title: Narcissistic personality and vulnerability to late-life suicidality.
abstract: 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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Psychiatry, Schulich School of Medicine and Dentistry, The University of Western Ontario, London, Ontario, Canada. Marnin.Heisel@ihsc.on.ca
authors.forename: Marnin J
authors.initials: MJ
authors.lastname: Heisel
authors.forename: Paul S
authors.initials: PS
authors.lastname: Links
authors.forename: David
authors.initials: D
authors.lastname: Conn
authors.forename: Robert
authors.initials: R
authors.lastname: van Reekum
authors.forename: Gordon L
authors.initials: GL
authors.lastname: Flett
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D015897:Comorbidity; D003631:Day Care, Medical; D003866:Depressive Disorder / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology; D005260:Female; D015577:Geriatric Assessment / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000706:statistics & numerical data; D009864:Ontario; D010554:Personality Disorders / Q000175:diagnosis* / Q000453:epidemiology / Q000523:psychology; D010555:Personality Inventory / Q000706:statistics & numerical data; D011594:Psychometrics; D018570:Risk Assessment; D012307:Risk Factors; D013405:Suicide / Q000523:psychology* / Q000706:statistics & numerical data; D013406:Suicide, Attempted / Q000523:psychology* / Q000706:statistics & numerical data