Narcissistic personality disorder: an opinionated review of the efficacy of psychotherapy

The literature base on the effectiveness of treatment for narcissistic personality disorder (NPD) is scarce with few empirically sound studies and there has been no systematic review for over a decade.The authors conducted a systematic review to analyze the outcome trials measuring the efficacy of psychotherapeutic interventions in improving NPD symptoms.A systematic search was conducted on Medline, Embase, and PsycINFO electronic databases.Eligible studies were selected based on pre-written inclusion criteria and their methodological quality was assessed using the Jadad scale.The literature search resulted in eight eligible studies, including six randomized controlled trials (RCTs), a non-randomized clinical trial, and a quasi-experimental study.The types of psychotherapeutic interventions examined were schema therapy (ST), clarification-oriented psychotherapy, psychodynamic therapy, and supportiveexpressive psychotherapy.Six studies compared the outcomes of these interventions against one another or a control group (treatment as usual (TAU) or waiting list).Two studies compared the efficacy of different settings including inpatient, outpatient, and day hospital treatment.Seven studies found that psychotherapeutic interventions resulted in a significant improvement in NPD and related symptoms.ST was shown to be more efficient than TAU and clarification-oriented therapy.There was no consistent evidence of the other intervention types outperforming one another and therefore further RCTs are needed to confirm whether any of them are superior.