• Dena M Bravata, Sharon A Watts, Autumn L Keefer, Divya K Madhusudhan, Katie T Taylor, Dani M Clark, Ross S Nelson, Kevin O Cokley, and Heather K Hagg.
• Center for Primary Care and Outcomes Research, Stanford University School of Medicine, Stanford, CA, USA. dbravata@gmail.com.
• J Gen Intern Med. 2020 Apr 1; 35 (4): 1252-1275.

BackgroundImpostor syndrome is increasingly presented in the media and lay literature as a key behavioral health condition impairing professional performance and contributing to burnout. However, there is no published review of the evidence to guide the diagnosis or treatment of patients presenting with impostor syndrome.PurposeTo evaluate the evidence on the prevalence, predictors, comorbidities, and treatment of impostor syndrome.Data SourcesMedline, Embase, and PsycINFO (January 1966 to May 2018) and bibliographies of retrieved articles.Study SelectionEnglish-language reports of evaluations of the prevalence, predictors, comorbidities, or treatment of impostor syndrome.Data ExtractionTwo independent investigators extracted data on study variables (e.g., study methodology, treatments provided); participant variables (e.g., demographics, professional setting); diagnostic tools used, outcome variables (e.g., workplace performance, reductions in comorbid conditions); and pre-defined quality variables (e.g., human subjects approval, response rates reported).Data SynthesisIn total, 62 studies of 14,161 participants met the inclusion criteria (half were published in the past 6 years). Prevalence rates of impostor syndrome varied widely from 9 to 82% largely depending on the screening tool and cutoff used to assess symptoms and were particularly high among ethnic minority groups. Impostor syndrome was common among both men and women and across a range of age groups (adolescents to late-stage professionals). Impostor syndrome is often comorbid with depression and anxiety and is associated with impaired job performance, job satisfaction, and burnout among various employee populations including clinicians. No published studies evaluated treatments for this condition.LimitationsStudies were heterogeneous; publication bias may be present.ConclusionsClinicians and employers should be mindful of the prevalence of impostor syndrome among professional populations and take steps to assess for impostor feelings and common comorbidities. Future research should include evaluations of treatments to mitigate impostor symptoms and its common comorbidities.

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