Narcissistic Personality Disorder (“NPD”) is a relatively rare mental condition affecting about 1% of the population and is more common in males than females. It is characterized by an inflated sense of self-importance, a lack of empathy for others, and a great need for admiration. NPD goes way beyond merely having a good deal of self-confidence or self-esteem.  Rather, those with NPD are typically preoccupied with power, prestige, vanity, and may think they deserve special treatment and fame.

NPD is indicated where five or more of the below are present*:

1. Has a grandiose sense of self-importance (e.g., exaggerates
   achievements and talents, expects to be recognized as superior
   without commensurate achievements).
2. Is preoccupied with fantasies of unlimited success, power,
   brilliance, beauty, or ideal love.
3. Believes that he or she is “special” and unique and can only be
   understood by, or should associate with, other special or highstatus
   people (or institutions).
4. Requires excessive admiration.
5. Has a sense of entitlement, i.e., unreasonable expectations of
   especially favorable treatment or automatic compliance with his
   or her expectations.
6. Is inter-personally exploitative, i.e., takes advantage of others to
   achieve his or her own ends.
7. Lacks empathy: is unwilling to recognize or identify with the
   feelings and needs of others.
8. Is often envious of others or believes that others are envious of
   him or her.
9. Shows arrogant, haughty behaviors or attitudes

The cause(s) of NPD have yet to be pinpointed. Likely results from a combination of both genetic and environmental factors.

Treatment: There are no medications that currently are effective with NPD.  Treatment is focused on psychotherapy and meaningful change often requires years of therapy.

*These are actually the DSM-IV criteria – the DSM V criteria are very similar but are less conducive to a list.