Récupération des fonctions mnésiques et exécutives après un burnout : suivi à un an de patients en arrêt de travail pour épuisement professionnel

Abstract

Objectives

Numerous studies have demonstrated an association between burnout and cognitive difficulties, yet there is a paucity of longitudinal research on the subject. This study aims to conduct a one-year follow-up on patients who have experienced clinical burnout. Additionally, the literature suggests that variables such as depression, anxiety, neuroticism, emotional regulation strategies, and return to employment may influence cognitive recovery and the patient's perception thereof. Therefore, this study also seeks to delineate the potential roles of these variables in patients’ cognitive recovery.

Method

We conducted two assessments with 22 patients (19 women and 3 men), with an average time lapse of 386.10 days (SD = 20.71) between evaluations. Cognitive functions were assessed using neuropsychological tests. Initially, the MEM-III and GREFEX were employed, while the MEM-IV (the only test altered between the initial encounter and follow-up) was used to assess memory in the second evaluation. The BRIEF-A questionnaire was utilized to evaluate executive functions. Additionally, the French Big Five Inventory, HADS, and the emotion regulation scale were employed to delve into the participants’ psychological profiles.

Results

Significant improvements were observed in all memory domains evaluated, encompassing auditory, immediate visual, and delayed visual memory. Regarding executive functions assessed through tests, only four out of sixteen analyses demonstrated significant improvement. These analyses pertained to errors in the interference condition of the Stroop test, categories in the MCST, time for TMT B, and the number of words generated in literal fluency tasks. Self-assessments from the BRIEF-A indicated improvement in the overall executive index and metacognition index. Anxiety and depression levels did not significantly differ one year after the initial assessment. Only burnout and neuroticism levels showed a significant decrease. Furthermore, no differences were observed between patients who had resumed employment and those still seeking employment.

Discussion

Memory impairments appear to be temporary and reversible, while executive function data reveal a more nuanced outcome, with a substantial difference between test-assessed recovery and patient self-evaluation. Test results indicate some improvements, particularly in tests assessing inhibition and mental flexibility. However, these improvements may be attributed to increased cognitive endurance, as these tests were administered last in the battery. Patient self-evaluations of executive functions may suggest increased confidence in their cognitive abilities. Exploring the role of self-esteem in the self-assessment of cognitive functions after burnout would be an intriguing avenue for further research. Finally, among all tested co-variables, only neuroticism seems to be associated with cognitive recovery in patients. Depression and anxiety do not consistently appear to have a predominant influence on the link between burnout and cognitive functions.

Conclusion

This study contributes to a nuanced understanding of post-burnout cognitive recovery. Executive and memory functions do not seem to evolve in the same manner. Additionally, the study highlights the importance of patients’ perceptions of their cognitive abilities. These findings underscore the necessity for in-depth research to guide clinical interventions and future investigations in this field.