Ditte Høyer Rotvig, Jeanett Østerby Bauer, Nanna Hurwitz Eller & Martin Balslev Jørgensen:
Work-related stress and the hypothalamic-pituitary-adrenal axis
Ugeskr Læger 2019;181:V03180206
This is a review on the topic of work-related stress (WRS), and how difficulities with differential diagnostics often arise because of overlapping symptoms between WRS and depression. Investigation into the hypothalamic-pituitary-adrenal (HPA) axis deviations seems to reveal the HPA axis as a promising biomarker, since studies have shown, that patients with melancholic type depression exhibit hypercortisolism, while patients with WRS exhibit hypocortisolism. More studies of better quality are needed, before anything conclusive can be said. Consensus regarding definition and a development of diagnostic criteria for WRS, e.g. the Swedish “exhaustion disorder”, could enable a better differentiation and contribute to more accurate treatment and research.