Original Article
JOURNAL OF GYNECOLOGY
ASSOCIATION OF EMOTIONAL MEAN PLATELET VOLUME
WITH BURNOUT IN ANEMIC WOMEN FROM CENTRAL ANATOLIA REGION
Mehmet Yavuz Okyay1 , Ayşe Yeşim Göçmen2, Emel Çağlayan3,
Neslihan Yeniel4, M.Fevzi Polat5, Namık Delibaş6
Affliation:
1. Assist. Prof.MD Department of Psychiatry, Bozok University Faculty of Medicine,Yozgat
2. Assist. Prof.MD Department of Biochemistry, Bozok University Faculty of Medicine, Yozgat
3.Assist. Prof.MD Department of Obstetrics and Gynecology, Bozok University Faculty of
Medicine,Yozgat
4.M.Sc. Laboratory of Clinical Biochemistry, Bozok University Faculty of Medicine Research
Hospital, Yozgat
5.Prof.MD Department of Biochemistry, Bozok University Faculty of Medicine, Yozgat
6.Prof.MD Department of Biochemistry, Hacettepe University Faculty of Medicine, Ankara
Corresponding Author: Mehmet Yavuz Okyay Assist. Prof.MD Department of Psychiatry, Bozok
University Faculty of Medicine,Yozgat , 66200, Yozgat, TURKEY
Telephone: +90 544 653 00 04 Fax: +90 354 217 71 50 E-mail: yavuzokyay@bozok.edu.tr
ABSTRACT
Objective: The aim of this study was to evaluate the relationship between biochemical
parameters and burnout syndrome among female anemic patients living in Yozgat, Turkey.
Methods: 675 women who applied to Bozok University Department of Obstetrics and
Gynecology clinic were included in this study. Iron (Fe), total iron-binding capacity (TIBC),
mean platelet volume (MPV), mean corpuscular volume (MCV), red cell distribution width
(RDW), hematocrit (HCT), hemoglobulin (Hb) and ferritin levels were evaluated. Emotional
burnout status was explored by the Maslach Burnout Inventory (MBI)
Results: There is a significant decrease in the values of hematological and iron indexes
among anemic women. Anemic women assessed their physical health status and general
stress level as worse compared to controls. High scores were found among 26,2% of anemic
women on MBI subscale of Emotional exhaustion. Ferritin levels and RDW were described
as main factors associated with anemia and in anemic women group. RDW and MPV were
correlated with MBI subscale scores.
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Conclusions: Determination of MPV and RDW values is relatively easy and inexpensive
method requiring small amount of blood for the diagnosis of anemia. RDW and MPV values
might be taken into account for the prevention of emotional distress, with special concern to
psychiatric treatments along with their primary anemia
anemic women who manifested high vulnerability.therapy.
Key words: Emotional burnout, anemia, mean platelet volume, red cell distribution width
INTRODUCTION
Prolonged stress leads to a loss of energy and
exhaustion which gives rise burnout that is associated
psychiatric treatments along with their primary anemia
therapy.
with a lack of motivation and increased feelings of
According to some publications, it is not clear whether
disparagement and cynicism [1]. Burnout is a
or not burnout syndrome is associated with the poor
syndrome of depersonalization, emotional exhaustion
quality
and a sense of low personal accomplishment [2].
depression and fatigue in people suffering from
People with anemia is a condition do not have enough
red blood cells in blood [3]. Anemia is typically
diagnosed on a complete blood count. In modern
whole blood counters, four parameters (red blood cell
(RBC) count, hemoglobin concentration, white blood
cell (WBC) and platelets) are measured, allowing
of
life,
especially
physical
functioning,
haematological malignancies. Therefore, the main
goal of this study was to evaluate relationship
between
biochemical
parameters
and
burnout
syndrome among female anemic patients living in
central Anatolia region.
Methods
others (hematocrit, mean platelet volume (MPV),
mean corpuscular volume (MCV), red cell distribution
The study included 675 women who applied to Bozok
width
and
mean
University Department of Obstetrics and Gynecology
and
mean
clinics. The patients were between the ages of 18-45
corpuscular hemoglobin concentration (MCHC)) to be
and not receiving anemia treatment. The exclusion
calculated [3]. Increase at RDW levels mainly due to
criteria were; pregnancy, any medication use and
anemia associated with nutritional deficiencies, and in
acute-chronic disease history besides from anemia.
(RDW),
corpuscular
hematocrit
hemoglobin
(HCT)
(MCH)
particular the first finding of iron deficiency anemia [4].
Iron (Fe), total iron-binding capacity (TIBC) and ferritin
The test of MPV is an indicator of platelet size. The
levels were measured immunoturbidimetrically using
increase in the value of MPV means increased mean
commercial kits on COBAS
platelet diameter leading to increased synthesis of
Diagnostics, Mannheim, Germany). Complete blood
new platelets at bone marrow. MPV test is often used
count analysis was analyzed using CELL-DYN 3700
for the differential diagnosis of thrombocytopenia [5]
hematology analyzer (Abbott
and generally remain unchanged in anemia.
Park, Illinois, USA) as a part of routine preoperative
Integra® (Roche
Laboratories, Abbott
blood sampling. Mean platelet volume (MPV), mean
In many countries as well as Turkey, anemia is
corpuscular volume (MCV), red cell distribution width
common among the females [6]. Especially female
(RDW), hematocrit (HCT) and mean corpuscular
patients
hemoglobin
assume
that
their
emotional
burnout
(MCH)
and
mean
corpuscular
symptoms are due to emotional status due to work
hemoglobin concentration (MCHC) were calculated by
rather than any physiological disorder like anemia.
autoanalyser. The neutrophil and lymphocyte counts
This condition leads to under-diagnose of burnout
were
recorded
and
the
Blood
neutrophil-to-
syndrome among these patients and lack of additional
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lymphocyte (N/L) ratio were manually calculated from
anemic
these parameters.
correlated with MBI subscale scores.
women
group;
RDW
and
MPV
were
An anonymous questionnaire which included; socio-
Discussion
demographic data and self-reported health status
Burnout is a prolonged response to chronic emotional
applied to the patient group.
and interpersonal stressors and is defined by the
three dimensions of exhaustion, cynicism, and
Emotional burnout status was explored by the
Maslach Burnout Inventory (MBI) [7]. The Maslach
Burnout Inventory (MBI) is a 22-item,7-level Likert
scale. The MBI comprises of three subscales;
emotional
exhaustion,tendency
others,diminished
feelings
to
depersonalize
of
personal
accomplishment in working with others.
SPSS 18.0 package program was used for data
analysis. ANOVA test was performed for parameters
inefficacy [8]. The purpose of this study was to identify
relationship between biochemical parameters and
burnout syndrome among female anemic patients. In
general burnout research, the results with respect to
gender are inconsistent. Some studies report a high
degree of burnout among women, while others show
that men are more often affected [9]. In the literature,
there are conflicting data concerning the correlation
between burnout and other variables, such as
consistent with the normal distribution and the Mann-
demographic and occupational factors and methods
Whitney U test was performed for parameters not
are quite heterogeneous [10].
consistent with the normal distribution. “Backward
High burnout, lead to feeling of worthlessness,
stepwise" method of analysis was preferred to show
unmotivated,
the independent effect of the variable. Pearson and
dissatisfaction
with
work
and
consequently lead to decrease in career self concept.
Spearman tests were used for correlation analysis.”p-
Negative feelings of people with a high burnout level
values” less than 0.05 was considered to be
are related to loss of a sense of their professional
statistically significant.
activity, loss of ability to self-realization, loss of
personal perspective. As the result of being in such a
Results
The study population and evaluated parameters in the
anemia and burnout groups are described in (Table
1).The study was explained to the participants and an
informed consent was given by each one. Every
patient was subjected to detailed history taking;
demographic data, history of present condition, past
history and psychiatric history.
According to our results; we observed decrease in the
values of hematological and iron indexes in the
anemic women group as expected. Anemic women
group assessed their physical health status and
general stress level as worse compared to controls
(p<0.001). High scores were found among 26,2% of
anemic women on MBI subscale of Emotional
condition for a long time a person loses the ability to
enjoy life, loses all or nearly all that has been the
basis for him/her.
A burnout syndrome also causes physical and mental
disorders.
People
having
psychopathological,
this
problem
psychosomatic,
reveal
somatic
symptoms and symptoms of social dysfunction. They
have
chronic
(dysfunction
of
tiredness,
memory
cognitive
and
dysfunction
attention),
sleep
disorders due to difficulties to sleep and early
awakening, personality disorders. These people can
develop
depression,
psychoactive
substance
dependence, can commit a suicide. The general
somatic symptoms are headache, gastrointestinal
disorders cardiovascular disorders [11].
exhaustion. RDW and ferritin levels were described
as main factors associated with anemia. In the
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The current research examined the demonstrated
relationship between burnout and RDW and MPV
values. Determination of MPV and RDW values is
relatively easy and inexpensive method for the
diagnosis of anemia. The relationship between
depression and increased platelet activity has been
previously stated by several studies [11, 12].
The originality of our study stands in the combination
of a validated and widely accepted questionnaire (the
MBI) and quantitative biochemical measurements.
Conclusion
As a conclusion RDW and MPV (an indicator of
platelet activity) values might be taken into account
for the prevention of emotional distress, with special
concern to anemic women who manifested high
vulnerability to burnout syndrome. Future research
should investigate the effect of emotional burnout on
MPV and RDW levels.
Disclosure
The authors report no conflict of interest. The authors
alone are responsible for the content and writing of
the paper.
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TABLE 1: COMPARISON OF VARIOUS PARAMETERS AMONG THE STUDY GROUPS
N=675
Group A
Group B
Group C
Group D
Anemia (-)
Anemia (-)
Anemia (+)
Anemia (+)
Burnout (-)
Burnout (+)
Burnout (-)
Burnout (+)
N=86
N=161
N=80
N=348
Hemoglobin (g/dl)
12.75 ± 1.16
12.01 ± 1.11
9.73 ± 2.16b
9.15± 2.13
HCT (%)
38.87 ± 3.60
36.47 ± 3.00
30.53 ± 5.84b
30.13 ± 5.34
MCV (fl)
80.19 ± 5.32
78.49 ± 5.00
64.60 ± 7.87b
62.60 ± 7.66
MCH (pg)
26.12 ± 4.23
25.52 ± 3.98
19.95 ± 3.97b
19.63 ± 3.05
MCHC (g/dl)
33.21 ± 1.54
32.21 ± 1.33
31.20 ± 2.73
30.20 ± 2.87
RDW (%)
13.81 ± 1.01
15.81 ± 1.34a
16.84 ± 2.68b
18.12 ± 3.22c
Platelet (x109/L)
350.29 ± 130.04
380.29 ± 121.13
392.04 ± 168.36
402.04 ± 168.18
Leukocyte (x 109/L)
9.53 ± 4.98
9.67 ± 4.18
11.39 ± 5.55
13.76 ± 5.34
Neutrophil (x 109/L)
3.98 ± 2.16
4.97± 2.76
5.39 ± 3.88
5.87 ± 3.23
MPV (fl)
8.00 ± 0.75
9.36 ± 1.45a
7.91 ± 0.48
9.49 ± 0.67c
Iron (μg/dl)
466.95 ± 92.43
448.35 ± 90.55
327.86 ± 53.79b
314.31 ± 50.56
TIBC (μg/dl)
73.73 ± 16.92
56.36 ± 16.01
49.80 ± 11.75b
59.80 ± 11.60
Ferritin (μg/ml)
42.7 ± 15.6
44.7 ± 15.12
22.7 ± 13.6b
20.7 ± 13.43
MBI
1.7 ± 0.6
4.3 ± 1.08*
2.1 ± 0.6
5.20 ± 1.26c
The values are expreed as mean ± STD. HCT hematocrit, MCV mean corpuscular volume, MCH mean corpuscular hemoglobin,
MCHC mean corpuscular hemoglobin concentration, RDW redcell distribution width, MPV mean platelet volume, TIBC total ironbinding capacity, MBI Maslach Burnout Inventory
a
p<0.05 between Group A and Group B
b
p<0.05 between Group C and Group A
c
p<0.05 between Group D and Group C
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