Role of rehabilitation in chronic stress-induced exhaustion disorder: A narrative review
Open accessAbstract
There has been an increase in cases of sick leave due to stress in several European countries in recent decades.Chronic stress-induced exhaustion disorder is linked with physiological and neurobiological changes, which may add to cognitive problems and long-term exhaustion.This narrative review summarizes the published evidence about the effectiveness of different interventions for the rehabilitation of patients with chronic stress-induced exhaustion disorder.Cognitive behavioural interventions and multimodal interventions reduce symptoms.Workplace interventions often improve return to work.Better sleep is associated with improvement of symptoms and return to work.Interventions for improving sleep might therefore be important.For improving cognitive function, which is a main complaint among patients with chronic stress-induced exhaustion disorder, aerobic and cognitive training may have some effect.Most interventions for the rehabilitation of chronic stress-induced exhaustion disorder have only marginal effects.Therefore, it is important to prevent the onset of this disorder.Objective: An increase in numbers of cases of sick leave due to stress have been reported from several European countries during recent decades.Chronic stress-induced exhaustion disorder is associated with physiological and neurobiological perturbations that may contribute to cognitive problems and longterm exhaustion.Rehabilitation of patients with chronic stress-induced exhaustion disorder is therefore challenging.This narrative review summarizes the evidence regarding the effectiveness of different interventions for the rehabilitation of patients with chronic stress-induced exhaustion disorder.Methods: Both structured and unstructured searches of research studies and reports were performed in order to find knowledge sources.The structured search had 2 predefined inclusion criteria: (i) chronic stress-induced exhaustion/clinical burnout/severe burnout/stress-induced exhaustion; and (ii) rehabilitation with improvement of symptoms and/or return to work as outcomes.Results: Cognitive behavioural interventions and multimodal interventions seem to reduce symptoms.Workplace interventions, either work-focused cognitive behavioural or workplace dialogue, seem to improve return to work.Sleep is important for both symptom improvement and return to work, and interventions for improving sleep might therefore be important.For improvement of cognitive function, which is a main complaint among patients with chronic stress-induced exhaustion disorder, aerobic and cognitive training may have some effect.Conclusion: In summary, the few studies of highquality that examine interventions for rehabilitation of chronic stress-induced exhaustion disorder show only marginal effects.Thus, it is important to prevent the onset of chronic stress-induced exhaustion disorder.
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In other countries, terms such as work-related neurasthenia, "work-related depression," "adjustment disorder," and "somatization syndrome" are used interchangeably to describe clinical burnout/ENTS.
“and in other countries, terms such as work-related neurasthenia, “work-related depression,” “adjustment disorder,” and “somatization syndrome” are used interchangeably to describe clinical burnout/ENTS [15].”
From Psychological Treatment of Exhaustion Due to Persistent Non-Traumatic Stress: A Scoping Review. (2024) · cites this paper as [15]
The 'Definition of chronic stress-induced exhaustion' section says nomenclature differs across countries and identifies job stress-related depression and possibly neurasthenia as equivalents to SED; it also says SED is often subsumed under adjustment disorder. It does not identify 'somatization syndrome' as an equivalent, and its qualifications do not support saying all these terms are used interchangeably. (LLM, conf=0.88)
Experimental — accuracy not yet measuredIn Sweden, the diagnosis of exhaustion disorder has been accepted into the Swedish ICD-10.
“In Sweden, the diagnosis of exhaustion disorder has been accepted into the Swedish ICD-10, and in other countries, terms such as work-related neurasthenia, “work-related depression,” “adjustment disorder,” and “somatization syndrome” are used interchangeably to describe clinical burnout/ENTS [15].”
From Psychological Treatment of Exhaustion Due to Persistent Non-Traumatic Stress: A Scoping Review. (2024) · cites this paper as [15]
The cardinal symptoms of ENTS include substantial debilitating levels of exhaustion coupled with cognitive impairments, but not necessarily a depressed mood.
“The cardinal symptoms of ENTS include substantial debilitating levels of exhaustion coupled with cognitive impairments, but not necessarily a depressed mood [15].”
From Psychological Treatment of Exhaustion Due to Persistent Non-Traumatic Stress: A Scoping Review. (2024) · cites this paper as [15]
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Cited by
Sorted by citations
Psychological Treatment of Exhaustion Due to Persistent Non-Traumatic Stress: A Scoping Review.
van de Leur, J. C., Jovicic, F., Åhslund, A., McCracken, L. M., & Buhrman, M. (2024) · International Journal of Behavioral Medicine · doi:10.1007/s12529-023-10185-y · Cited by 16 · see citing works
“In Sweden, the diagnosis of exhaustion disorder has been accepted into the Swedish ICD-10, and in other countries, terms such as work-related neurasthenia, “work-related depression,” “adjustment disorder,” and “somatization syndrome” are used interchangeably to describe clinical burnout/ENTS [15].”
BackgroundMethodMediators during a Multimodal intervention for stress-induced exhaustion disorder
van de Leur, J. C., Johansson, F., McCracken, L. M., Åhs, F., Brodda Jansen, G., & Buhrman, M. (2024) · Cognitive Behaviour Therapy · doi:10.1080/16506073.2023.2295217 · Cited by 5 · see citing works
“There is currently no inter-nationally accepted nomenclature for exhaustion due to persistent non-traumatic stress, and different terms are utilized; Clinical burnout, exhaustion disorder, job stress-related depression, and possibly neurasthenia (Wallensten et al., 2019).”
- Authors
- Wallensten, J., Åsberg, M., Wiklander, M., & Nager, A.
- Affiliations
- Danderyds sjukhus (SE)
- Karolinska Institutet (SE)
- Corresponding author
- Wallensten, J
- Venue
- Journal of Rehabilitation Medicine
- Publisher
- Medical Journals Sweden AB
- Published
- 2019
- Volume
- 51
- Issue
- 5
- Pages
- 331-342
- ISSN
- 1650-1977 (ISSN-L)
- OpenAlex
- W2921761261
- Cited by
- 56
- References
- 83
- Citations by year
- 2025: 9 · 2024: 11 · 2023: 13 · 2022: 9 · 2021: 7 · 2020: 7
- FWCI
- 0.88
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Locations
- Journal of Rehabilitation Medicine (publishedVersion)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Topics
- Social Sciences › Psychology › Social Psychology › Stress and Burnout Research
- Health Sciences › Health Professions › General Health Professions › Workplace Health and Well-being
- Health Sciences › Health Professions › Physical Therapy, Sports Therapy and Rehabilitation › Medical Practices and Rehabilitation
- Keywords
- burnout, rehabilitation therapy, sick leave, return to work, workplace interventions, cognitive-behavioural intervention, multimodal intervention, sleep interventions, cognitive function, aerobic exercise, cognitive training, burnout prevention
- MeSH terms
- Adult, Chronic Disease, Fatigue, Female, Humans, Male, Middle Aged, Stress, Physiological, Cognitive Behavioral Therapy
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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