Perfectionism can be easy to dismiss as harmless—from the outside it can look like talent, ambition, and high standards. But psychologists have long suggested another perspective: that excessive drive and self-criticism can lead to self-destruction, suggesting a link between perfectionism and suicide. Still, there's been little research aimed at sussing out the connection. Now, a new study, the most comprehensive to date, suggests that perfectionism can be a relevant risk factor for suicide.

The work, led by Martin Smith at the University of Ontario, doesn't use new data; instead, it's a meta-analysis encompassing 45 previous studies, using information from 11,747 participants. One of the first questions facing researchers was how to define perfectionism. They found that the studies covered 15 different definitions and ways of measuring perfectionism. They mostly fell into three broad categories: demanding perfection from oneself, demanding perfection of others, and perceiving others as demanding perfection from oneself.

Researchers believed a meta-analysis could suggest which aspects of perfectionism, if any, showed the strongest relations with suicide ideation and actual suicide attempts. Recognizing which personality traits are closely tied to thoughts of suicide could make intervention easier; it could also undercut the notion that perfectionist striving is healthy.

The study notes that a sizable portion of the research suggests "relentlessly pursuing perfection engenders intense psychological pain." Perfectionists often lead stressful lives, while their prickly personality traits can leave them feeling disconnected from others. Intense psychological pain coupled with emotional isolation might lead to thoughts of suicide as a means of escape.

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They found that 13 of the 15 dimensions of perfectionism showed a connection with increased thoughts of suicide. Of the three general categories, holding others to perfectionist standards had little to no relationship with suicidal ideation; demanding perfection from oneself or feeling that it was being demanded by others, though, showed a small to moderate positive relationship with suicidal thoughts. Feeling incapable of meeting others' weighty expectations also showed an association with repeated suicide attempts.

"Perfectionists are their own worst critics—good enough is never enough," the authors write. That casts a dark shadow on our intuitive definitions of perfectionism. But there's more work to be done: Researchers note that we need more data from a more diverse group of people over a longer period of time (most of the included studies were not longitudinal). Understanding how perfectionism may interact with other suicidal factors is also a priority.

"Our findings lend credence to the long-standing notion that feeling incapable of living up to the lofty standards of others is a part of the premorbid personality of people at risk for suicide," the researchers write. Recognizing this commonsense idea could help us better understand suicide—and ways we might be able to prevent it.

If you or someone you know is considering suicide, help is available. Call 1-800-273-8255 to speak with someone now or text START to 741741 to message with the Crisis Text Line.