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Schizoid personality disorder

Schizoid personality disorder (SPD) is a personality disorder characterized by a lack of interest in social relationships, a tendency towards a solitary or sheltered lifestyle, secretiveness, emotional coldness, detachment, and apathy. Affected individuals may be unable to form intimate attachments to others and simultaneously demonstrate a rich, elaborate and exclusively internal fantasy world.

SPD is not the same as schizophrenia or schizotypal personality disorder. But there is some evidence of links and shared genetic risk between SPD, other cluster A personality disorders and schizophrenia. Thus, SPD is considered to be a “schizophrenia-like personality disorder”.[3][4]

Critics argue that the definition of SPD is flawed due to cultural bias and that it does not constitute a mental disorder but simply an avoidant attachment style requiring more distant emotional proximity.[5][6] If that is true, then many of the more problematic reactions these individuals show in social situations may be partly accounted for by the judgments commonly imposed on people with this style. However, it is important to note that impairment is mandatory for any behaviour to be diagnosed as a personality disorder. SPD seems to satisfy this criterion because it is linked to negative outcomes. These include a significantly compromised quality of life, smaller GAF scores even after 15 years and one of the lowest levels of “life success” of all PDs (measured as “status, wealth and successful relationships”).[7][8]

Schizoid personality disorder is a poorly studied disorder and there is little clinical data on SPD because it is rarely encountered in clinical settings. The effectiveness of psychotherapeutic and pharmacological treatments for the disorder have yet to be empirically and systematically investigated.[1]

DiagnosisDSM-5 criteria

The Diagnostic and Statistical Manual of Mental Disorders is a widely used manual for diagnosing mental disorders. DSM- 5 still includes schizoid personality disorder with the same criteria as in DSM-IV.[37]

According to the DSM, those with SPD may often be unable to, or will rarely express aggressiveness or hostility, even when provoked directly. These individuals can seem vague or drifting about their goals and their lives may appear directionless. Others view them as indecisive in their actions, self-absorbed, absentminded and detached from their surroundings (”not with it” or ”in a fog”). Excessive daydreaming is often present. In cases with severe defects in the capacity to form social relationships, dating and marriage may not be possible.[38]

ICD-10 criteria

The Classification of Mental and Behavioural Disorders of ICD-10 lists schizoid personality disorder under (F60.1).[37]

It is characterized by at least four of the following criteria:

  • Emotional coldness, detachment or reduced affect.
  • Limited capacity to express either positive or negative emotions towards others.
  • Consistent preference for solitary activities.
  • Very few, if any, close friends or personal relationship, and a lack of desire for such.
  • Indifference to either praise or criticism.
  • Little interest in having sexual experiences with another person (taking age into account).
  • Taking pleasure in few, if any, activities.
  • Indifference to social norms and conventions.
  • Preoccupation with fantasy and introspection.

It is a requirement of ICD-10 that a diagnosis of any specific personality disorder also satisfies a set of general personality disorder criteria.

Content retrieved from: https://en.wikipedia.org/wiki/Schizoid_personality_disorder.

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