{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,13]],"date-time":"2026-05-13T03:48:55Z","timestamp":1778644135160,"version":"3.51.4"},"reference-count":55,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2023,2,21]],"date-time":"2023-02-21T00:00:00Z","timestamp":1676937600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Brain Sciences"],"abstract":"<jats:p>Background: Previous research suggests that there is a link between perfectionism and symptoms of depression. This study aimed to see if different types of perfectionism are linked differently to symptoms of depression in mood disorders and if there is a relationship between perfectionism and symptoms of mania in bipolar disorder. Methods: A systematic search was conducted in the databases PsycINFO, EMBASE, Web of Science, and PubMed to find papers which examined the relationship in clinical depression and bipolar disorder. A meta-analysis pooled the correlation effect sizes for mood symptoms severity and the severity of the perfectionism subtype. Results: Twelve papers were included in the review, with five of these being included in the meta-analysis. The meta-analysis found statistically significant positive correlations between greater severity of depression symptoms and more severe perfectionism for the following subtypes: concern over mistakes, doubts about actions, other-oriented perfectionism, parental criticism, self-oriented perfectionism, and socially prescribed perfectionism. There was no significant relationship between depression symptoms and perfectionism subtypes of organisation and personal standards. There were not enough studies reporting data for manic symptoms for the meta-analysis or for any firm conclusions to be drawn. Conclusions: The relationship between depression and perfectionism differs depending on the particular type of perfectionism examined. Most studies were cross-sectional and correlational, so causation cannot be inferred, and future longitudinal studies are needed.<\/jats:p>","DOI":"10.3390\/brainsci13030377","type":"journal-article","created":{"date-parts":[[2023,2,22]],"date-time":"2023-02-22T02:31:55Z","timestamp":1677033115000},"page":"377","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["The Relationship between Mood Symptom Severity and Perfectionism Subtypes in Mood Disorders: A Systematic Review and Meta-Analysis"],"prefix":"10.3390","volume":"13","author":[{"given":"Katy","family":"Lea","sequence":"first","affiliation":[{"name":"School of Psychology, University of Southampton Highfield Campus, University Road, Southampton SO17 1BJ, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5357-4281","authenticated-orcid":false,"given":"Thomas","family":"Richardson","sequence":"additional","affiliation":[{"name":"School of Psychology, University of Southampton Highfield Campus, University Road, Southampton SO17 1BJ, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nina","family":"Rauze","sequence":"additional","affiliation":[{"name":"School of Psychology, University of Southampton Highfield Campus, University Road, Southampton SO17 1BJ, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2023,2,21]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"American Psychiatric Association (2013). Diagnostic and Statistical Manual of Mental Disorders, American Psychiatric Association. [5th ed.].","DOI":"10.1176\/appi.books.9780890425596"},{"key":"ref_2","unstructured":"World Health Organization (2022). International Classification of Disease 11."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"2861","DOI":"10.1038\/s41598-018-21243-x","article-title":"Prevalence of depression in the community from 30 countries between 1994 and 2014","volume":"8","author":"Lim","year":"2018","journal-title":"Sci. Rep."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"426","DOI":"10.1016\/j.jad.2020.12.151","article-title":"Bipolar disorder: Prevalence, help-seeking and use of mental health care in England. Findings from the 2014 adult psychiatric morbidity survey","volume":"282","author":"Humpston","year":"2021","journal-title":"J. Affect. Disord."},{"key":"ref_5","doi-asserted-by":"crossref","unstructured":"Dome, P., Rihmer, Z., and Gonda, X. (2019). Suicide risk in bipolar disorder: A brief review. Medicina, 55.","DOI":"10.3390\/medicina55080403"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"543","DOI":"10.1111\/bdi.12296","article-title":"Life expectancy in bipolar disorder","volume":"17","author":"Kessing","year":"2015","journal-title":"Bipolar Disord."},{"key":"ref_7","unstructured":"World Health Organization (2021, December 01). Depression and Other Common Mental Disorders: Global Health Estimates, Available online: https:\/\/apps.who.int\/iris\/handle\/10665\/254610."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"e30","DOI":"10.1017\/S2045796019000180","article-title":"The excess costs of depression: A systematic review and meta-analysis","volume":"29","author":"Konnopka","year":"2020","journal-title":"Epidemiol. Psychiatr. Sci."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"141","DOI":"10.1001\/jamapsychiatry.2020.2993","article-title":"Adjunctive psychotherapy for bipolar disorder: A systematic review and component network meta-analysis","volume":"78","author":"Miklowitz","year":"2021","journal-title":"JAMA Psychiatry"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"1266","DOI":"10.1017\/S0033291718004208","article-title":"Cognitive behaviour therapy for depression in primary care: Systematic review and meta-analysis","volume":"49","author":"Santoft","year":"2019","journal-title":"Psychol. Med."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"1301","DOI":"10.1002\/jclp.22435","article-title":"The relationship between perfectionism and psychopathology: A meta-analysis","volume":"73","author":"Limburg","year":"2016","journal-title":"J. Clin. Psychol."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"132","DOI":"10.1080\/87568225.2016.1140991","article-title":"Self-compassion as a mediator of maladaptive perfectionism and depressive symptoms in college students","volume":"30","author":"Mehr","year":"2016","journal-title":"J. Coll. Stud. Psychother."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"66","DOI":"10.1521\/ijct.2011.4.1.66","article-title":"Perfectionism in anxiety and depression: Comparisons across disorders, relations with symptom severity, and role of Comorbidity","volume":"4","author":"Wheeler","year":"2011","journal-title":"Int. J. Cogn. Ther."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"132","DOI":"10.1016\/j.jad.2019.03.003","article-title":"Buffering against maladaptive perfectionism in bipolar disorder: The role of self-compassion","volume":"250","author":"Fletcher","year":"2019","journal-title":"J. Affect. Disord."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"467","DOI":"10.1017\/S0033291799008879","article-title":"Cognitive vulnerability in patients with bipolar disorder","volume":"30","author":"Scott","year":"2000","journal-title":"Psychol. Med."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"205","DOI":"10.1016\/j.jad.2011.12.036","article-title":"Depression as a disease of modernity: Explanations for increasing prevalence","volume":"140","author":"Hidaka","year":"2012","journal-title":"J. Affect. Disord."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"276","DOI":"10.1037\/0021-843X.105.2.276","article-title":"Perfectionism and depression: Longitudinal assessment of a specific vulnerability hypothesis","volume":"105","author":"Hewitt","year":"1996","journal-title":"J. Abnorm. Psychol."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"121","DOI":"10.1037\/cbs0000306","article-title":"Perfectionism and its role in depressive disorders","volume":"54","author":"Hewitt","year":"2022","journal-title":"Can. J. Behav. Sci."},{"key":"ref_19","first-page":"61","article-title":"Perfectionism and eating disorders: A review of the literature","volume":"13","year":"2004","journal-title":"Eur. Eat. Disord. Rev."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"1052","DOI":"10.1111\/bjc.12378","article-title":"The association between maternal perinatal mental health and perfectionism: A systematic review and meta-analysis","volume":"61","author":"Evans","year":"2022","journal-title":"Br. J. Clin. Psychol."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"203","DOI":"10.1016\/j.cpr.2010.04.009","article-title":"Perfectionism as a transdiagnostic process: A clinical review","volume":"31","author":"Egan","year":"2011","journal-title":"Clin. Psychol. Rev."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"37","DOI":"10.3109\/13651501.2013.859707","article-title":"The role of obsessive beliefs in patients with major depressive disorder","volume":"18","author":"Bahceci","year":"2014","journal-title":"Int. J. Psychiatry Clin. Pract."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"64","DOI":"10.1016\/j.paid.2014.10.053","article-title":"Understanding perfectionism and depression in an adult clinical population: Is outcome expectancy relevant to psychological functioning?","volume":"75","author":"Cheng","year":"2015","journal-title":"Personal. Individ. Differ."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"1016","DOI":"10.1016\/j.jad.2013.08.029","article-title":"Anxiety, stress and perfectionism in bipolar disorder","volume":"151","author":"Corry","year":"2013","journal-title":"J. Affect. Disord."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"34","DOI":"10.1186\/s40345-017-0102-8","article-title":"Does perfectionism in bipolar disorder pedigrees mediate associations between anxiety\/stress and mood symptoms?","volume":"5","author":"Corry","year":"2017","journal-title":"Int. J. Bipolar Disord."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"124","DOI":"10.1037\/h0087194","article-title":"Relative stability of dimensions of perfectionism in depression","volume":"35","author":"Cox","year":"2003","journal-title":"Can. J. Behav. Sci."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"783","DOI":"10.1016\/S0005-7967(98)00188-0","article-title":"Perfectionism and depression symptom severity in major depressive disorder","volume":"37","author":"Enns","year":"1999","journal-title":"Behav. Res. Ther."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"61","DOI":"10.1016\/j.psychres.2013.10.001","article-title":"Implicit motives and cognitive variables: Specific links to vulnerability for unipolar or bipolar disorder","volume":"215","author":"Fuhr","year":"2014","journal-title":"Psychiatry Res."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"459","DOI":"10.1007\/s00737-012-0310-2","article-title":"The role of perfectionism in postpartum depression and symptomatology","volume":"15","author":"Maia","year":"2012","journal-title":"Arch. Women\u2019s Ment. Health"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"387","DOI":"10.1002\/jclp.22146","article-title":"Parental relationships and behavioral approach system dysregulation in young adults with bipolar disorder","volume":"71","author":"Muralidharan","year":"2015","journal-title":"J. Clin. Psychol."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"869","DOI":"10.1007\/s00702-010-0419-2","article-title":"The impact of perfectionism and anxiety traits on action monitoring in major depressive disorder","volume":"117","author":"Schrijvers","year":"2010","journal-title":"J. Neural Transm."},{"key":"ref_32","doi-asserted-by":"crossref","unstructured":"Beck, A.T., Steer, R.A., and Brown, G.K. (1996). Manual for the Beck Depression Inventory-II, The Psychological Corporation.","DOI":"10.1037\/t00742-000"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"56","DOI":"10.1136\/jnnp.23.1.56","article-title":"A rating Scale for depression","volume":"23","author":"Hamilton","year":"1960","journal-title":"J. Neurol. Neurosurg. Psychiatry"},{"key":"ref_34","doi-asserted-by":"crossref","unstructured":"Lovibond, S.H., and Lovibond, P.F. (1995). Manual for the Depression Anxiety Stress Scales, Psychology Foundation of Australia.","DOI":"10.1037\/t01004-000"},{"key":"ref_35","unstructured":"Blatt, S.J., D\u2019Afflitti, J.P., and Quinlan, D.M. (1979). Depressive Experiences Questionnaire, Educational Testing Service."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"573","DOI":"10.1016\/S0006-3223(02)01866-8","article-title":"The 16-item quick inventory of depressive symptomatology (QIDS), clinician rating (QIDS-C), and self-report (QIDS-SR): A psychometric evaluation in patients with chronic major depression","volume":"54","author":"Rush","year":"2003","journal-title":"Biol. Psychiatry"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"382","DOI":"10.1192\/bjp.134.4.382","article-title":"A new depression scale designed to be sensitive to change","volume":"134","author":"Montgomery","year":"1979","journal-title":"Br. J. Psychiatry"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"245","DOI":"10.1348\/0144665031752934","article-title":"The positive and negative affect schedule (panas): Construct validity, measurement properties and normative data in a large non-clinical sample","volume":"43","author":"Crawford","year":"2004","journal-title":"Br. J. Clin. Psychol."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"429","DOI":"10.1192\/bjp.133.5.429","article-title":"A rating scale for mania: Reliability, validity and sensitivity","volume":"133","author":"Young","year":"1978","journal-title":"Br. J. Psychiatry"},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"807","DOI":"10.1001\/archpsyc.1991.01810330031005","article-title":"Independent assessment of manic and depressive symptoms by self-rating: Scale characteristics and implications for the study of mania","volume":"48","author":"Bauer","year":"1991","journal-title":"Arch. Gen. Psychiatry"},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"381","DOI":"10.1037\/0021-843X.90.5.381","article-title":"A behavioral paradigm for identifying persons at risk for bipolar depressive disorder: A conceptual framework and five validation studies","volume":"90","author":"Depue","year":"1981","journal-title":"J. Abnorm. Psychol."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"449","DOI":"10.1007\/BF01172967","article-title":"The dimensions of perfectionism","volume":"14","author":"Frost","year":"1990","journal-title":"Cogn. Ther. Res."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"456","DOI":"10.1037\/0022-3514.60.3.456","article-title":"Perfectionism in the self and social contexts: Conceptualization, assessment, and association with psychopathology","volume":"60","author":"Hewitt","year":"1991","journal-title":"J. Pers. Soc. Psychol."},{"key":"ref_44","unstructured":"Weissman, A.N., and Beck, A.T. (1978). Development and Validation of the Dysfunctional Attitudes Scale: A Preliminary Investigation, American Educational Research Association."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"368","DOI":"10.1080\/00223891.2013.838172","article-title":"The short form of the revised almost perfect scale","volume":"96","author":"Rice","year":"2014","journal-title":"J. Personal. Assess."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"677","DOI":"10.1007\/s10608-006-9060-7","article-title":"Conceptualization and measurement of adaptive and maladaptive aspects of performance perfectionism: Relations to personality, psychological functioning, and academic achievement","volume":"30","author":"Chang","year":"2006","journal-title":"Cogn. Ther. Res."},{"key":"ref_47","doi-asserted-by":"crossref","unstructured":"Obsessive Compulsive Cognitions Working Group (OCCWG) (2001). Development and initial validation of the obsessive beliefs questionnaire and the interpretation of intrusions inventory. Behav. Res. Ther., 39, 987\u20131006.","DOI":"10.1016\/S0005-7967(00)00085-1"},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"775","DOI":"10.1016\/j.jrp.2012.08.007","article-title":"Perfectionism: The good, the bad, and the creative","volume":"46","author":"Wigert","year":"2012","journal-title":"J. Res. Pers."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"1373","DOI":"10.1016\/S0191-8869(03)00235-6","article-title":"Is perfectionism good, bad, or both? Examining models of the perfectionism construct","volume":"36","author":"Bieling","year":"2004","journal-title":"Personal. Individ. Differ."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"442","DOI":"10.1017\/S1352465820000144","article-title":"Examining the roles of metacognitive beliefs and maladaptive aspects of perfectionism in depression and anxiety","volume":"48","author":"Hughes","year":"2020","journal-title":"Behav. Cogn. Psychother."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"419","DOI":"10.1111\/j.1600-0447.1998.tb10025.x","article-title":"Are dysfunctional attitudes in depressive disorder trait or state dependent?","volume":"97","author":"Ohrt","year":"1998","journal-title":"Acta Psychiatr. Scand."},{"key":"ref_52","unstructured":"Leahy, R.L., and Dowd, E.T. (2002). Clinical Advances in Cognitive Psychotherapy: Theory and Application, Springer Publishing Company."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"24","DOI":"10.1007\/s10608-008-9218-6","article-title":"Dysfunctional attitudes, attributional styles, and phase of illness in bipolar disorder","volume":"34","author":"Miklowitz","year":"2010","journal-title":"Cogn. Ther. Res."},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"170","DOI":"10.1080\/16506073.2021.1952302","article-title":"The efficacy of randomised controlled trials of cognitive behaviour therapy for perfectionism: A systematic review and meta-analysis","volume":"51","author":"Galloway","year":"2022","journal-title":"Cogn. Behav. Ther."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"277","DOI":"10.4088\/JCP.v67n0215","article-title":"A randomized controlled trial of cognitive therapy for bipolar disorder: Focus on long-term change","volume":"67","author":"Ball","year":"2006","journal-title":"J. Clin. Psychiatry"}],"container-title":["Brain Sciences"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2076-3425\/13\/3\/377\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T18:38:38Z","timestamp":1760121518000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2076-3425\/13\/3\/377"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,2,21]]},"references-count":55,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2023,3]]}},"alternative-id":["brainsci13030377"],"URL":"https:\/\/doi.org\/10.3390\/brainsci13030377","relation":{},"ISSN":["2076-3425"],"issn-type":[{"value":"2076-3425","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,2,21]]}}}