Narcissistic personality disorder

Answer 1

Definition

Narcissistic personality disorder is a condition in which there is an inflated sense of self-importance and an extreme preoccupation with one's self.

Causes, incidence, and risk factors

The cause of this disorder is unknown. Narcissistic personality disorder usually begins by early adulthood.

Symptoms

A person with narcissistic personality disorder:

• Reacts to criticism with rage, shame, or humiliation
• Takes advantage of other people to achieve his or her own goals
• Has feelings of self-importance
• Exaggerates achievements and talents
• Is preoccupied with fantasies of success, power, beauty, intelligence, or ideal love
• Has unreasonable expectations of favorable treatment
• Requires constant attention and admiration
• Disregards the feelings of others, lacks empathy
• Has obsessive self-interest
• Pursues mainly selfish goals

Signs and tests

Personality disorders are diagnosed based on a psychological evaluation and the history and severity of the symptoms.

Treatment

Psychotherapy may help the affected person relate to others in a more positive and compassionate manner.

Expectations (prognosis)

The outcome varies with the severity of the disorder.

Complications

• Relationship and family problems
• Alcohol or other drug dependence

References

Moore DP, Jefferson JW. Narcissistic personality disorder. In: Moore DP, Jefferson JW, eds. Handbook of Medical Psychiatry. 2nd ed. Philadelphia, Pa: Mosby Elsevier; 2004: chap 140.

Young JQ. Narcissistic personality disorder. In: Ferri FF, ed. Ferri's Clinical Advisor 2008: Instant Diagnosis and Treatment. 1st ed. Philadelphia, Pa: Mosby Elsevier; 2008.

Answer 2

Definition

Narcissistic personality disorder is a condition in which people have an inflated sense of self-importance and an extreme preoccupation with themselves.

Causes, incidence, and risk factors

The causes of this disorder are unknown. An overly sensitive personality and parenting problems may affect the development of this disorder.

Symptoms

A person with narcissistic personality disorder may:

• React to criticism with rage, shame, or humiliation
• Take advantage of other people to achieve his or her own goals
• Have excessive feelings of self-importance
• Exaggerate achievements and talents
• Be preoccupied with fantasies of success, power, beauty, intelligence, or ideal love
• Have unreasonable expectations of favorable treatment
• Need constant attention and admiration
• Disregard the feelings of others, and have little ability to feel empathy
• Have obsessive self-interest
• Pursue mainly selfish goals

Signs and tests

Like other personality disorders, narcissistic personality disorder is diagnosed based on a psychological evaluation and the history and severity of the symptoms.

Treatment

Psychotherapy (for example, talk therapy) may help the affected person relate to other people in a more positive and compassionate way.

Expectations (prognosis)

The outcome depends on the severity of the disorder.

Complications

• Alcohol or other drug dependence
• Relationship, work, and family problems

References

Blais MA, Smallwood P, Groves JE, Rivas-Vazquez RA. Personality and personality disorders. In: Stern TA, Rosenbaum JF, Fava M, Biederman J, Rauch SL, eds. Massachusetts General Hospital Clinical Psychiatry. 1st ed. Philadellphia, Pa: Mosby Elsevier;2008:chap 39.

Reviewed By

Review Date: 11/14/2010

Linda Vorvick, MD, Medical Director, MEDEX Northwest Division of Physician Assistant Studies, University of Washington School of Medicine; and David B. Merrill, MD, Assistant Clinical Professor of Psychiatry, Department of Psychiatry, Columbia University Medical Center, New York, NY. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.