Entrepreneurs, executives, and any individuals in decision-making positions are frequently exposed to emotionally tense situations that they must manage in order to navigate the challenges of business administration, ensuring the continuity of the enterprise and achieving milestones that secure successful market positioning (Stephan, 2018). Those emotionally tense situations, accompanied by stress, affect the venture and also their well-being. There is an abundant literature that has explored stress in the work environment, and particularly in the entrepreneurship work (Lerman et al., 2021; Neneh, 2024). Despite the relevance of stressors potentially leading to mood disturbances, anxiety symptoms, or even burnout, references in the literature specifically addressing such manifestations among women in corporate decision-making roles remain exceedingly scarce. Moreover, within the general population, some studies suggest a certain degree of controversy (Purvanova & Muros, 2010). Some studies suggest that certain stressors, for individuals in positions of responsibility, may act as motivators, whereas for others, they become obstacles (Lerman et al., 2021). In this regard, some authors even argue that the level of psychological capital serves as a protective factor against emotional and motivational consequences (Ross et al., 2021).

The emotional response to work-related conditions has long been a subject of interest within occupational psychology, leading to the development of explanatory theoretical frameworks. One such theoretical model of psychological stress in the workplace is the 'job demand/job control' model (Jönsson et al., 2003; Karasek, 1979; Karasek & Theorell, 1990; Pinto et al., 2014). According to this model, when job demands are high and the degree of control over one’s work is low, a detrimental form of stress arises that negatively impacts health. This is a theoretically relevant aspect for the practical observation of women in leadership roles, as their daily activity typically involves high demands, yet their leadership position affords them a certain degree of control. Other studies (Elovainio et al., 2007) have reinforced this line of inquiry, indicating that psychological distress—not exclusively among individuals in leadership positions—is essentially associated with the interplay between job control and job strain.

The role of mood disorders, symptoms of anxiety, and particularly the so-called burnout syndrome is a matter of particular interest within a population of women in executive positions, whose responsibilities constitute the motivation for this study. For women executives and in entrepreneurial positions, the pressures associated with management may be intensified by the self-perceived performance (Mouratidou et al., 2024), or by the domestic roles they typically balance alongside their professional activities (De Clercq & Brieger, 2022). Family dynamics and achievement expectations placed on women entrepreneurs can act as stressors or even barriers to entrepreneurship, as highlighted by some studies (Dewitt et al., 2023). The literature has already addressed this issue, analysing the balance between personal and professional life for women entrepreneurs (Kaciak & Welsh, 2020) and emphasizing the importance of public policies in maintaining this balance (Eddleston & Powell, 2012). Additionally, the link between mood disorders, anxiety, and burnout in the workplace has been studied in various works (De Clercq & Brieger, 2022; Hakanen et al., 2008). However, issues related to mental health and its impact on the work performance of women entrepreneurs remain a scarcely studied topic.

Anxiety is defined as the anticipatory emotional response to an imminent threat, whether real or imagined. The global prevalence of anxiety is estimated to be around 7.3%. In Europe, it stands at 1.8%, with higher rates among women (1%-5.6%) than men (0.6%-1.5%) (Reyes Marrero & de Portugal Fernández del Rivero, 2019). The World Health Organization (World Health Organization, 2025) reports that anxiety disorders impacted 301 million individuals suffering, data for the year 2019. Stress is the physiological response to anxiety, often characterized by headaches, discomfort, tension, fatigue, stomach upset, or loss of sleep. Generally, it is transient and can be either positive (eustress), motivating the individual to overcome the difficulty, or negative (distress), which exhausts the person, preventing clear thinking to resolve the source of concern. Depression is a mood disorder that may include symptoms such as sadness, a sense of emptiness, frustration, and irritability, feelings of guilt, worthlessness, or helplessness, anhedonia or loss of interest in pleasurable activities, and cognitive difficulties in concentrating, remembering, or making decisions. Additionally, it can lead to loss of appetite and weight, pain, and other physical symptoms. In more persistent and severe cases, it may include suicidal ideation and even suicide attempts (Mayo Clinic, 2023). According to WHO (2022) data, by 2019, depression affected approximately 280 million people globally, representing 5% of the adult population. This condition is more prevalent in women than men. Burnout syndrome is an inadequate response to a process of chronic stress specifically related to the work environment. Gil-Monte and Peiró (1999) define it as a reaction to prolonged work-related stress, which involves negative attitudes and feelings towards colleagues and one's own work, along with a sense of exhaustion. Regarding burnout, WHO (2022) stated that around 25% of workers experienced this syndrome, though WHO notes that the figure has gradually declined since the end of the COVID-19 pandemic.

Mood disorders, in addition to their psychological effects, are associated with productivity losses and entail related social costs (Collins et al., 2005; Despiégel et al., 2012). Psychological disorders such as depression, anxiety, and the characteristic conditions of burnout syndrome can lead to absenteeism, that is, absences from work due to leave or even medical sick days. Absenteeism is typically measured by the number of days absent; in contrast, presenteeism is more challenging to quantify. Presenteeism is characterized by a reduction in performance without physical absence from the workplace, linked to a lack of focus on the task at hand. The individual is not fully engaged in their work activities during working hours (Adler et al., 2006; Schultz et al., 2009). The connection between burnout, job dissatisfaction, absenteeism, and presenteeism has been corroborated in a literature review (Salvagioni et al., 2017). Some authors (Kiefl et al., 2024) have highlighted the link between presenteeism and workload, which tends to be high among small entrepreneurs, as the entire responsibility for the business falls on them. The evidence remains somewhat controversial. While some studies indicate that entrepreneurship can lead to toxic stress levels, they also find that, on average, entrepreneurs experience less job burnout than employees. According to certain authors, solo entrepreneurs exhibit the lowest burnout risk compared to other entrepreneurial groups (Obschonka et al., 2023). In this sense, professional experience has been proposed as a factor that helps reduce emotional disturbances associated with decision-making in individuals holding managerial or entrepreneurial positions (Serna-Zuluaga et al., 2024). In this regard, several studies have underscored the importance of coping strategies among entrepreneurs to ensure their mental health (Kiefl et al., 2024).

Despite the marked interest in the influence of emotional and psychological factors in general among entrepreneurs and individuals in decision-making positions, as well as the controversies raised, evidence specifically regarding women in these roles remains limited. The novelty of this study lies in assessing the incidence of mood disturbances, anxiety, and burnout among a population that, to the best of our knowledge, has been the focus of very few empirical studies: women in decision-making roles, entrepreneurs, and executives. The aim is to explore potential links between these psychological disturbances and the demographic profiles and labour market positions of these women. Additionally, the study seeks to determine whether there is any relationship between these psychological signs and perceptions of performance, absenteeism, and presenteeism, given the implications these factors have for business management and viability.

Consequently, the primary objective of this study is to analyse the relationship between mood disorders and the socio-professional profile of female entrepreneurs or executives. Given the impact of the business class on the generation of wealth within a country or region, obtaining reliable information on whether high levels of stress impair decision-making is of particular relevance. The study is structured around two hypotheses. The main hypothesis (H1) is that female entrepreneurs and executives exhibit more symptoms of anxiety than of depression. This predominance of anxiety contributes to maintaining motivation and resilience in the face of adversity, resulting in relatively low levels of burnout within this population. In line with this, the second hypothesis (H2) posits that the presence of mood-related symptoms has a minimal impact on absenteeism and medical leave rates.

The structure of the manuscript is organised as follows: an Introduction, which outlines the relevance of the study and the scarcity of similar research, supported by various bibliographic references that highlight the study’s contribution to addressing a knowledge gap. The Methods section describes the procedure followed, including ethical committee approval, sample size, the instruments administered, and the rationale for their selection. The Results section presents the findings without interpretation, alongside the statistical tests employed and their corresponding outcomes. The Discussion is focused on interpreting the results in light of existing knowledge. The Conclusions section reflects the authors’ interpretation of the findings. Finally, the manuscript includes a section on the Practical implications and potential applications of the study, as well as a section addressing its Limitations and proposing Future lines of research.

This study was conducted using a non-random cross-sectional design based on a sample obtained through the selfless/disinterested collaboration of businesswomen and executives of Galicia. Galicia is a region at the northwest of Spain. In the compilation of data has been key the support of "Woman Emprende" an initiative by the University of Santiago de Compostela (Spain), which promotes entrepreneurship among female university students in Galicia; and the association of businesswomen and executives "Executivas de Galicia". "Executivas de Galicia" is an association with a strong representation of the female entrepreneurial community in Galicia. The last one comprises nearly 300 professionals from various executive and managerial fields, both public and private. The design of this study was previously approved by the Ethics Committee of the University of Murcia (Spain), registration no: 3512/CEIH/2023. No data that could identify the respondents, nor any data that could allow identification through cross-referencing, was gathered to ensure the anonymity of the participants (e.g., the name of the company or information regarding residence data below the provincial level was not recorded). The people who analysed the data were blind to the origin of it. As an inclusion criterion, participants were required to provide informed consent, be female, and currently hold a position as a business owner or executive within a company.

A total of 223 women in positions of responsibility and/or business ownership responded to the questionnaire. After excluding incomplete cases in essential elements (e.g., not responding to the mood and burnout questionnaires, women in employee positions, neither executives nor business owners), a total of 199 cases were analysed. Data were collected from mid-February to mid-May 2024.

The questionnaire was divided into four sections, requesting: a) information related to their sociodemographic profile, b) data on health and mood status, including the Goldberg Anxiety and Depression Scale (Goldberg et al., 1988) (see Appendix 1) and the Burnout Clinical Subtype Questionnaire (BCSQ-12) Montero-Marín et al., 2011), c) questions regarding the impact on their social and personal lives, and d) data concerning the personal economic repercussions related to their mood over the past 12 months (see Appendix 2). The mood and burnout questionnaires, following their respective protocols, referred to the preceding two weeks.

The Goldberg Anxiety and Depression Scale (GADS) is designed to be used by non-psychiatrists and provides dimensional measures of the severity of each disorder. Each section consists of nine questions addressing signs of anxiety and depression, respectively. The full set of nine questions should only be administered if there are positive responses to the first four. In the anxiety section, at least two positive answers are required among the first four questions to proceed with the remaining five. In the depression section, at least one positive response among the first four questions is necessary to continue with the remaining five questions. Thus, scores range from 1 to 9 in each section, and consequently from 1 to 18 in the entire test. The Goldberg test has been validated across various clinical and non-clinical settings (George et al., 2011; Montenegro Peña et al., 2013), as well as among different population groups, including the assessment of outcomes by gender. In this case, no differences attributable to gender were found in the test results (Leach et al., 2008).

Burnout has conventionally been conceptualised as a multidimensional construct encompassing exhaustion, cynicism, and inefficiency. The Burnout Clinical Subtype Questionnaire (BCSQ-12) Montero-Marín et al., 2011) has identified three distinct subtypes: the frenetic subtype, associated with overload; the under-challenged subtype, linked to a lack of development; and the worn-out subtype, connected to neglect. The BCSQ-12, which operationalises the dimensions of overload, lack of development, and neglect, is posited as a succinct yet theoretically grounded instrument for capturing the diverse phenomenological expressions of burnout. According to the test authors, the BCSQ-12 offers advantages over the gold standard instrument for measuring burnout, the Maslach Burnout Inventory General Survey (MBI-GS) (De Beer et al., 2024; Maslach & Jackson, 1981), in characterising work-related discomfort experienced in relation to one's occupation. The BCSQ-12 has been employed with various types of populations (Abós et al., 2021; Montero-Marín et al., 2011) and has been specifically validated with the Spanish population. The test comprises 12 statements that individuals are required to rate on a scale from 1 to 7, where 1 indicates strong disagreement with the statement, and 7 indicates strong agreement. Consequently, the total score on the burnout test ranges from 12 (indicating a very low level of burnout) to 84 points (indicating the highest level of burnout).

In the BCSQ-12 test, the items are additionally grouped into three dimensions: Overload, Lack of Development, and Neglect. The Overload dimension includes items related to: excessive dedication to work, restriction of personal life, the perception that work poses a health risk, and the neglect of personal needs. The Lack of Development dimension comprises items about: the desire for another job, the view that work is an obstacle to personal development, the belief that work limits the expression of talent, and the consideration of work as a limitation of personal opportunities. The Neglect dimension includes items related to: the desire to leave the job, the capacity to resist frustration, the intention to abandon work when faced with difficulties, and items related to the willingness to give up at work when it requires more effort.

First, the data from the descriptive statistical analyses, based on central tendency and dispersion measures —means, medians, and standard deviations (SD)— are presented. Correlation analyses are then performed. When applicable, a robust linear correlation or ANOVA was conducted, depending on the type of variables. In cases where the criteria for these tests were not met, a non-parametric test was used: either the Kruskal-Wallis test or Spearman’s rank correlation, depending on the characteristics of the variables. Finally, the analysis was completed by applying a binary logistic regression to estimate the probabilities of absenteeism based on other variables of interest in the study. The odds ratios were calculated. For the data analysis, the statistical software Stata 14.1 was used.

There is a notable scarcity of studies —such as the one we have conducted— focusing on women entrepreneurs or executives and the links between mood disorders, anxiety, burnout, and absenteeism behaviours, despite the considerable implications these emotional disturbances may have for individuals in positions of business leadership and decision-making. Decision-makers, such as female entrepreneurs and executives, are frequently required to navigate highly uncertain scenarios, which may significantly impact the future of their companies, their personal assets, and the livelihoods of employees under their supervision. It is, therefore, logically expected that such circumstances could lead to elevated levels of emotional distress. Additionally, entrepreneurial women often juggle their professional responsibilities with caregiving duties, such as caring for children and dependent family members. This dual role increases the likelihood of encountering stressful situations. However, a high level of resilience often observed in entrepreneurial profiles may explain why, despite the personal and business-related challenges, average levels of anxiety, depression, and burnout have been relatively low in our results. Chadwick and Raver (2020) established a positive association between resilience and venture survival, indicating that ventures demonstrating greater resilience are more likely to endure in the long term. In other studies, such as that conducted by Zastempowski (2024) on a sample of 1,848 Polish entrepreneurs —without disaggregation by gender— the focus was placed on personality traits, a theme that lies outside the scope of our investigation, although it represents a promising line of enquiry. It is possible that the three factors identified among micro-entrepreneurs (openness to experience, conscientiousness, and extraversion) also contribute to a characteristic emotional tendency that fosters resilience. The ability to cope with adversity, adapt to demanding situations, and maintain mental well-being is a key factor contributing to their sustained performance and emotional stability. In this regard, some authors have noted that female entrepreneurs exhibit strong coping mechanisms. However, certain women entrepreneurs remain unaware of these mechanisms, which can result in elevated stress levels and a heightened sense of isolation in their careers (Krithiga & Velmurugan, 2024).

Regardless of the resilience capacity that has been primarily observed through the assessment of burnout levels, in our sample anxiety symptoms have been highly prevalent. The four primary signs exhibited a very high prevalence (see Figure 1) additionally, 77.89% of the sample displayed at least two of the primary defined signs of anxiety. Women in decision-making positions, entrepreneurs and executives, are subject to high levels of anxiety. This condition manifests in sleep disturbances, affecting both quantity and quality, in addition to other somatic consequences such as headaches, vegetative symptoms (tremors, tingling, dizziness, sweating, diarrhoea), and psychological rumination that results in persistent concerns about health (see Figure 2). Similar results have been found by previous research. In this sense, some authors (Kiefl et al., 2024) have found correlations between proactive coping and both job demands and mental exhaustion, suggesting a proactive coping against work-related stress, although in this instance, no sex-disaggregated analysis was performed on the sample (n=117).

The findings reveal a predominance of anxiety-related symptomatology relative to stress-related manifestations. This pattern may account for the observed low levels of burnout, aligning with prior research (Manchiraju et al., 2024) that underscores the critical role of stress as a necessary antecedent in the development of burnout. In addition, the motivation of female entrepreneurs and executives, along with their education and experience, may explain the resilient profile observed in the mood and burnout assessments. In this same vein, some authors (De Clercq & Brieger, 2022), using data from various countries, have found that women entrepreneurs, seeking to combine professional and private responsibilities, derive benefits even in environments initially considered hostile to female entrepreneurship.

To the best of our knowledge, no studies have examined the consequences of burnout in terms of absenteeism and medical leave among women entrepreneurs and executives. On this subject, the most studied population, especially recently following the COVID epidemic, has been healthcare professionals. In this group, a relationship has indeed been observed, with some authors (Lee et al., 2023) showing that healthcare workers with higher levels of burnout, particularly in the exhaustion dimension, have a higher risk of unplanned absenteeism (OR=1.04). Our study’s contribution indicates that, as observed among women entrepreneurs and in executive positions, the likelihood of absenteeism and medical leaves was linked to anxiety and burnout scores. As reported in the results section, the probability of absenteeism increases significantly as anxiety symptoms rise, and to a lesser extent, when burnout symptoms also increase.

This study has provided a gender-based analysis of the influence of mood alterations anxiety, and signs of burnout among female entrepreneurs and decision-makers within Spanish companies, particularly from a sample of Galicia, a northern region. The entrepreneurial woman is characterized by her dynamism (Fernández Fernández et al., 2024). The data reveal a profile of women typically around 40 years old, with a high level of education (predominantly university graduates), who engage in entrepreneurial activities after extensive experience in the workforce, often exceeding two decades (with slightly less experience in the case of those exclusively running businesses and approximately ten years in their current position. Women who venture into entrepreneurial activity do so with a solid foundation of education and experience. The fact that the majority of businesses are small in size in the sample matches with the Spanish business network where large companies, given that in Spain (Ministerio de Industria y Turismo, 2024), large companies (those with more than 250 employees) represent only 0.19% of the total.

Consistent with H1, women in entrepreneurial and executive roles exhibit a predominance of anxiety-related symptoms over those associated with depression. The symptom related to the perception of lack of energy (see Figure 3) was present in a substantial proportion of female entrepreneurs and executives. In this instance, the test required completion when any of the four symptoms were present, which occurred in a high percentage (68.35%). Upon completing the depression test, it became evident that symptoms related to lack of energy and cognitive slowing, such as difficulty concentrating or bradyphrenia, were the most prevalent (see Figure 4). The activity associated with decision-making roles appears to manifest more in apathetic symptoms than in mood-related symptoms, such as hopelessness, anhedonia, or loss of confidence. This can be interpreted as a greater emphasis on physical exhaustion associated with emotional tension rather than a psychological impact that limits motivation, which does not appear to be the case based on the results obtained. These findings are independent of the woman's position within the company, as well as her experience in the labour market or current role. From an analytical perspective, the concentration of symptomatology primarily in the somatic rather than affective domain may offer a dual explanatory framework. First, it is plausible that the elevated intrinsic motivation observed in this population segment enhances psychological resilience, mitigating the subjective perception of distress. Second, the somatisation of psychological discomfort may contribute to the underrecognition of such manifestations as clinically relevant mental health issues. This symptomatological ambiguity could, in part, elucidate the low prevalence of help-seeking behaviours and the limited utilisation of professional psychological support services among women occupying leadership or decision-making roles. These potential explanatory mechanisms, however, fall beyond the scope of the present study. Nevertheless, we contend that they warrant further investigation in future research endeavours.

These findings on mood and anxiety disorders are highly valuable for studying their connection with work performance. Previous studies (Esposito et al., 2007), though not conducted on a population of female entrepreneurs and executives, have shown that the presence of mood and anxiety disorders correlates with lower presenteeism scores compared to those without such disorders. In any case, although the number of female entrepreneurs and executives reporting medical leaves and absences is low over this population of highly resilient women in executive positions, therefore, it can be concluded that the second hypothesis (H2) has likewise been supported, our analyses show that among those who do experience such absences, a significant proportion (69.44%) attributed them to the work environment. Consequently, measures aimed at improving the workplace environment can reduce absenteeism and sick leave, thereby enhancing productivity for the companies.

Concerning the presence of burnout-related symptoms, our findings indicate that the overload dimension displayed markedly elevated scores on the measurement scale. This profile appears to predominate among women in leadership positions within business activities. The profiles characterised by these features are closely aligned with the frenetic subtype described by Montero-Marín et al. (2011). The frenetic subtype is defined by an excessive dedication to work, often manifested in individuals who display high levels of involvement, ambition, and occupational overload. The profile of those with elevated levels in the overload dimension is marked by a willingness to risk their health and sacrifice personal well-being and life in pursuit of achieving positive outcomes. Additionally, our results have demonstrated a strong correlation between depression scores and the burnout scale, as well as high levels of overload. Thus, as scores on these scales improve, the sense of overload diminishes. The profile of female entrepreneurs and executives is marked by high resilience in the face of anxiety-inducing factors, along with an ability to manage overload, enabling them to overcome adverse circumstances and persist in their objectives. The fact that average performance is estimated to be reduced (26.5% on average), combined with the finding that factors associated with depressive symptoms increase signs of overload, as well as evidence that anxiety and burnout symptoms lead to reduced performance through a higher likelihood of absenteeism and medical leaves, highlights the need for mental and emotional health policies and improvement plans, both for medical reasons and for the economic performance of companies.

One key aspect to reflect upon is the limited social support network that women entrepreneurs and those in decision-making positions within companies often experience. Our results revealed that 60.10% reported a decrease in their social relationships. Moreover, 66.37% indicated that they have no relationships with colleagues, either at work or outside of it. The lack of social networks is a factor that increases emotional vulnerability and may reduce performance in managerial roles. Equally striking is the finding that, despite experiencing high levels of anxiety and mood disturbances, the search for support does not rely on resources provided by mental health professionals (63.93% reported that they had not consulted with a mental health professional). Instead, they resort to general coping strategies or emotional release through activities such as exercise, yoga, or other pursuits (58.88% reported engaging in these activities).