Public Release: 

Sexes differ in their immune reactions to burnout on the job and depression

Implications for stress management to prevent cardiovascular and other inflammation-related health problems

American Psychological Association

WASHINGTON -- Recent findings show that work-related burnout can lead to inflammatory processes, which plays a key role in the initiation and progression of cardiovascular disease and other inflammatory-linked illness. Now, researchers find evidence that men and women differ in their inflammatory reactions to work-related burnout and depression

According to a new study from the Journal of Occupational and Health Psychology, published by the American Psychological Association (APA), women who experience job burnout and men who experience depression were found to have increased levels of two inflammation biomarkers - fibrinogen and C-reactive protein (CRP). Both of these biomarkers have been associated in numerous studies, with an increased risk of future cardiovascular disease and stroke, over and above the conventional risk factors like blood lipids and glucose.

In the first large-scale study showing a physiological difference in how men and women react to emotional states, researcher Sharon Toker, Ph.D., candidate of Tel Aviv University and co-authors examined micro-inflammation blood markers and levels of burnout, depression and anxiety in 630 healthy, employed women and 933 healthy, employed men to determine which emotions are more likely to present more problems for each sex. Blood levels of CRP and fibrinogen concentrations were used to measure levels of micro-inflammation. Fibrinogen is a blood-clotting factor that responds to vascular and tissue injury and CRP is a complex set of proteins produced when the body is dealing with a major infection or trauma.

Depression in the study is defined as a generalized distress encompassing all life domains and burnout is defined as a depletion of an individual's energetic resources at work. Anxiety is defined as a person experiencing negatively-toned arousal.

The women in the study who scored higher on burnout scores had a 1.6 fold risk of having an elevated level of CRP (>3), and elevated levels of fibrinogen compared with their non-burned out counterparts (after controlling for their levels of depression and anxiety). Whereas the men in the study who scored higher on depression scores (controlling for their levels of burnout and anxiety) had a 3.15 fold risk of having an elevated level of CRP (>3), and elevated levels of fibrinogen compared to the non-depressed men.

These results suggest that the burned-out women and depressed men are at a greater risk for future inflammation-related diseases, like diabetes, heart disease and strokes compared with their non-burned out and non-depressed counterparts. All these linkages were obtained after taking into account a host of physiological factors well known to be associated with CRP and fibrinogen levels.

Even though burnout and depression affect men and women differently, the health consequences end up being the same, said Dr. Toker, who suggests that gender difference be included when comparing certain emotions and health risks. "The findings also confirm that emotional states do indeed affect a person's risk for developing cardiovascular disease," said Toker. "This information can be used to help medical and mental health professionals design more appropriate stress management interventions for each sex and hopefully prevent long-lasting health consequences."


Article: "The Association Between Burnout, Depression, Anxiety, and Inflammation Biomarkers: C-Reactive Protein and Fibrinogen in Men and Women," Sharon Toker, Ph.D. candidate, and Arie Shirom, Ph.D., Tel Aviv University; Itzhak Sharpira, Ph.D., and Shlomo Berliner, Ph.D., Tel Aviv Sourasky Medical Center; Samuel Melamed, Ph.D., National Institute of Occupational & Environmental Health and Tel Aviv University; Journal of Occupational Health Psychology, Vol. 10, No. 4.

Full text of the article is available from the APA Public Affairs Office or at

Sharon Toker, PhD candidate can be reached by phone at 972-3-648-2322 or by email at and Arie Shirom, PhD can be reached by phone at 972-2-563-6890 or by email at

The American Psychological Association (APA), in Washington, DC, is the largest scientific and professional organization representing psychology in the United States and is the world's largest association of psychologists. APA's membership includes more than 150,000 researchers, educators, clinicians, consultants and students. Through its divisions in 53 subfields of psychology and affiliations with 60 state, territorial and Canadian provincial associations, APA works to advance psychology as a science, as a profession and as a means of promoting health, education and human welfare.

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