Do Burned-Out and Work-Engaged Employees Differ in the Functioning of the Hypothalamic-Pituitary-Adrenal Axis?

Scand J Work Environ Health. 2006 Oct;32(5):339-48. doi: 10.5271/sjweh.1029.


Objectives: The central aim of the present study was to examine differences in the functioning of the hypothalamic-pituitary-adrenal (HPA) axis between 29 burned-out, 33 work-engaged, and 26 healthy reference managers, as identified with the Maslach Burnout Inventory-General Survey and the Utrecht Work Engagement Scale.

Methods: All of the managers were employed in a large Dutch telecommunications company. Salivary cortisol was sampled on three consecutive workdays and one nonworkday to determine the cortisol awakening response. Salivary dehydroepiandrosterone-sulfate (DHEAS), a cortisol counterbalancing product of the HPA axis, was measured on these days 1 hour after managers awakened. The dexamethasone suppression test was used to investigate the feedback sensitivity of the HPA axis.

Results: The morning cortisol levels were higher on the workdays than on the nonworkday, but this effect did not differ between the three groups. The burned-out, work-engaged, and reference groups did not differ in the cortisol and DHEAS levels, the slope of the cortisol awakening response, and the cortisol : DHEAS ratio. The work-engaged group showed a stronger cortisol suppression in response to the dexamethasone suppression test than the other two groups, the finding suggesting higher feedback sensitivity among work-engaged managers.

Conclusions: Burned-out and work-engaged managers only differ marginally in HPA-axis functioning.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Burnout, Professional / physiopathology*
  • Humans
  • Hydrocortisone / analysis*
  • Hydrocortisone / metabolism
  • Hypothalamo-Hypophyseal System / metabolism*
  • Male
  • Middle Aged
  • Netherlands
  • Pituitary-Adrenal System / metabolism*


  • Hydrocortisone