Psych CASC / OSCE · General adult psychiatry — personality disorders
Explain NPD formulation and treatment limits — CASC communication station
MRCPsych/FRANZCP-style communication station: explain pathological narcissism without stigma, outline frame and psychotherapy options, clarify medication limits, address suicide risk after shame, check understanding.
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Station brief
Format. Communication station, approximately 7–10 minutes active time after reading. You are the psychiatry registrar in the outpatient clinic. [1]
Candidate instructions. Explain what narcissistic personality patterns mean in plain language without moral attack, outline why structured talking therapy and a clear therapeutic frame are central, clarify that medication does not cure NPD itself, address shame-related suicide risk after criticism, and check understanding. The examiner plays the patient. [1][2]
References3ShowHide
- [1]Caligor E, Levy KN, Yeomans FE Narcissistic personality disorder: diagnostic and clinical challenges Am J Psychiatry, 2015.PMID 25930131
- [2]Gabbard GO Narcissism and suicide risk Ann Gen Psychiatry, 2022.PMID 35065658
- [3]Crisp H, Gabbard GO Principles of Psychodynamic Treatment for Patients With Narcissistic Personality Disorder J Pers Disord, 2020.PMID 32186987