A pervasive pattern of grandiosity (in fantasy or behaviour), need for admiration, and lack of empathy, beginning in early adulthood and present in a variety of contexts, as indicated by five (or more) of the following:
- has a grandiose sense of self-importance (e.g., exaggerates achievements and talents, expects to be recognized as superior without commensurate achievements, high ego)
- is preoccupied with fantasies of unlimited success, power, brilliance, beauty, or ideal love
- requires excessive admiration
- has a sense of entitlement, i.e., unreasonable expectations of especially favourable treatment or automatic compliance with his or her expectations
- is interpersonally exploitative, i.e., takes advantage of others to achieve his or her own ends
- lacks empathy: is unwilling to recognize or identify with the feelings and needs of others
- is often envious of others or believes that others are envious of him or her
- shows arrogant, haughty behaviors or attitudes
Coexisting disorders and alternative diagnoses (Source: ) Narcissistic personality disorder is often diagnosed in conjunction withother forms of mental disorders; for example, mood disorders such as depression, eating disorders and substance/alcohol abuse. People with narcissistic personality disorder may have multiple personality disorders, often including
Patients with narcissistic personality disorder should be differentiated from other disorders within the "Cluster B personality disorders." Narcissists are grandiose, histrionics are melodramic, people with antisocial behavior (psychopaths) are cold-blooded and borderlines are needy.
Unlike patients with borderline personality disorder, the narcissist possesses an unwavering sense of self-worth. He or she is less impulsive and self-abusive or destructive and less concerned about being abandoned.
Unlike the histrionic patient, the narcissist is oriented toward achieving success and is proud of his or her possessions and talents. Narcissists do not show emotion as often as histrionic patients and they hold back their feelings for others.
Narcissists are less impulsive, less aggressive and less deceitful than people with antisocial personality disorder. Compared to people with antisocial personality disorder, there are less criminals among the narcissists.