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Narcissistic personality disorder is a mental illness coded on axis 2 of the DSM-IV and requires a diagnosis by a qualified mental health professional. The two terms are similar and someone called a megalomaniac is not unlikely to show symptoms of Narcissism. In fact, they could be a narcissist but they may or may not be diagnosed with narcissistic personality disorder.

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Q: If u are a megalomaniac are you a narcissist?
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