“自恋狂”，1825年（英国评论家威廉·西德尼·沃克在1852年发表的一封信中提到），由 ego（自我）和 mania（狂热）组合而成。在1890年代之前，这个词并不常用，当时主要用来翻译德语的 Ich-Sucht（自我沉迷）。
[The egomaniac, as opposed to the megalomaniac,] does not regard it as necessary to dream of himself as occupying some invented social position. He does not require the world or its appreciation to justify in his own eyes himself as the sole object of his own interest. He does not see the world at all. Other people simply do not exist for him. The whole 'non-Ego' appears in his consciousness merely as a vague shadow or a thin cloud. The idea does not even occur to him that he is something out of the common, that he is superior to other people, and for this reason either admired or hated ; he is alone in the world ; more than that, he alone is the world and everything else, men, animals, things are unimportant accessories, not worth thinking about. [Max Nordau, "Degeneration," English translation, 1895]
[自恋狂与夸大狂的区别在于，] 他并不认为有必要幻想自己身处某个虚构的社会地位。他不需要外界的认可来证明自己是唯一值得关注的对象。他根本看不到世界。对他来说，其他人简直就像不存在一样。整个“非自我”在他的意识中不过是模糊的影子或稀薄的云彩。他甚至没有意识到自己与众不同，认为自己优于他人，因此被仰慕或憎恨；他孤独地生活在这个世界上；更重要的是，他认为自己就是整个世界，其他人、动物、事物都只是无关紧要的附属品，不值得他去思考。[马克斯·诺道，《退化论》，英文版，1895年]
诺道的书在当时广受阅读、讨论和引用，因此这个词也与他紧密相关（例如，《阿戈拉》，1895年7月）。
除了沃克的用法，这个词在1895年前的印刷出现频率较低，主要集中在医学领域，尤其是心理学方面：
The most frequent, yet the most extraordinary of these perversions of temper, are seen in young females. It is a species of aberration of the intellect, but short of insanity, real enough, but exaggerated, fictitious, factitious, and real at the same time. It frequently has its origin in dyspepsia, hysteria, or other malady, and in emotion of various kinds, such as disappointment, vexation, &c. Its object is frequently to excite and to maintain a state of active sympathy and attention, for which there, is as it were, a perpetual, morbid, and jealous thirst. It was rather aptly designated, by the clever relative of one patient, an ego-mania. [Marshall Hall, M.D., "Practical Observations and Suggestions in Medicine," London, 1845]
这些情绪扭曲中，最常见但又最离奇的，常见于年轻女性。它是一种智力的偏离，但尚未达到精神病的程度，真实而又夸张、虚构、伪造，同时又又真实。它常常源于消化不良、歇斯底里或其他疾病，以及各种情绪，如失望、烦恼等。其目的往往是激发并维持一种主动的同情和关注状态，仿佛有一种永无止境、病态而又嫉妒的渴望。正如一位患者的聪明亲属所说，这种状态被相当恰当地称为 ego-mania（自恋狂）。[马歇尔·霍尔医学博士，《医学中的实用观察与建议》，伦敦，1845年]
