Wright, Amelia, Fisher, Peter L, Baker, Nita et al. · Journal of psychosomatic research · 2021 · DOI
This review looked at seven studies examining whether perfectionism (setting very high standards and worrying about mistakes) is connected to depression in people with ME/CFS. Researchers found strong links between perfectionism and depression, particularly worrying excessively about making mistakes. However, there's much less research on whether perfectionism is linked to anxiety in ME/CFS patients.
Understanding psychological factors like perfectionism that co-occur with ME/CFS may help clinicians better support patients and develop targeted interventions. This research highlights that depression in ME/CFS patients may not exist in isolation but could be linked to maladaptive thought patterns that could potentially be addressed through psychological approaches alongside biomedical care.
This review cannot establish causation—it only shows correlation, meaning we cannot determine whether perfectionism causes depression in ME/CFS, depression causes perfectionism, or whether both are independent consequences of ME/CFS itself. The findings apply only to depression; the relationship with anxiety remains unclear due to insufficient research. The studies reviewed had methodological limitations that may affect the strength of these conclusions.
About the PEM badge: “PEM required” means post-exertional malaise was an explicit required diagnostic criterion for participant inclusion in this study — not that PEM was studied, observed, or discussed. Studies using criteria that do not require PEM (e.g. Fukuda, Oxford) are tagged “PEM not required”. How the atlas works →
The first block is for the primary paper and is the citation you should use in research work. The atlas-snapshot line only applies if you are specifically referring to this atlas’s reading of the paper on the date shown.
Primary citation
Wright, Amelia, Fisher, Peter L, Baker, Nita, O'Rourke, Louise, & Cherry, Mary Gemma (2021). Perfectionism, depression and anxiety in chronic fatigue syndrome: A systematic review.. Journal of psychosomatic research. https://doi.org/10.1016/j.jpsychores.2020.110322
BibTeX
@article{mecfsatlas-wright-2021-perfectionism-depression,
author = {Wright, Amelia and Fisher, Peter L and Baker, Nita and O'Rourke, Louise and Cherry, Mary Gemma},
title = {Perfectionism, depression and anxiety in chronic fatigue syndrome: A systematic review.},
journal = {Journal of psychosomatic research},
year = {2021},
doi = {10.1016/j.jpsychores.2020.110322},
note = {PubMed: 33278659},
url = {https://www.mecfsatlas.com/evidence/wright-2021-perfectionism-depression},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-29. https://www.mecfsatlas.com/evidence/wright-2021-perfectionism-depression
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