Sharing a Diagnosis of Narcissistic Personality: a Challenging Decision with Associated Risks and Benefits

Purpose of Review This paper aims to examine diagnostic sharing of narcissistic personality from multiple vantage points and to describe strategies that might help clinicians in patient management. Recent Findings In recent years, clinicians increasingly have been motivated to discuss with patients the diagnosis of borderline personality disorder (BPD), an intervention bolstered by the emergence of empirically validated treatments for BPD and by advocacy organizations calling for diagnostic sharing. Despite these advances, clinical experience suggests that the diagnosis of narcissistic personality, including narcissistic personality disorder (NPD) or clinically significant narcissistic traits, is rarely shared with patients. We review emerging information about diagnostic classification and assessment, epidemiology, heritability, neurobiology, prognosis, and the utility of evidence-based treatments, which may facilitate a conversation on diagnosis (as demonstrated in multiple clinical scenarios provided as examples). Summary Diagnostic sharing has become a central element in the informed consent process. Understanding the risks and benefits of sharing a diagnosis of narcissistic personality is essential for clinical practice.