Physicians whose personality traits include maladaptive perfectionism are at increased risk of depression and suicidal ideation compared with peers who don’t bear this type of neurosis.

What’s more, psychology researchers found the relative rate of risk held steady before and during the COVID pandemic, suggesting its constancy.

While the study subjects were in Israel, the findings are likely generalizable to the U.S.

That’s because the hallmarks of maladaptive perfectionism, as listed by Physicians Anonymous, will be familiar to physicians and the families who love them throughout the Western world:

• Excessive preoccupation with past mistakes.
• Fears about making new mistakes.
• Doubts about whether one is doing something correctly. 
• Extreme concern with the high expectations of others.
• A pressing need for feelings of control over any situation in which one is involved.

Frontiers in Psychiatry published the new work in July.

Maladaptive perfectionism associates with poorer mental health

Lead author Dafna Kleinhendler-Lustig, senior author Yari Gvion, both of Bar-Ilan University, and co-authors surveyed 160 physicians before the pandemic and 86 of them during.

More than one-fifth of the cohort, 22%, fell into a subgroup considered high-risk for suicidal behaviors over the course of a lifetime.

More than a quarter, 27%, reported suicidal ideation during the last 12 months, and 13.4% reported suicidal ideation during the last three months.

More than a third, 34.6%, exhibited moderate to severe levels of depressive symptoms, and more than half the sample reported burnout symptoms.

More tellingly still, the researchers found maladaptive perfectionism correlated with current suicidal ideation, burnout and depression.

A call for systematic intervention

In their discussion the authors remark that, in physicians who were characterized with high maladaptive perfectionism, “depression served as a significant risk factor for suicidal ideation during the pandemic, which places these individuals at increased risk for suicidality.”

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“These results highlight the importance of implementing intervention programs among physicians to reduce suicidal risk and to better identify rigid perfectionism and depressive symptoms.”

The figures are less troubling than those uncovered by Medscape in its 2023 physician survey. This found more than half of U.S. doctors, 53%, feeling burned out. In 2018, before COVID-19 was a thing, the burnout rate registered at “only” 42%.

Medscape also found 23% of U.S. doctors feeling depressed in 2023, up from 15% in 2018.

The Israeli study is available in full for free.