“VIP” status or wealth of th eir friends. In dependent personality disorder, the individual
is excessively dependent on othe rs for praise and guidance, but is without the flamboyant,
exaggerated, emotional features of individu als with histrionic personality disorder.
Many individuals may display histrionic personality traits. Only when these traits are
inflexible, maladaptive, and persisting and cause significant functional impairment or
subjective distress do they constitu te histrionic personality disorder.
Personality change due to another medical condition. Histrionic personality disorder
must be distinguished from personality ch ange due to another medical condition, in
which the traits that emerge ar e attributable to the effects of another medical condition on
the central nervous system. 
Substance use disorders. The disorder must also be distinguished from symptoms that
may develop in association with persistent substance use.
Narcissistic Personality Disorder
Diagnostic Criteria 301.81 (F60.81)
A pervasive pattern of grandiosity (in fantasy or behavior), need for admiration, and lack
of empathy, beginning by early adulthood and present in a variety of contexts, as indicated
by five (or more) of the following:
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 high-status 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).