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Narcissistic Personality Disorder Workup

  • Author: Sheenie Ambardar, MD; Chief Editor: David Bienenfeld, MD  more...
 
Updated: May 09, 2016
 

Approach Considerations

No specific laboratory studies are employed to diagnose narcissistic personality disorder (NPD). Nevertheless, in view of the high incidence of substance abuse in patients with this disorder, it is wise to obtain a toxicology screen to rule out drugs and alcohol as possible causes of narcissistic character pathology.

The diagnosis of NPD is often made after obtaining a history of narcissistic symptoms from pertinent sources (including the patient, the patient’s family and friends, and the clinician’s own observations). However, more specific personality tests can also be used to facilitate diagnosis. There is some debate regarding the usefulness and reliability of these tests, but they can be helpful in elucidating character pathology outside the strict confines of the criteria listed in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5).[1]

These personality tests are typically either self-report questionnaires given directly to the patient or semistructured interviews conducted by the clinician. Examples are the Personality Diagnostic Questionnaire–4 (PDQ-4), the Millon Clinical Multiaxial Inventory III (MCMI-III), and the International Personality Disorder Examination (IPDE). Each test uses a series of questions to determine the presence or absence of character pathology, and all may be valuable aids to the clinician trying to establish a formal diagnosis of NPD.[20]

 
 
Contributor Information and Disclosures
Author

Sheenie Ambardar, MD Adult Psychiatrist, Private Practice

Sheenie Ambardar, MD is a member of the following medical societies: American Psychiatric Association

Disclosure: Nothing to disclose.

Chief Editor

David Bienenfeld, MD Professor, Departments of Psychiatry and Geriatric Medicine, Wright State University, Boonshoft School of Medicine

David Bienenfeld, MD is a member of the following medical societies: American Medical Association, American Psychiatric Association, Association for Academic Psychiatry

Disclosure: Nothing to disclose.

Acknowledgements

Mohammed A Memon, MD Chairman and Attending Geriatric Psychiatrist, Department of Psychiatry, Spartanburg Regional Medical Center

Mohammed A Memon, MD is a member of the following medical societies: American Association for Geriatric Psychiatry, American Medical Association, and American Psychiatric Association

Disclosure: Nothing to disclose.

Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Medscape Salary Employment

Acknowledgments

Dr. Ambardar would like to thank Dr. Donald C. Fidler, Farnsworth Endowed Chair of Psychiatric Education at West Virginia University, for generously granting permission to use his video clip in the multimedia section of this article.

References
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  2. American Psychiatric Association. Alternative DSM-5 model for personality disorders. Fifth Edition. Washington, DC: American Psychiatric Publishing, Inc; 2013. 761-81.

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  21. Roth BE. Narcissistic patients in group therapy: containing affects in the early group. Ronningstam E. Disorders of Narcissism: Diagnostic, Clinical, and Empirical Implications. Washington DC: American Psychiatric Press; 1998. 221-238.

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This is an actor portrayal of a patient with narcissistic personality disorder. This video clip was provided courtesy of Donald C. Fidler, MD, FRCP-I.
 
 
 
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