In western countries, narcissism cases are increasing and it has been mentioned as a “narcissism epidemic” (1). According to a report published in 2003, affected individual’s statement i.e. “I am an important person” has increased to 80% in young people. Many research says that narcissism is associated with self-esteem. However, there was evidence available that both narcissism and self-esteem was distinct in several views which include its phenotype, its consequences, its development, and its geneses(2).

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What Is The Prognosis For Narcissistic Personality Disorder?

The prognosis for Narcissistic Personality Disorder is not systematically studied yet and there are no guidelines standardized till date(3). As there is no specific drug therapy for Narcissistic Personality Disorder, care and support are typically required for the lifelong period. Present-day management and care are generally founded on theoretical psychodynamic models of narcissistic personality disorder and the capabilities of physicians with afflicted entities in clinical settings. Even though they are deliberate, but studies indicate higher drop out percentages.

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Comorbidity i.e. the presence of other personality disorder is high in narcissism(5). Bipolar disorder, anorexia, and alcohol/substance use disorders are common among narcissism. Most of the patients show improvement in depression and anxiety. However, advanced cases are difficult to handle as they show arrogance, dominance, superiority, emotional distress, and sense of depressive.

Neuroimaging research had proved the abnormalities which were associated with the gray matter in the left anterior insula of the brain of affected individuals(6). The gray matter directly related to empathy, care, emotive sense, and mental reasoning. These are the keystones of reasons for developing a narcissistic personality disorder.

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Many patients with depressive symptoms show drastic changes that threaten their self-esteem. The rate of occurrence of depressive symptoms in narcissism has been assessed to be 42% to 50%(4). It causes severe narcissistic disgrace, downfall, disappointment, and loss of understanding. If Narcissistic Personality Disorder is left uncared, signs and symptoms may get worse over the period and the patient exhibits profound narcissism which is difficult for geriatric people.

The Pathological Narcissism Inventory is a very important measurement for evaluating the grandiose and susceptible subjects of narcissistic pathology. PNI report says that middle-aged people from West Germany recorded higher on grandiose subscales. The main reason for such scores is because of their natural traits developed from the period of childhood to young adult which later has become more stable in middle age. Environmental, community, genomic and neurobiological influences are a key factor for the cause of their narcissistic personality.

Conclusion

A narcissistic personality disorder is an abnormal behavior illness described in type B clusters of personality disorder. It exists in affected individuals to a long period and occurs across a variety of social situations. The prognosis is not well researched and there are no suitable strategies of treatment practiced till date. As there is no specific drug therapy for Narcissistic Personality Disorder, care and support are typically requires for the lifelong period. Present-day management and care are generally founded on theoretical psychodynamic models of narcissistic personality disorder and the capabilities of physicians with afflicted entities in clinical settings.

References:  

  1. Twenge JM, Campbell WK. The narcissism epidemic: Living in the age of entitlement. New York, NY, US: Free Press; 2009.
  2. Diagnostic and statistical manual of mental disorders : DSM-5 (5th ed.). Washington [etc.]: American Psychiatric Publishing. 2013. pp. 645, 669–72.
  3. Caligor, Eve; Levy, Kenneth N.; Yeomans, Frank E. (May 2015). "Narcissistic Personality Disorder: Diagnostic and Clinical Challenges". The American Journal of Psychiatry. 172 (5): 415–22.
  4. Dhawan, Nikhil; Kunik, Mark E.; Oldham, John; Coverdale, John (July – August 2010). "Prevalence and treatment of narcissistic personality disorder in the community: a systematic review". Comprehensive Psychiatry. 51 (4): 333–39.
  5. Paris, Joel (2014). "Modernity and narcissistic personality disorder". Personality Disorders: Theory, Research, and Treatment. 5 (2): 220–226.
  6. Namkung H, Kim SH, Sawa A. The Insula: An Underestimated Brain Area in Clinical Neuroscience, Psychiatry, and Neurology [published correction appears in Trends Neurosci. 2018 Aug;41(8):551-554]. Trends Neurosci. 2017;40(4):200–207. doi:10.1016/j.tins.2017.02.002
  7. Roche MJ, Pincus AL, Conroy DE, Hyde AL, Ram N. Pathological narcissism and interpersonal behavior in daily life. Personal Disord. 2013;4(4):315–323. doi:10.1037/a0030798

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Sheetal DeCaria MD

Written, Edited or Reviewed By:

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Last Modified On: June 15, 2019

This article does not provide medical advice. See disclaimer

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