Construction and evaluation of a self rating scale for stress‐induced Exhaustion Disorder, the Karolinska Exhaustion Disorder Scale

Abstract

Prolonged stress (≥ six months) may cause a condition which has been named exhaustion disorder (ED) with ICD-10 code F43.8. ED is characterised by exhaustion, cognitive problems, poor sleep and reduced tolerance to further stress. ED can cause long term disability and depressive symptoms may develop. The aim was to construct and evaluate a self-rating scale, the Karolinska Exhaustion Disorder Scale (KEDS), for the assessment of ED symptoms. A second aim was to examine the relationship between self-rated symptoms of ED, depression, and anxiety using KEDS and the Hospital Anxiety and Depression Scale (HAD). Items were selected based on their correspondence to criteria for ED as formulated by the Swedish National Board of Health and Welfare (NBHW), with seven response alternatives in a Likert-format. Self-ratings performed by 317 clinically assessed participants were used to analyse the scale’s psychometric properties. KEDS consists of nine items with a scale range of 0–54. Receiver operating characteristics analysis demonstrated that a cut-off score of 19 was accompanied by high sensitivity and specificity (each above 95%) in the discrimination between healthy subjects and patients with ED. Reliability was satisfactory and confirmatory factor analysis revealed that ED, depression and anxiety are best regarded as different phenomena. KEDS may be a useful tool in the assessment of symptoms of Exhaustion Disorder in clinical as well as research settings. There is evidence that the symptom clusters of ED, anxiety and depression, respectively, reflect three different underlying dimensions.

Cost-Effectiveness of Acceptance and Commitment Therapy and a Workplace Intervention for Employees on Sickness Absence due to Mental Disorders

“…The items in KEDS covers different symptoms of exhaustion: ability to concentrate, memory, physical stamina, mental stamina, recovery, sleep, hypersensitivity to sensory impressions, experience of demands, and irritation and anger. A cut-of score of 19 has been shown to discriminate between healthy subjects and patients with exhaustion and confirmatory factor analysis supports the idea of exhaustion disorder as a separate disorder (Beser et al, 2014;Persson, Osterberg, Viborg, Jonsson, & Tenenbaum, 2017).…”

“…The level of stress symptoms was assessed with the Karolinska Exhaustion Disorder Scale (KEDS) (Beser et al, 2014). This 9-item questionnaire (rated 0-6) with a scale range of 0-54, was developed based on the diagnosis of exhaustion disorder.…”

Mediators of Change in Cognitive Behavior Therapy for Clinical Burnout

“…A significant lack of psychological energy dominates the picture, combined with disturbed concentration or memory, decreased ability to cope with demands, emotional instability, sleep disturbance, substantial physical weakness and physical symptoms such as ache, palpitation, dizziness, or sensitivity to sound. Symptoms should cause clinically significant suffering or impairment 12,13 . ED frequently co-occurs with depression, anxiety and sleep disturbances, but can occur without these conditions 13,14 .…”

<p>Infeksi herpes simpleks virus 1 rekuren dengan faktor predisposisi stres emosional</p><p>Recurrent herpes simplex virus 1 infection with predisposing factors of emotional stress</p>

“…Molekul-molekul sinyal spesifik yang dikeluarkan pada fase stres akut dan kronik antara lain epinephrine,IL-1, IL-6, Cyclic Adenosine Monophosphate (cAMP), glukokortikoid dan prostaglandin sehingga berimplikasi terjadinya reaktivasi penyakit HSV dan rekuren. 19,22,23 Setelah diketahui adanya stres emosional pada pasien ini yang diduga sebagai pemicu RIH disarankan untuk berkonsultasi dengan bagian Psikiatri akan tetapi menolak sehingga diberikan pengelolaan stres oleh bagian Ilmu Penyakit Mulut serta terapi farmakologis berupa asiklovir sistemik, kortikosteroid topikal berupa triamcinolone acetonide 0,1%, Benzydamin HCl dalam bentuk lozenges, vitamin B 12 dan asam folat. Pengeloaan stres oleh bagian Ilmu Penyakit Mulut yang dapat diberikan berupa sugesti terhadap diri sendiri (self suggetion).…”