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Am J Geriatr Psychiatry 15:734-741, September 2007
© 2007 American Association for Geriatric Psychiatry
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Article

Narcissistic Personality and Vulnerability to Late-Life Suicidality

Marnin J. Heisel, Ph.D., Paul S. Links, M.D., FRCP(C), David Conn, M.B., FRCP(C), Robert van Reekum, M.D., FRCP(C), and Gordon L. Flett, Ph.D.

Departments of Psychiatry and of Epidemiology and Biostatistics, Schulich School of Medicine and Dentistry, The University of Western Ontario, and Lawson Health Research Institute, London, Ontario, Canada (MJH); the Center for the Study and Prevention of Suicide, Department of Psychiatry, University of Rochester School of Medicine and Dentistry, Rochester, New York (MJH); the Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada (PSL, DC, RvR); and the Department of Psychology, York University, Toronto, Ontario, Canada (GLF); and the Kunin-Lunenfeld Applied Research Unit (RvR), Baycrest, Toronto, Ontario, Canada (DC and RvR).

Objective: Narcissistic personality (NP) has been implicated as a potential vulnerability factor for late-life suicide. The present study investigated whether NP increases vulnerability to suicidal ideation and behavior among geriatric depression day-hospital patients.

Methods: Using a retrospective database analysis, the authors examined demographic data, diagnostic information, and scores on self-report (Geriatric Depression Scale [GDS]) and clinician-rated depression measures (Hamilton Rating Scale for Depression [HAM-D]), for 608 geriatric psychiatry patients 65 years or older.

Results: Of the 538 patients meeting study inclusion criteria, 20 had NP, defined as either narcissistic personality disorder (n = 13) or narcissistic personality traits (n = 7). Patients with NP were rated significantly higher on the HAM-D suicide item than those without NP, controlling for age, sex, depression (GDS), and cognitive functioning.

Conclusion: Findings suggest that NP may be a clinical marker of elevated suicide risk among depressed older adults. Clinicians are advised to assess the presence of self-pathology and its potential impact upon psychological functioning in depressed older patients, and to incorporate discussions of life transitions into therapeutic work with those at-risk for suicide.

Key Words: Suicide ideation • suicidal behavior • narcissistic personality • depression






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