I tend to limit the use of this word to the lost souls; those who turned to intrinsically bad to evil people when dealing with their harsh environment during childhood and whose free will chose the easiest, ugliest, and self-centered path. Narcissists are one example.

For all the others, I like to call them imbalanced intrinsically good folks! No matter the level of the neurosis, it is always reversible when we wake up and decide to take our power back.