A 35 year old corporate manager who has had a history of strained relationships with colleagues, friends, and family members attends a mental health clinic. He describes a pattern of feeling undervalued, even though he believes he deserves admiration and recognition for his accomplishments.

He is noted to show a grandiose sense of self-importance, and a tendency to dominate conversations, often steering them toward topics that highlight his achievements and success.

Which of the following is the most likely diagnosis?

Options:
explanation: This patient's presentation is consistent with Narcissistic Personality Disorder (NPD). NPD is characterised by a pervasive pattern of grandiosity, a strong need for admiration, and arrogance. NPD is a Class B personality disorder; a group of mental health conditions characterised by dramatic, emotional, or erratic behaviours. By contrast, dissociative disorders are characterised by the presence of two or more distinct personality states, which involve a disruption in identity, consciousness, and memory. It may present with amnesia, gaps in memory, or the presence of different identities.
name: Dissociative disorders
label: e
answer: no
explanation: This patient's presentation is consistent with Narcissistic Personality Disorder (NPD). NPD is characterised by a pervasive pattern of grandiosity, a strong need for admiration, and arrogance. NPD is a Class B personality disorder; a group of mental health conditions characterised by dramatic, emotional, or erratic behaviours. By contrast, Class A personality disorders are characterised by odd or eccentric behaviours such as paranoid or schizoid personality disorder.
name: Class A personality disorder
label: b
answer: no
explanation: This patient's presentation is consistent with Narcissistic Personality Disorder (NPD). NPD is characterised by a pervasive pattern of grandiosity, a strong need for admiration, and arrogance. NPD is a Class B personality disorder; a group of mental health conditions characterised by dramatic, emotional, or erratic behaviours. By contrast, Class C personality disorders are characterised by excessive fear or anxiety, such as avoidant or obsessive-compulsive personality disorder.
name: Class C personality disorders
label: c
answer: no
explanation: This patient's presentation is consistent with Narcissistic Personality Disorder (NPD). NPD is characterised by a pervasive pattern of grandiosity, a strong need for admiration, and arrogance. NPD is a Class B personality disorder; a group of mental health conditions characterised by dramatic, emotional, or erratic behaviours. By contrast, depressive disorders are mood disorders with symptoms such as low mood, reduced interest in daily activities, fatigue and suicidal thoughts.
name: Depressive disorders
label: d
answer: no
explanation: This is the correct answer. This patient's presentation is consistent with Narcissistic Personality Disorder (NPD). NPD is characterised by a pervasive pattern of grandiosity, a strong need for admiration, and arrogance as seen in this case. NPD is a Class B personality disorder; a group of mental health conditions characterised by dramatic, emotional, or erratic behaviours.
name: Class B personality disorder
label: a
answer: yes

Correct answer: a