BACKGROUND: Chronic stress can cause an imbalance within the autonomic nervous system, thereby affecting cardiovascular and mental health. Physical activity (PA) may have a positive effect on the autonomic nervous system and stress-related disorders, such as depression and burnout. Heart rate variability (HRV) is a non-invasive marker of the autonomic nervous system. However, limited and inconsistent data exist on the exact relationship between HRV, PA and depression and burnout symptoms. The HARMODI study aims to explore whether HRV is a feasible marker of depression and burnout symptoms and aims to evaluate the role of PA in the treatment of stress-related disorders.
METHODS: This is an observational study with a cross-sectional up to 8 week follow-up study design. A total of 153 patients, undergoing psychiatric inpatient treatment with burnout syndrome (Z73) and depressive episode (F32 or F33) or adjustment disorder (F43.2), will be recruited. Data on depression and burnout symptoms, HRV recordings (24-hour, supine, standing and exercise stress test), cognitive function, cardiorespiratory fitness, cardiovascular health, balance and strength will be collected at baseline (T1) and after up to 8 weeks (T2). Continuous data on PA and Ecological Momentary Assessments of exhaustion, mood and tension will be monitored daily throughout inpatient treatment. Multiple regression models, adjusted for potential confounders, will assess the association between HRV as the primary outcome, PA and depression and burnout severity score.
BACKGROUND: The protocol has been approved by Swiss Ethics Committee, Cantonal Ethics Committee Zürich. Results of HARMODI will be disseminated through peer-reviewed journals and conference presentations.
BACKGROUND: NCT05874856.

Marital burnout has not been extensively studied despite its huge consequences on family wellbeing and quality of family life. This study, using randomised-controlled trial, tested the impact of rational-emotive couple intervention on marital burnout in a sample of parents seeking a divorce. A total of 67 parents who participated during the rational-emotive couple intervention (RECI) were assessed using the marital burnout scale, Beck depression inventory, and parent rational and irrational beliefs scale. Crosstabulation, multivariate test analysis, and bivariate analysis were used to analyse the data collected. Results show a significant reduction of marital burnout in RECI group participants, and significant improvement was maintained at the follow-up stage. The result of the group and gender interaction effect shows no significant interaction effect of group and gender on participants\' marital burnout at Time two and Time 3, respectively. The results indicate that a decrease in parents\' irrational beliefs accounts for marital burnout among couples seeking a divorce. Marital burnout is positively associated with depression among couples seeking a divorce. This study concludes that the RECI is an effective intervention that reduces marital burnout which is a direct consequence of irrational beliefs which later metamorphose into depressive symptoms.

UNASSIGNED: To investigate the factor structure and verify the validity and reliability of the Korean version of the Digital Burnout Scale (DBS) among Generation Z university students.
UNASSIGNED: The World Health Organization guidelines were employed in the forward and back translation, synthesis, cross-cultural adaptation, and pre-survey phases to result in the Korean version of the DBS. The Korean version was then used to collect data from 330 university students online. Construct, convergent, discriminant, and concurrent validity, and internal consistency were assessed.
UNASSIGNED: The Korean version of the DBS had three subscales (digital aging, digital deprivation, and emotional exhaustion) and included 24 items. The results of the confirmatory factor analysis indicated adequate model fit indices. Convergent, discriminant, and concurrent validity were satisfactory. The Cronbach\'s ⍺ for the overall scale was 0.95.
UNASSIGNED: The Korean version of the DBS has good reliability and validity and can be used as a tool to assess the level of risk of digital burnout and provide appropriate support and intervention.
UNASSIGNED: The Korean version of the DBS will serve as a framework for developing healthy digital education by grasping individual characteristics. Longitudinal research is recommended to identify factors that cause digital usage and burnout for various age groups.

BACKGROUND: Researchers have made great efforts to help parents of children with intellectual disabilities overcome the stress and burden. Learning to be resilient is one effective strategy.
OBJECTIVE: This study explores resilience among parents of children with intellectual disabilities and how career burnout and self-regulation relate to parents\' resilience in mainland China.
METHODS: The Burnout Scale, the Self-Regulation Scale and the Resilience Scale were administered to 324 parents of children with intellectual disabilities.
RESULTS: Results showed that career burnout significantly negatively influenced resilience (β = -0.269, p = 0.000), while self-regulation significantly positively influenced resilience (β = 0.754, p = 0.000). In addition, self-regulation moderated the relationships between career burnout and resilience (β = 0.176, p = 0.003).
CONCLUSIONS: The findings offer valuable insights for enhancing the resilience of parents of children with intellectual disabilities.

BACKGROUND: To explore the associations between anxiety and depression symptoms and academic burnout among children and adolescents in China, and to examine the role of resilience and self-efficacy in addressing academic burnout.
METHODS: A total of 2,070 students in grades 4-8 were recruited from two primary and three middle schools in Shanghai, completed the Elementary School Student Burnout Scale (ESSBS), the Multidimensional Anxiety Scale for Children-Chinese (MASC-C), the Center for Epidemiological Studies Depression Scale (CES-D), the Connor-Davidson Resilience Scale (CD-RISC), and the General Self-Efficacy Scale (GSES), with 95.04% effective response rate. Multivariable regression analyses examining the associations between anxiety / depression symptoms and academic burnout (as well as the associations between resilience / self-efficacy and academic burnout) were performed using STATA 16.0 and SmartPLS 3.0.
RESULTS: Anxiety symptoms (β = 0.124, p < 0.01) and depression symptoms (β = 0.477, p < 0.01) were positively correlated with academic burnout. Resilience partially mediated the association between depression symptoms and academic burnout (β = 0.059, p < 0.01), with a mediation rate of 12.37%. Self-efficacy partially mediated the associations between anxiety symptoms and academic burnout (β = 0.022, p < 0.01) and between depression symptoms and academic burnout (β = 0.017, p < 0.01), with mediation rates of 17.74% and 3.56%, respectively. Resilience and self-efficacy together (β = 0.041, p < 0.01) formed a mediating chain between depression symptoms and academic burnout, with a mediation rate of 8.6%.
CONCLUSIONS: Anxiety and depression symptoms were positively associated with academic burnout. Resilience and self-efficacy were found to mediate the associations partially.

The global trend of advanced aging comes at the cost of amplified onset of age-related diseases. Dementia is a common multifactorial age-related neurodegenerative disorder, which manifests with progressive declines in cognitive functioning and ability to perform activities of daily living. As polices discourage institutionalized care, family members act as primary caregivers and endure increased vulnerability to physical and mental health problems secondary to care-related changes in life routine and relationships. Targeting clinically significant distress at earlier stages through valid brief measures may promote caregivers\' wellbeing and dementia care continuity/quality. This study aimed to determine the optimal cutoff score of the Depression Anxiety Stress Scale 8-items (DASS-8) in a convenience sample of 571 European caregivers (Mean age = 53 ± 12 years, Italian = 74.4%, Swiss = 25.6%) through three methods. K-means clustering classified the sample into high- and low-distress clusters based on DASS-8 score of 19. Receiver operator curve (ROC) analysis using 48 and 7 cutoffs of the Zarit Burden Interview (ZBI) and the Three-Item University of California, Los Angeles, Loneliness Scale-version 3 (UCLALS3), revealed two DASS-8 cutoffs (12.5 and 14.5, area under the curve (AUC) = 0.85 and 0.92, p values < .001, 95% CI 0.82-0.88 and 0.89 to 0.94, sensitivity = 0.81 and 0.78, specificity = 0.76 and 0.89, Youden index = 0.57 and 0.67, respectively). Decision modeling produced two DASS-8 cutoffs (9.5 and 14.5) for predicting low and high caregiving burden and loneliness, respectively. According to the median of all DASS-8 cutoffs (14.5) the prevalence of mental distress was 50.8%. Distress correlated with key mental problems such as burnout and loneliness-in path analysis, DASS-8 scores were predicted by the ZBI, UCLALS3, care dependency, and receiving help with care, especially among older, female, and spouse caregivers. Further diagnostic workup should follow to confirm psycho-pathogenicity among caregivers with DASS-8 scores above 14.5. Investigations of the DASS-8 in other countries/populations may confirm the validity of this cutoff score.

BACKGROUND: Although research on burnout syndrome in medical students has increased in recent years, results are inconsistent about which factors are associated with a high risk for burnout syndrome. The aim of this study was to assess the prevalence of high risk of burnout syndrome and to identify factors associated with burnout in medical students in preclinical and clinical training.
METHODS: A cross-sectional study was conducted at the University of Kragujevac, Serbia. The Maslach Burnout Inventory Student Survey and an epidemiological questionnaire on basic socio-demographic and academic characteristics were used. Statistical evaluation was performed through logistic regression analysis, using Odds Ratio (OR) and 95% Confidence Interval (CI).
RESULTS: Among medical students, no statistically significant differences were found in the prevalence of high risk of burnout syndrome in preclinical (14.8%) and clinical grade (15.1%), p > 0.05. High risk for burnout syndrome in preclinical study years was independently associated with the female sex (adjusted OR = 0.41, 95%CI = 0.19-0.91, p = 0.028), and cigarette smoking (adjusted OR = 2.47, 95%CI = 1.05-5.78, p = 0.038). The high risk of burnout syndrome was associated with sedatives use (adjusted OR = 4.03, 95%CI = 1.27-12.73; p = 0.018) only in clinical years medical students. The frequency of alcohol consumption was correlated with the high risk of burnout syndrome in medical students in both preclinical and clinical training, but without statistical significance (both p for trend < 0.1).
CONCLUSIONS: There was a significant prevalence of burnout among medical students, with some modifiable associated factors revealed.

OBJECTIVE: The purpose of this qualitative descriptive study was to describe the experience of diabetes burnout in young adults with type 1 diabetes (T1DM). In addition, aims included participant perspectives of risk and protective factors associated with burnout and ways to balance everyday life with diabetes self-management (DSM).
METHODS: Young adults with T1DM (N = 11) were recruited through social media platforms and modified snowball sampling and interviewed. Informational redundancy was achieved. Qualitative thematic coding and analysis were conducted within and across transcripts.
RESULTS: Diabetes burnout was described as the willingness to put diabetes and DSM on the \"back burner\" and let things slide due to exhaustion, frustration, apathy, and the desire to be like everyone else for a while. Risk and protective factors were identified along with strategies to achieve balance of DSM in everyday life.
CONCLUSIONS: This study identified a clear definition of diabetes burnout and acknowledges this concept as distinct and separate from other psychosocial conditions. Health care providers can utilize this information to identify individuals at risk for diabetes burnout and offer more effective support to lessen the overall burden associated with T1DM.

This study investigated relationships between social and emotional concerns, loneliness, and school burnout, as these factors are associated with adaptive functioning during adolescence residence in Asia (i.e., China, Hong Kong) and the UK. Analysis of data from 2849 participants illuminated compelling insights. The participants reported a high level of loneliness, notably among girls in the UK. The research generated 11 preferred conversation topics (i.e., future and aspirations, anything, learning, nothing, mental health, personal interests, health, relationships, psychosocial issues, social issues, feelings). Among them, future and aspirations lead the way, aligning with developmental needs. A desire for mental health discussions coexisted with heightened loneliness and burnout among participants who pursued such conversations. The low achievers tended to talk about mental health issues or have nothing to say. High achievers were drawn to social issues, emphasizing their distinct socio-emotional needs. Forging a connection between personal interests and mitigated school burnout underscores the potential for individual passions to harmonize with educational experience. These findings underscore the exigency for bespoke interventions addressing the evolving emotional terrain of adolescents, especially in the pandemic\'s aftermath. The study\'s implications underscore the importance of empathetic listening and proactive engagement between adolescents and supportive adults. This research enriches the comprehension of pandemic-induced adolescent experiences and suggests avenues for future investigations into long-term emotional well-being. CLASSIFICATION CODE: 2800 (Developmental Psychology).

UNASSIGNED: To determine the prevalence of anxiety, depression and burnout in residents of Gynecology and Obstetrics during COVID-19 pandemic in Brazil and its associated factors.
UNASSIGNED: Cross-sectional study involving all regions of Brazil, through the application of a sociodemographic questionnaire, the Hospital Anxiety and Depression Scale (HAD) and the Maslach Burnout Inventory (MBI-HSS) instrument. Multivariate analysis was performed after adjusting the Poisson model.
UNASSIGNED: Among the 719 participating medical residents, screening was positive for anxiety in 75.7% and for depression in 49.8% of cases. Burnout syndrome was evidenced in 41.3% of the physicians studied. Those with depression are more likely to have anxiety (OR 0.797; 95%CI 0.687 - 0.925) and burnout syndrome (OR 0.847 95%CI 0.74 - 0.97). Residents with anxiety (OR 0.805; 95%CI 0.699 - 0.928) and burnout (OR 0.841; 95%CI 0.734 - 0.963) are more likely to have depression.
UNASSIGNED: High prevalence of anxiety, depression and burnout were found in residents of Gynecology and Obstetrics in Brazil, in addition to important correlations between anxiety-depression and depression-burnout.