Narcissistic personality disorder

The cause of this disorder is unknown. Early life experiences, such as insensitive parenting, are thought to play a role in developing this disorder.

A person with this 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

Narcissistic personality disorder is diagnosed based on a psychological evaluation. The health care provider will consider how long and how severe the person's symptoms are.

Talk therapy may help the person relate to other people in a more positive and compassionate way.

Outcome of treatment depends on the severity of the disorder and how willing the person is to change.

Complications may include:

• Alcohol overuse or illegal drug use
• Mood and anxiety disorders
• Relationship, work, and family problems

Personality disorder - borderline; Narcissism

American Psychiatric Association. Narcissistic personality disorder. Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision (DSM-5-TR), Washington, DC: American Psychiatric Association Publishing; 2022.

Blais MA, Rivas-Vazquez R, Ruchensky JR, Stein MB. Personality and personality disorders. In: Stern TA, Wilens TE, Fava M, eds. Massachusetts General Hospital Comprehensive Clinical Psychiatry. 3rd ed. Philadelphia, PA: Elsevier; 2025:chap 37.

Updated by: Fred K. Berger, MD, addiction and forensic psychiatrist, Scripps Memorial Hospital, La Jolla, CA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.