Before I start this review, I'd like to say a few things:
1. If you replace the word American in any title with the word Albanian, it immediately becomes funny, for example Albanian Psycho or I'm Afraid of Albanians.
2. If you haven't seen the movie, don't read this. Just don't. It gives a lot away, and it will confuse you and ruin it for you.
3. This isn't so much a review as an analysis of the movie. I will also incorporate aspects of the book to ensure a deeper understanding of what's going on.
Patrick Bateman is a high-level Wall Street executive at his father's company Pierce & Pierce. He's rich, powerful, and very superficial. He idolizes Donald Trump. He listens to popular music. He buys all the right clothes, hangs out with all the right people, and so on. His image is his identity. He hangs out with a circle of friends, including Timothy Bryce (Price in the novel), and Luis Carruthers, the closeted homosexual whose fiancee he's screwing (along with Bateman's own fiancee Evelyn, played by Reese Witherspoon). Patrick Bateman has an unhealthy penchant for pornography, video tapes, and serial killers, and he has a taste for murder that he cannot contain.
Throughout the movie, Bateman murders and maims numerous people, including his associate Paul Allen (Owen in the book) whose face is hit repeatedly with an axe while Huey Lewis and the News is playing in the background. Bateman hates Paul Allen for a few reasons. He has a better business card, a better apartment, and he can always get a reservation at Dorsia, the restaurant du jour. He also thinks Patrick Bateman is Marcus Halberstram.
Everyone who dies in the movie goes pretty much unnoticed, except for Paul Allen, who is rich and, therefore, important enough to start an investigation. The movie ends with him murdering a prostitute and one of the scriptwriters (Quinevere Turner) and going on a killing spree that culminates with a telephoned confession on his lawyer's answering machine.
The next day, Bateman talks to his lawyer about the message, and the lawyer thought it was pretty funny, but that Bateman gut is too much of a weasel to do any of that. He continues to call Bateman Davis, and Bateman corrects him, telling him several times that he did indeed kill Paul Allen. The lawyer says that's impossible because he'd had dinner with Paul Allen just last week.
Then the movie ends, and people start asking what just happened.
There are two schools of thought on this issue. The first is this:
Bateman didn't kill anyone. The killings were all just hallucinations, and he thought they were real. He lost his grip on reality ssome time ago, and these dead people are all just part of his twister nightmare of a daydream. This theory is supported by several pieces of evidence: the lawyer's dinner with Paul Allen in London after his supposes murder, the disappearing trail of blood as he drags Paul Allen's corpse out of his apartment complex, and the ease with which Bateman destroys several police cars with a handgun.
The other theory is this:
Bateman is a psychotic killer, but it's the 80's, and no oone cares, especially since he's rich and powerful. There's evidence to support this theory as well: All the men in the movie are pretty much identical. They all look and act the same, and they're all shallow and self-absorbed. In the beginning, Bateman tells the audience that there's an idea of a Patrick Bateman, but there is no real him. That can be interpreted as saying that he is only who he appears to be. He is only what is on the surface. Any attempt to see the real him would be futile. Since everyone is pretty much the same, no one is ever able to keep track of who is who. Bateman's lawyer calls him Davis. Paul Allen calls him Halberstram. No one seems to notice or care. It's possible, even likely, that the person the lawyer met in London was not really Paul Allen, but someone else altogether. Meanwhile, Paul Allen is rotting is a bathtub somewhere in Hell's Kitchen.
It's all very confusing, and there is no clear answer, but one thing is certain. The movie is more than just gratuitous sex and violence.