Work-related stress is associated with impaired neuropsychological test performance: a clinical cross-sectional study

Abstract

Patients on sick leave due to work-related stress often complain about impaired concentration and memory. However, it is undetermined how widespread these impairments are, and which cognitive domains are most long-term stress sensitive. Previous studies show inconsistent results and are difficult to synthesize. The primary aim of this study was to examine whether patients with work-related stress complaints have cognitive impairments compared to a matched control group without stress. Our secondary aim was to examine whether the level of self-reported perceived stress is associated with neuropsychological test performance. We used a broad neuropsychological test battery to assess 59 outpatients with work-related stress complaints (without major depression) and 59 healthy controls. We matched the patients and controls pairwise by sex, age and educational level. Compared to controls, patients generally showed mildly reduced performance across all the measured domains of the neuropsychological test battery. However, only three comparisons reached statistical significance (p < 0.05). Effect sizes (Cohen's d) were generally small to medium. The most pronounced differences between patients and controls were seen on tests of prospective memory, speed and complex working memory. There were no statistical significant associations between self-reported perceived stress level and neuropsychological test performance. In conclusion, we recommend that cognitive functions should be considered when evaluating patients with work-related stress complaints, especially when given advice regarding return to work. Since this study had a cross-sectional design, it is still uncertain whether the impairments are permanent. Further study is required to establish causal links between work-related stress and cognitive deficits.

• Attention
• burnout
• cognitive deficit
• cognitive impairment
• memory
• neuropsychological test
• occupational
• processing speed
• work stress

Acknowledgements

The authors thank all the patients and controls participating in this study, Birthe B. Hjort for administrative work and David Glasscock, Claus Friche, Lotte Q. Michaelsen, Ole B. Knudsen and Kåre Spliid for all the psychological assessments.

Declaration of interest

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of this article.

This study was funded by The Danish Working Environment Research Fund, The Health Research Fund of Central Denmark Region, and The Danish Ramazzini Centre.