Executive function and attention in patients with stress-related exhaustion: perceived fatigue and effect of distraction

Abstract

Cognitive impairment has frequently been shown in patients who seek medical care for stress-related mental health problems. This study aims to extend the current knowledge of cognitive impairments in these patients by focusing on perceived fatigue and effects of distraction during cognitive testing. Executive function and attention were tested in a group of patients with stress-related exhaustion (n = 25) and compared with healthy controls (n = 25). Perceived fatigue was measured before, during and after the test session, and some of the tests were administered with and without standardized auditory distraction. Executive function and complex attention performance were poorer among the patients compared to controls. Interestingly, their performance was not significantly affected by auditory distraction but, in contrast to the controls, they reported a clear-cut increase in mental tiredness, during and after the test session. Thus, patients with stress-related exhaustion manage to perform during distraction but this was achieved at a great cost. These findings are discussed in terms of a possible tendency to adopt a high-effort approach despite cognitive impairments and the likelihood that such an approach will require increased levels of effort, which can result in increased fatigue. We tentatively conclude that increased fatigue during cognitive tasks is a challenge for patients with stress-related exhaustion and plausibly of major importance when returning to work demanding high cognitive performance.

Keywords:

• Burnout
• exhaustion disorder
• cognitive function
• neuropsychological
• tiredness
• effort approach

Acknowledgements

The authors thank all the patients and controls for participating in this study. The authors also thank Sandra Pettersson, Agneta Lindegård Andersson, and Emina Hadzibajramovic for valuable help with administration and statistics. Special thanks also go to Jerry Larsson, Thorleif Thorlin, and Patrik Säterö for their support and advice in the initial stages of this study. This study was funded by grants from The Healthcare Sub-Committee, Region Västra Götaland (Hälso-och sjukvårdsutskottet), The Anna Ahrenberg Foundation for Scientific and other Purposes, The Local Research and Development Council, Göteborg and Södra Bohuslän, and Wilhelm and Martina Lundgren Foundation.

Disclosure statement

No potential conflict of interest was reported by the authors.

Additional information

Funding

This study was funded by grants from The Healthcare Sub-Committee, Region Västra Götaland [grant numbers VGFOUREG-80191, -234241, and -312871], The Anna Ahrenberg Foundation for Scientific and other Purposes [granted 8 April 2011], The Local Research and Development Council, Göteborg and Södra Bohuslän [grant number VGFOUGSB-247651], and Wilhelm and Martina Lundgren Foundation [granted October 2011].