Cogn Behav Ther. 2025 Aug 26:1-21. doi: 10.1080/16506073.2025.2547199. Online ahead of print.
ABSTRACT
Perfectionism is associated with multiple mental health disorders, but its role as a prognostic factor in treatment outcomes remains debated. This systematic review assessed the impact of perfectionism on mental health disorder treatment outcomes. Seven databases were searched from to 11 October 2024, for randomised controlled trials that examined the relationship between perfectionism and treatment outcomes. A citation search was also performed. Sixteen randomised controlled trials with 2197 participants were included. Of these, fifteen explored how baseline perfectionism impacted primary mental health disorder treatment outcomes for eating disorders (N = 4), anxiety disorders (N = 3), obsessive-compulsive disorder (N = 3), major depressive disorder (N = 2), mixed depressive disorders (N = 2) and body dysmorphic disorder (N = 1). Nine of these fifteen studies (56%) found higher baseline perfectionism was associated with poorer treatment outcomes, while five (38%) found no significant association, and one (6%) reported mixed findings. Four out of five studies with children and adolescents reported negative impacts of baseline perfectionism. Overall, baseline perfectionism appears to have a mix of negative and non-significant effects on treatment outcomes across age groups. Limitations include the high risk of bias in some studies and the absence of meta-analyses. Clinicians should assess for perfectionism and address it when it hinders progress.
PMID:40856635 | DOI:10.1080/16506073.2025.2547199
