Open Access Highly Accessed Research article

Narcissism in patients admitted to psychiatric acute wards: its relation to violence, suicidality and other psychopathology

Marit F Svindseth12*, Jim Aage Nøttestad23, Juliska Wallin4, John Olav Roaldset12 and Alv A Dahl56

Author Affiliations

1 Department of Psychiatry, Sunnmore Hospital, N-6026 Aalesund, Norway

2 National University of Science and Technology, N-7440 Trondheim, Norway

3 Department of Forensic Psychiatry, Broset, St. Olav's Hospital, N-7440 Trondheim, Norway

4 Department of Social Sciences, Mälardalen University, S-635 13 Eskilstuna, Sweden

5 Department of Clinical Cancer Research, The Norwegian Radiumhospital, Rikshospitalet University Hospital, N-0310 Oslo, Norway

6 Faculty Division The Norwegian Radiumhospital, University of Oslo, N-0316 Oslo, Norway

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BMC Psychiatry 2008, 8:13  doi:10.1186/1471-244X-8-13

Published: 27 February 2008



The objective was to examine various aspects of narcissism in patients admitted to acute psychiatric wards and to compare their level of narcissism to that of an age- and gender-matched sample from the general population (NORM).


This cross-sectional study interviewed 186 eligible acute psychiatric patients with the Brief Psychiatric Rating Scale (BPRS) and the Global Assessment of Functioning (GAF). The patients filled in the Narcissistic Personality Inventory-21 item version (NPI-21), The Hospital Anxiety and Depression Scale (HADS) and the Rosenberg Self-Esteem Scale. High and low narcissism was defined by the median of the total NPI-21 score. An age- and gender-matched control sample from the general population also scored the NPI-21 (NORM).


Being male, involuntary admitted, having diagnosis of schizophrenia, higher self-esteem, and severe violence were significantly associated with high narcissism, and so were also low levels of suicidality, depression, anxiety and GAF scores. Severe violence and high self-esteem were significantly associated with high narcissism in multivariable analyses. The NPI-21 and its subscales showed test-retest correlations ≥0.83, while the BPRS and the HADS showed lower correlations, confirming the trait character of the NPI-21. Depression and suicidality were negatively associated with the NPI-21 total score and all its subscales, while positive association was observed with grandiosity. No significant differences were observed between patients and NORM on the NPI-21 total score or any of the NPI subscales.


Narcissism in the psychiatric patients was significantly associated with violence, suicidality and other symptoms relevant for management and treatment planning. Due to its trait character, use of the NPI-21 in acute psychiatric patients can give important clinical information. The similar level of narcissism found in patients and NORM is in need of further examination.