Psychopaths are good at taking credit for others' accomplishments but rarely produce anything of value. They're generally quite lazy, in fact. They're politically effective and do well in many social environments in the short run, but their long-term contributions are almost always disastrous.
You don't need to be a psychopath to make tough decisions: firing bad employees, for example. You just need experience, vision, and the willingness to take responsibility for difficult decisions.
I think a slight narcissism can be beneficial as a motivator for some people, but that's a different discussion.