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AIMS Neuroscience 2021The temporal-parietal junction (TPJ) is a key structure for the embodiment, term referred to as the sense of being localized within one's physical body and is a... (Review)
Review
Targeting temporal parietal junction for assessing and treating disembodiment phenomena: a systematic review of TMS effect on depersonalization and derealization disorders (DPD) and body illusions.
The temporal-parietal junction (TPJ) is a key structure for the embodiment, term referred to as the sense of being localized within one's physical body and is a fundamental aspect of the self. On the contrary, the sense of disembodiment, an alteration of one's sense of self or the sense of being localized out of one's physical body, is a prominent feature in specific dissociative disorders, namely depersonalization/derealization disorders (DPD). The aims of the study were to provide: 1) a qualitative synthesis of the effect of Transcranial Magnetic Stimulation (TMS), taking into account its use for therapeutic and experimental purposes; 2) a better understanding on whether the use of TMS could support the treatment of DPD and other clinical conditions in which depersonalization and derealization are displayed. To identify suitable publications, an online search of the PubMed, Cochrane Library, Web of science and Scopus databases was performed using relevant search terms. In addition, an in-depth search was performed by screening review articles and the references section of each included articles. Our search yielded a total of 108 records through multiple databases searching and one additional record was identified through other sources. After duplicates removal, title and abstract reading, we retained 16 records for the assessment of eligibility. According to our inclusion criteria, we retained 8 studies. The selected studies showed that TMS targeting the TPJ is a promising technique for treating disembodiment phenomena DPD and for inducing reversible disembodiment states in healthy subjects. These data represent the first step towards a greater understanding of possible treatments to be used in disembodiment disorders. The use of TMS over the TPJ appears to be promising for treating disembodiment phenomena.
PubMed: 33709023
DOI: 10.3934/Neuroscience.2021009 -
Iranian Journal of Psychiatry Apr 2023Burnout is a psychological symptom characterized by emotional exhaustion, depersonalization, and lack of personal accomplishment. Several systematic reviews have... (Review)
Review
Burnout is a psychological symptom characterized by emotional exhaustion, depersonalization, and lack of personal accomplishment. Several systematic reviews have examined the prevalence of burnout in some communities, including the communities of physicians, nurses, students, and teachers. Risk factors, consequences of burnout, and related interventions have also been evaluated in several systematic review studies. The purpose of this systematic review was to investigate the prevalence, risk factors, consequences, and interventions associated with burnout among military personnel in all types of studies. Studies that quantitatively examined burnout in military personnel after 2000 were identified through systematic searches in PubMed, Scopus, Web of Knowledge, Embase, PsychInfo, and PsycArticles databases. A total of 43 studies met the criteria for inclusion in this systematic review. Of these, 34 were cross-sectional, 7 were longitudinal, 1 was case-control and 1 was experimental. Half of the studies had more than 350 samples. The studies were from 17 different countries, among which the United States had the largest number with 17 studies. 33 studies were measured with one version of Maslach Burnout Inventory (MBI). Totally, only 10 studies reported a prevalence of burnout and/or its subscales. The prevalence of high emotional exhaustion ranged from 0% to 49.7% (median 19%), the prevalence of high depersonalization ranged from 0% to 59.6% (median 14%) and the prevalence of low personal accomplishment ranged from 0% to 60% (median 6.4%). In this systematic review, work environment factors (such as workload, shift work), psychological factors (anxiety, depression, stress), and duration and quality of sleep were shown as risk factors of burnout or its subscales. Also, psychological distress was observed as the consequence of burnout in more than one study. The studies investigated in this systematic review showed a relatively moderate prevalence of burnout. In fact, burnout was associated with work environment factors and psychological variables.
PubMed: 37383961
DOI: 10.18502/ijps.v18i2.12371 -
Frontiers in Public Health 2023Burnout may be suffered not only by experienced nurses, but also by those in training. The university environment can be highly stressful for student nurses, who are... (Meta-Analysis)
Meta-Analysis
INTRODUCTION
Burnout may be suffered not only by experienced nurses, but also by those in training. The university environment can be highly stressful for student nurses, who are exposed to various stress-producing situations.
AIM
The aim of this study is to identify and analyse the main risk factors for burnout among nursing students.
METHODS
A systematic review with meta-analysis was performed. The search equation used was "Burnout AND Nursing students". Quantitative primary studies on burnout in nursing students, and related risk factors published in English or Spanish and with no restriction by year of publication were included.
RESULTS
A sample of n = 33 studies were included. Three variables are identified can influence burnout in nursing students: academic, interpersonal, environmental and/or social factors. The meta-analyses, with the higher sample of n = 418 nursing students, show that some personality factors, empathy, and resilience are correlated with emotional exhaustion, depersonalization and personal accomplishment.
CONCLUSION
The personality factors that can influence the development of burnout in nursing students, such as resilience and empathy, among others, must be taken into account when preventing the appearance and treating burnout. Professors should teach nursing students to prevent and recognize the most frequent symptoms of burnout syndrome.
Topics: Humans; Students, Nursing; Burnout, Professional; Burnout, Psychological; Emotions; Empathy
PubMed: 37213651
DOI: 10.3389/fpubh.2023.1142576 -
World Journal of Psychiatry Oct 2019Dissociation, which is defined as the failure to associate consciousness, memory, identity, emotion, perception, body representation, motor control, and behavior into an...
BACKGROUND
Dissociation, which is defined as the failure to associate consciousness, memory, identity, emotion, perception, body representation, motor control, and behavior into an integrated whole, has long been assumed to be generated by trauma. If dissociation is a product of trauma exposure, then dissociation would be a major mental health outcome observed in studies of disaster survivors. Although some studies have examined dissociation in disasters, no systematic literature reviews have been conducted to date on the topic.
AIM
To systematically evaluate the literature on the association between disaster and dissociation to determine the prevalence and incidence of dissociation after exposure to disaster and further examine their relationship.
METHODS
EMBASE, Medline, and PsychINFO were searched from inception to January 1, 2019 to identify studies examining dissociative disorders or symptoms related to a disaster in adult or child disaster survivors and disaster responders. Studies of military conflicts and war, articles not in English, and those with samples of 30 or more participants were excluded. Search terms used were "disaster*" and dissociation ("dissociat*," "multiple personality," "fugue," "psychogenic amnesia," "derealization," and "depersonalization"). Reference lists of identified articles were scrutinized to identify studies for additional articles.
RESULTS
The final number of articles in the review was 53, including 36 articles with samples of adults aged 18 and above, 5 of children/adolescents under age 18, and 12 of disaster workers. Included articles studied several types of disasters that occurred between 1989 and 2017, more than one-third (38%) from the United States. Only two studies had a primary aim to investigate dissociation in relation to disaster and none reported data on dissociative disorders. All of the studies used self-report symptom scales; none used structured interviews providing full diagnostic assessment of dissociative disorders or other psychopathology. Several studies mixed exposed and unexposed samples or did not differentiate outcomes between exposure groups. Studies examining associations between dissociation and disaster exposure have been inconclusive. The majority (75%) of the studies compared dissociation with posttraumatic stress, with inconsistent findings. Dissociation was found to be associated with a wide range of other psychiatric disorders, symptoms, and negative emotional, cognitive, and functional states.
CONCLUSION
The studies reviewed had serious methodological limitations including problems with measurement of psychopathology, sampling, and generation of unwarranted conclusions, precluding conclusions that dissociation is an established outcome of disaster.
PubMed: 31649861
DOI: 10.5498/wjp.v9.i6.83 -
Psychology Research and Behavior... 2023Research on healthcare shows that the relationship between empathy and burnout is complex. The aim of this systematic review and meta-analysis is to clarify the link... (Review)
Review
Research on healthcare shows that the relationship between empathy and burnout is complex. The aim of this systematic review and meta-analysis is to clarify the link between different empathic components and burnout components in healthcare professionals. A systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidance. The search strategy was applied in PubMed, PsycINFO, CINAHL, Scopus, and Medline, from January 1990 to January 2021. Population included nurses and doctors. Key inclusion criteria were articles addressing the relationship between different components of empathy and professional performance and wellbeing or burn out, or studies using burnout and empathy measures with validity support from commonly accepted sources of evidence. Risk of bias was assessed using the Mixed Methods Appraisal Tool. From 1159 references identified, 22 studies were included in the systematic review, and 5 studies in the meta-analysis. Empathic Concern was significantly correlated with Depersonalization and Personal Accomplishment. Moreover, the links between Perspective Taking, Depersonalization and Personal Accomplishment were statistically significant. In conclusion, exploring and understanding the complex links between empathy and burnout could help healthcare professionals as well as institutions to reduce the risk of suffering burnout.
PubMed: 36814637
DOI: 10.2147/PRBM.S384247 -
Deutsches Arzteblatt International Nov 2011"Burnout syndrome" is now a common reason for medical excuses from work, and thus an important topic in health-related economics. Much research is still needed, however,... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
"Burnout syndrome" is now a common reason for medical excuses from work, and thus an important topic in health-related economics. Much research is still needed, however, to establish the scientific basis for this entity, the criteria by which it might be diagnosed and classified, and how it should be treated.
METHODS
A systematic review of this topic, previously published as an HTA report, is presented here together with a selective overview of pertinent literature.
RESULTS
There currently exists neither an officially accepted definition nor a valid instrument for the differential diagnosis of burnout syndrome. Its manifestations are generally considered to lie along three dimensions: emotional exhaustion, depersonalization, and reduced performance ability and/or motivation. Most of the available studies on its epidemiology and differential diagnosis provide no more than a low level of evidence for their conclusions. There have been no controlled trials of treatments for burnout.
CONCLUSION
High-quality controlled studies on burnout syndrome are lacking. A standardized and internationally accepted diagnostic instrument with a validated rating scale should be developed. There is also a need for epidemiological and health-economic studies on the prevalence, incidence, and cost of burnout. The etiology and pathogenesis of burnout should be studied with special regard to the possible role of neurobiological factors. Treatments for it should be studied systematically so that their effects can be judged at a high level of evidence. In view of the current lack of knowledge about what is called "burnout," the term should not be used as a medical diagnosis or as a basis for decisions regarding disability or other socioeconomic matters.
Topics: Burnout, Professional; Diagnosis, Differential; Humans; Prevalence; Risk Assessment
PubMed: 22163259
DOI: 10.3238/arztebl.2011.0781 -
Frontiers in Psychiatry 2021Burnout among healthcare personnel has been exacerbated by the COVID-19 pandemic's unique features. During the COVID-19 pandemic, this systematic review and...
Burnout among healthcare personnel has been exacerbated by the COVID-19 pandemic's unique features. During the COVID-19 pandemic, this systematic review and meta-analysis aims to provide a complete assessment of the prevalence of burnout across various healthcare personnel. Until January 2021, systematic searches for English language papers were conducted using PubMed, Scopus, EMBASE, Web of Science, Cochrane Library, and ProQuest. Thirty observational studies were found after conducting systematic searches. The pooled overall prevalence of burnout was 52% [95% confidence interval (CI) 40-63%]. Pooled emotional exhaustion (EE), depersonalization (DP), and lack of personal accomplishment (PA) were 51% (95% CI 42-61%), 52% (95% CI 39-65%), and 28% (95% CI 25-31%), respectively. This study demonstrated that nearly half of the healthcare workers experienced burnout during the COVID-19 pandemic. In the studies that were included, non-frontline COVID-19 exposed healthcare personnel also experienced burnout. From high to lower middle-income countries, there was a gradient in the prevalence of total burnout, EE, and lack of PA. Further studies on burnout in low and lower-middle-income countries are suggested. A uniform diagnostic tool for the assessment of burnout is warranted.
PubMed: 34858231
DOI: 10.3389/fpsyt.2021.758849 -
European Journal of Radiology Open Dec 2023Burnout among physicians has a prevalence rate exceeding 50%. The radiology department is not immune to the burnout epidemic. Understanding and addressing burnout among... (Review)
Review
RATIONALE AND OBJECTIVES
Burnout among physicians has a prevalence rate exceeding 50%. The radiology department is not immune to the burnout epidemic. Understanding and addressing burnout among radiologists has been a subject of recent interest. Thus, our study aims to systematically review studies reporting the prevalence of burnout in physicians in the radiology department while providing an overview of the factors associated with burnout among radiologists.
MATERIALS AND METHODS
The search was conducted from inception until November 13th, 2022, in PubMed, Embase, Education Resources Information Center, PsycINFO, and psycArticles. Studies reporting the prevalence of burnout or any subdimensions among radiology physicians, including residents, fellows, consultants, and attendings, were included. Data on study characteristics and estimates of burnout syndrome or any of its subdimensions were collected and summarized.
RESULTS
After screening 6379 studies, 23 studies from seven countries were eligible. The number of participants ranged from 26 to 460 (median, 162; interquartile range, 91-264). In all, 18 studies (78.3%) employed a form of the Maslach Burnout Inventory. In comparison, four studies (17.4%) used the Stanford Professional Fulfillment Index, and one study (4.3%) used a single-item measure derived from the Zero Burnout Program survey. Overall burnout prevalence estimates were reported by 14 studies (60.9%) and varied from 33% to 88%. High burnout prevalence estimates were reported by only five studies (21.7%) and ranged from 5% to 62%. Emotional exhaustion and depersonalization prevalence estimates were reported by 16 studies (69.6%) and ranged from 11%-100% and 4%-97%, respectively. Furthermore, 15 studies (65.2%) reported low personal accomplishment prevalence, ranging from 14.7% to 84%. There were at least seven definitions for overall burnout and high burnout among the included studies, and there was high heterogeneity among the cutoff scores used for the burnout subdimensions.
CONCLUSION
Burnout in radiology is increasing globally, with prevalence estimates reaching 88% and 62% for overall and high burnout, respectively. A myriad of factors has been identified as contributing to the increased prevalence. Our data demonstrated significant variability in burnout prevalence estimates among radiologists and major disparities in burnout criteria, instrument tools, and study quality.
PubMed: 37920681
DOI: 10.1016/j.ejro.2023.100530 -
Journal of Personalized Medicine Aug 2022Dissociative disorders encompass loss of integration in essential functions such as memory, consciousness, perception, motor control, and identity. Nevertheless,... (Review)
Review
BACKGROUND
Dissociative disorders encompass loss of integration in essential functions such as memory, consciousness, perception, motor control, and identity. Nevertheless, neuroimaging studies, albeit scarce, have suggested the existence of particular brain activation patterns in patients belonging to this diagnostic category. The aim of this review is to identify the main functional neuroimaging correlates of dissociative disorders.
METHODS
we searched the PubMed database to identify functional neuroimaging studies conducted on subjects with a diagnosis of a dissociative disorder, following the PRISMA guidelines. In the end, we included 13 studies in this systematic review, conducted on 51 patients with dissociative identity disorder (DID), 28 subjects affected by depersonalization disorder, 24 with dissociative amnesia, and 6 with other or not specified dissociative disorders.
RESULTS
Prefrontal cortex dysfunction seems prominent. In addition, changes in the functional neural network of the caudate are related to alterations of identity state and maintenance of an altered mental status in DID. Another role in DID seems to be played by a dysfunction of the anterior cingulate gyrus. Other regions, including parietal, temporal, and insular cortices, and subcortical areas were reported to be dysfunctional in dissociative disorders.
CONCLUSIONS
Prefrontal dysfunction is frequently reported in dissociative disorders. Functional changes in other cortical and subcortical areas can be correlated with these diagnoses. Further studies are needed to clarify the neurofunctional correlations of each dissociative disorder in affected patients, in order to identify better tailored treatments.
PubMed: 36143190
DOI: 10.3390/jpm12091405 -
Frontiers in Human Neuroscience 2021Burnout can be defined as an occupational syndrome resulting from poorly managed chronic workplace stress. It is characterized by three dimensions: feelings of energy...
Burnout can be defined as an occupational syndrome resulting from poorly managed chronic workplace stress. 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. Teachers are among the human service professionals particularly vulnerable to occupational burnout. Teaching is a highly demanding and challenging task, in that requires constant confrontation with different stakeholders (students and their parents, administrators). Among teachers, physical education teachers have been particularly understudied even though a recently published systematic review has found that they are exposed to high levels of stress. To better explore burnout syndrome among physical education teachers, the present systematic review was undertaken, searching up to six languages. Fifty-six studies were included in the present review. The reported rate of high emotional exhaustion ranged from 11.52 to 60.6%, according to the single study. Pooling together 12 studies and totaling 2,153 physical education teachers, the prevalence rate of high emotional exhaustion was computed to be 28.6 [95% CI 21.9-35.8]. The reported rate of high depersonalization ranged from 3.6 to 45.2%, according to the single study. Pooling together 11 studies and totaling 2,113 physical education teachers, the prevalence rate of high depersonalization was computed to be 14.5% [95% CI 8.0-22.4]. The reported rate of low personal accomplishment ranged from 13.63 to 55.6%, according to the single study. Pooling together 12 studies and totaling 2,153 physical education teachers, the prevalence rate of low personal accomplishment was computed to be 29.5% [95% CI 23.8-35.4]. The reported rate of overall burnout ranged from 10.0 to 51.6%, according to the single study. Pooling together 7 studies and totaling 1,101 physical education teachers, the prevalence rate of overall burnout was computed to be 23.9% [95% CI 13.6-36.0]. No evidence of publication bias could be found, both visually inspecting the funnel plot and conducting the Egger's linear regression test. Burnout imposes a significant burden among physical education teachers. Based on the information contained in the present systematic review and meta-analysis, tailored interventions could be designed to mitigate such a burden. However, due to the limitations of the studies included in the present systematic review and meta-analysis, further research in the field is urgently warranted. https://osf.io/69ryu/, identifier: 10.17605/OSF.IO/69RYU.
PubMed: 34955783
DOI: 10.3389/fnhum.2021.553230