced professional efficacy. Burnout is particularly common on physicians and in other health professionals, like nurses. This problem represents a public health crisis with negative impacts on individual health professionals, patients and healthcare organizations and systems. Systems factors that play a role in burnout include work compression, demands of electronic health records, production pressure and lack of control over one’s professional life.
ConclusionsPhysician burnout is an under-recognized and under-reported problem, and, unfortunately, physicians often do not recognize symptoms of burnout, and even less often do they seek help. Burnout refers specifically to phenomena in the occupational context and should not be applied to describe experiences in other areas of life. There are different clinical forms of burnout and various therapeutic strategies. The individual and social impacts of burnout highlight the need for preventive interventions and early identification of this health condition in the work environment. Psychiatrists play a key role in the multidisciplinary diagnosis and treatment of burnout.
Disclosure of InterestNone Declared
Serotonin reuptake inhibitors and its cognitive burden…or relief.: A brief review
- M. J. Amorim, F. Araújo, P. Passos Perestrelo, M. Maia Marques
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- Journal:
- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, p. S1011
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- Article
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Introduction
The use of selective serotonin reuptake inhibitors (SSRIs) has increased exponentially and worldwide in the last decade. Taking into account their tolerability and safety profile, they constitute the first line, in all age groups and in polimedicated population, for treatment of depressive, anxious, and phobic disorders, among others. Although safe, especially when compared to first generation antidepressants, they are not totally exempt of adverse effects, and may cause, especially in this context, some degree of cognitive impairment, which may or may not be completely reversible. On the other hand, and despite the controversy related to the subject, some studies suggest a possible protective effect of this pharmacologic class regard the development of cognitive disfunction, which, although not very consistent, should not be neglected.
ObjectivesTo understand the cognitive impact of short- and long-term use of SSRIs, given the increasing use in an aging, polymedicated population.
MethodsBrief sistematic review of selected articles from Pubmed, Medline and Uptodate databases, with the keywords “SSRIs”, “cognitive”, “impairment”, “adverse effects”, “dementia”.
ResultsSSRIs are not entirely exempt from cognitive effects, despite their recognized safety profile. Some of the adverse effects typically related to the class, such as hyponatraemia, especially when insidious and silent course, as well as anticholinergic activity (typically associated with first generation antidepressants, but not exclusive) interfere with global functionality and may clinically present as mild cognitive impairment or even major neurocognitive disorders. Furthermore, given their potential to induce or inhibit the cytochrome P450 system, they are significantly implicated in pharmacokinetic drugs interactions that increase cognitive burden associated with other psychotropic drugs.
In the long term, and in certain patient populations, it has been hypothesized that they may exert some protective effect on physiological and pathological cognitive functions decline, by preventing neuronal death, acetylcholine decrease and amoyloidogenesis.
ConclusionsDespite their benign adverse effect profile, when compared with tricyclic antidepressants, SSRIs are not devoid of adverse effects on cognitive domains. However, and despite contradictory and inconsistent results, when well tolerated, SSRIs may confer benefits in terms of preserving global functionality, far beyond the affective symptoms resolution that motivated their introduction in the first place.
Disclosure of InterestNone Declared