Considerations in misdiagnosis of narcissistic personality disorder

The present paper identified some diagnostic considerations which might be responsible for misdiagnoses of narcissistic personality disorder. Although conventional diagnostic criteria, e.g., DSM-III-R, for narcissistic personality disorder have suggested a rather homogeneous set of features including, e.g., inflated grandiosity, excessive omnipotence, overt arrogance, diminished empathic capacities, onanistic behavior, pathological self-centeredness, and propensities toward self-indulgence, many narcissistic conditions are misdiagnosed because the symptoms are less obvious if not altogether camouflaged. Diagnostic miscalculations can often mislead clinicians from focusing on verifiable and essential aspects of the disorder and lead to unnecessary therapeutic detours and eventual failures. Improved recognition of the heterogeneity of such patients might improve diagnostic consistency and eventual therapeutic outcome.