Whether narcissism is a real disorder – as opposed to a dimension of personality on which we all vary - is controversial, as it is both. Does Donald Trump conform to the clinical pattern?

Professional psychiatrists, and psychotherapists, are loath to go on record saying that Trump has a psychiatric disorder on the premise that one cannot do a diagnosis without an office visit and most narcissists are quite unlikely to recognize that they have a problem and to schedule an appointment.

Fortunately, the DSM is written so clearly, and so simply, that the diagnosis is transparent. Here are the symptoms.

Does Trump have Narcissistic Personality Disorder

According to DSM-5, individuals with NPD have most (at least five) or all of the symptoms listed below (generally without commensurate qualities or accomplishments).

1 Grandiosity with expectations of superior treatment by others.

2 Fixated on fantasies of power, success, intelligence, attractiveness, etc.

3 Self-perception of being unique, superior, and associated with high-status people and institutions.

4 Needing constant admiration from others.

5 Sense of entitlement to special treatment and to obedience from others.

6 Exploitative of others to achieve personal gain.

7 Unwilling to empathize with others' feelings, wishes, or needs.

8 Intensely jealous of others and the belief that others are equally jealous of them.

9 Pompous and arrogant demeanor.

Among other criteria, the symptoms must be severe enough to impair the individual's ability to develop meaningful relationships with others and reduce an individuals ability to function at work. As far as the first of these is concerned, Trump evidently has no close personal friends.

Work function is also an issue. The ghost author of Art of the Deal, Tony Schwartz, found it impossible to interview Trump who quickly became bored. He gleaned most of the necessary information by being a fly on the wall in Trump's office.

Some of the DSM criteria are less relevant to Trump given his birth to money and life as a plutocrat that guarantee contact with high-status persons and being fawned over as a VIP. For those that are clearly relevant, he checks out on all symptoms, it seems. According to DSM criteria, Donald Trump suffers from narcissistic personality disorder.

Can a Narcissist Function as a US President?

It is, perhaps, no surprise that widely held impressions about Trump's narcissism are corroborated by the DSM criteria. The key question to ask is whether, having come so far despite his psychiatric disorder, Trump, or any other narcissistic personality can communicate well enough to be an effective leader of the free world.

There have been many narcissistic heads of state before but the clearest examples, such as Fidel Castro, Saddam Hussein, and Hugo Chavez, have been dictators.

Narcissists are difficult to deal with, whether as friends, or as politicians. They do not feel the need to build consensus, which is why most are screened out by democratic systems of government.

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