2004
Volume 37, Issue 4
  • ISSN: 0921-5077
  • E-ISSN: 1875-7235

Abstract

Samenvatting

Burn-out is een stress-gerelateerd uitputtingssyndroom dat zich geleidelijk ontwikkelt als gevolg van overactieve stressfysiologie en te weinig fysiologisch herstel. We onderscheiden milde burn-out, waarbij de patiënt binnen drie tot zes maanden herstelt en weer aan het werk kan, en ernstige burn-out, waarbij het fysiologische stresssysteem ontregeld is en de uitputtingsklachten dermate hevig zijn dat normaal functioneren thuis en op het werk langdurig is verstoord. De overmatige stressfysiologie wordt veroorzaakt door aanhoudende externe en interne stressoren in combinatie met een ineffectieve copingstijl, terwijl tegelijkertijd de mogelijkheid tot rust en (biologisch) herstel ontoereikend is. Gezien de mate van de onderliggende fysiologische verstoringen vraagt ernstige burn-out om een andere aanpak dan milde burn-out. In dit artikel beschrijven wij de biopsychosociale effecten van chronische stressfysiologie en vertalen we deze naar verschillende fases waarin ernstige burn-out zich ontwikkelt, met de daarbij horende fysieke, mentale, emotionele en gedragsmatige symptomen. Daarnaast beschrijven we op hoofdlijnen de diagnostiek en behandeling van ernstige burn-out, waarbij de nadruk in eerste instantie ligt op het terug-reguleren van het fysiologische stresssysteem, alvorens een start kan worden gemaakt met psychotherapeutische interventies.

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