Megalomania (from the Greek word μεγαλομανία; megalo-, meaning large, and mania) is a historical term for behavior characterized by an obsession or preoccupation with wealth, power, genius, or omnipotence—often generally termed as delusions of grandeur or grandiose delusions. Megalomania denotes an obsession with having and/or obtaining, grandiosity and extravagance (especially in the form of great fame and popularity, material wealth, social influence or political power, or more than one or even all of the aforesaid). It may be a symptom of manic or paranoid disorders.[citation needed] However it is not considered a distinct mental disorder of itself according to the Diagnostic and Statistical Manual of Mental Disorders.

Delusions of grandeur, commonly seen in psychosis, may be seen as distinct from megalomania: a megalomaniac's overwhelming and excessive preoccupation with his or her own importance, though it may be considered pathological, is not necessarily delusional. A delusion of grandeur, if it is a true delusion, must meet the psychiatric criteria for delusion. Whereas it is possible, in the case of megalomania, for an actually important man/woman to be preoccupied with his/her own actual importance, a person suffering from delusions of grandeur would stubbornly entertain patently false, generally fantastic and often highly complex ideas of his/her own importance, often with a supernatural or science-fictional bent.

A person suffering from delusions of grandeur may actually be an important figure, as in the case of the mathematician John Nash, who once rejected a prestigious academic chair on the grounds that he was due to be enthroned as the Emperor of Antarctica. Delusions of grandeur would seem to be one of the two main—and possibly connected—delusions of paranoid schizophrenia. And, it is interesting to note, delusions of grandeur, though constituting psychotic ideation, are possibly largely recreational in nature and represent irrational and compelling but not unpleasant or disturbing fantasies.

In a PBS interview, John Nash said the following about his own delusions of grandeur: What is salient in delusions of grandeur is not just that the grandiose self conception is usually fantastic but also that the ordinary and laborious channels of achievement are completely circumvented and a shortcut route is taken to a "success" which is exaggerated to the point of caricature, as in the case of John Nash maintaining that he was to be Emperor of Antarctica. Sigmund Freud once said that "It might be maintained that...paranoid ideation is a caricature of a philosophical system." In delusions of grandeur the sense of caricature is present without the sense of grand rationale that is provided in delusions of persecution.

What may go overlooked, because of the psychotic context of the delusory belief, is that delusions of grandeur are not only venal but evince a desire for success without effort, a common element of criminal thought patterns. Looked at in this light, delusions of grandeur may be indicative of either a comorbid personality disorder or of the integration of personality disorder and thought disorder in paranoid schizophrenia. That is to say that delusions of grandeur, as described above by John Nash, may not constitute a discrete thought disorder (i.e. paranoid schizophrenic ideation) that is visited on an otherwise well personality.

There is a sense of personal complicity in delusions of grandeur and it is possible that paranoid schizophrenia involves significant and possibly prior personality disorder. John Nash was described by many who knew him as insufferably narcissistic before he became schizophrenic.

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