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The impact of perfectionism on treatment outcomes of mental health disorders: a systematic review of randomised controlled trials

Jiang, Zhaohong; Egan, Sarah J; Greene, Danyelle; Frost, Macey; Ma, Yu; Shafran, Roz; (2025) The impact of perfectionism on treatment outcomes of mental health disorders: a systematic review of randomised controlled trials. Cognitive Behaviour Therapy 10.1080/16506073.2025.2547199. (In press). Green open access

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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.

Type: Article
Title: The impact of perfectionism on treatment outcomes of mental health disorders: a systematic review of randomised controlled trials
Location: England
Open access status: An open access version is available from UCL Discovery
DOI: 10.1080/16506073.2025.2547199
Publisher version: https://doi.org/10.1080/16506073.2025.2547199
Language: English
Additional information: © 2025 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group. This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives License (http://creativecommons.org/licenses/by-nc-nd/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited, and is not altered, transformed, or built upon in any way. The terms on which this article has been published allow the posting of the Accepted Manuscript in a repository by the author(s) or with their consent.
Keywords: Perfectionism; mental health disorders; treatment outcomes; randomised controlled trials
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > UCL GOS Institute of Child Health
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > UCL GOS Institute of Child Health > Population, Policy and Practice Dept
URI: https://discovery.ucl.ac.uk/id/eprint/10214606
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