Can clinical and subclinical forms of narcissism be considered risk factors for suicide-related outcomes? A systematic review.
Level 3 - non-randomized controlled study
Systematic review of non-randomized observational studies
PubMed 38437765 · doi:10.1016/j.jpsychires.2024.02.017
What was done
Authors conducted a PRISMA-guided systematic review searching PubMed, Scopus, and PsycInfo for studies examining clinical narcissism (narcissistic personality disorder [NPD] diagnosis or criteria) and subclinical traits (grandiose and vulnerable narcissism) in relation to suicide-related outcomes. Eligible designs included cohort, case-control, cross-sectional, and case series. Outcomes assessed included suicidal ideation (SI), non-suicidal self-injury (NSSI), deliberate self-harm (DSH), suicide attempts (SA), suicide risk (SR), and capability for suicide. A total of 47 studies were included.
What was found
Categorical NPD diagnosis or criteria showed no association with SI and mixed results for SA. Analysis by trait dimensions showed clearer patterns: vulnerable narcissism was associated with SI, less impulsive NSSI, and DSH (outcomes characterized by low intent to die). Grandiose narcissism was protective against SI and SR, but was associated with severe NSSI and multiple SA characterized by high intent to die and planning. No pooled numerical effect sizes or risk ratios were reported in the abstract.
Why it matters
Assessing dimensional narcissistic traits—particularly distinguishing vulnerable from grandiose profiles—provides clearer suicide risk stratification than categorical NPD diagnoses alone.
Limits
The included literature was limited by between-study heterogeneity and a lack of longitudinal studies. The abstract does not report quantitative effect sizes, pooled estimates, sample demographics, or formal risk-of-bias assessments.
Cited by
- contradicts Narcissists do not tend to commit suicide.