The Role of Vulnerable and Grandiose Narcissism in the Inpatient Treatment of Stress-Related Depressive Disorders

Author(s): Roberto La Marca, Monika Scheiwiller, Michael Pfaff, Pearl La Marca-Ghaemmaghami, Heinz Böker

Depression relapse rates are high, therefore, identifying factors related to mental health and treatment outcome is important. We examined differences between inpatients with a stress-related depression and healthy controls regarding narcissism, stress, resource alterations, exhaustion, and depression. Twenty-one healthy controls and 36 inpatients with a stress-related depressive disorder completed questionnaires assessing vulnerable and grandiose narcissism (PNIvn, PNIgn), perceived stress (PSS), resource gain and actual or threatened resource loss during the past six months (COR-Egain, COR-Eloss, COR-Eloss?), vital exhaustion (MQ), and depression severity (BDI-II). Depression severity was additionally assessed using the HAMD17. Most data was assessed repeatedly, i.e. after treatment initiation, before treatment termination, and at six months follow-up. Inpatients revealed significantly higher levels of PSS, COR-Eloss, COR-Eloss?, MQ, BDI-II, HAMD17, and PNIvn, while PNIgn reached a trend significance level. In healthy controls, PNIvn correlated positively with COR-Eloss. In inpatients, PNIvn was positively related to levels of PSS, COR-Eloss, COREloss?, and BDI-II, while PNIgn was positively correlated with levels of PSS. Higher PNIvn at the beginning was further significantly associated with a stronger decrease in PSS until follow-up, and in BDI-II until the end or followup. These results underline the importance of personality factors in the treatment of stress-related depression.