Fast Five Quiz: Narcissistic Personality Disorder

Stephen Soreff, MD

Disclosures

January 10, 2020

A mental status examination in a patient with narcissistic personality disorder may reveal depressed mood due to dysthymia or major depressive disorder, both of which may be related to the paradoxically low self-esteem often present. Once in therapy, patients with narcissistic personality disorder may be in increased danger of suicide as they identify depressive elements. Conversely, patients in the throes of narcissistic grandiosity may display signs of hypomania or mania. In general, patients with cluster B personality disorders (including narcissistic, borderline, antisocial, and histrionic personality disorders) are at substantially greater risk for suicide. In patients with narcissistic personality disorder in particular, sudden life stressors (eg, job loss or unexpected financial misfortune) can lead to "surprise" or "shame" suicides.

Narcissistic personality disorder typically manifests by young adulthood (early to middle 20s) and may worsen in middle or old age as a consequence of the onset of physical infirmities or declining physical attractiveness. In addition to feeling intellectually and socially superior to others, people who are narcissistic are often quite vain regarding their physical appearance. Narcissistic traits can be exhibited by typical adolescents who are unlikely to go on to develop narcissistic personality disorder. Narcissistic personality disorder is more commonly found in men than in women.

Read more about the presentation of narcissistic personality disorder.

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