Patient will present as → a 50-year-old male who lives alone in a cabin on several acres of land. He rarely interacts with his family or community other than when he comes to town once a month to pick up supplies.
Patients tend to have emotional aloofness, indifferent to praise or criticism, without bizarre or idiosyncratic thinking
- Exhibit voluntary social withdrawal
- Content with social isolation (vs avoidant)
- Limited emotional expression
- No association with schizophrenia
DSM-5 Diagnostic Criteria
A pervasive pattern of detachment from social relationships and a restricted range of expression of emotions in interpersonal settings, beginning by early adulthood and present in a variety of contexts, as indicated by four (or more) of the following:
- Neither desires nor enjoys close relationships, including being part of a family.
- Almost always chooses solitary activities.
- Has little, if any, interest in having sexual experiences with another person.
- Takes pleasure in few, if any, activities.
- Lacks close friends or confidants other than first-degree relatives.
- Appears indifferent to the praise or criticism of others.
- Shows emotional coldness, detachment, or flattened affectivity.
Does not occur exclusively during the course of schizophrenia, a bipolar disorder or depressive disorder with psychotic features, another psychotic disorder, or autism spectrum disorder and is not
- cognitive, behavioral, psychoanalysis
- only if patient suffers from concomitant depression or transient psychosis
|Schizoid personality disorder is characterized by an inability to form and maintain meaningful personal relationships. They lack close relationships with others and enjoy solitary activities. They find little interest in having sex. Individuals with schizoid personality disorder present with a flat affect and are indifferent to praise.|
It has a high correlation with schizophrenia
Schizotypal, not schizoid, personality disorder is related to schizophrenia.
The patient should be treated with an antidepressant
Since this patient does not present with symptoms of co-morbid depression, he does need to be treated with antidepressants.
No specific treatment is needed at this time
The patient is likely very responsive to criticism and praise
Patients with SPD are often indifferent to praise or criticism, and likewise do not offer praise or criticism as readily as non-affected patients.
The patient likely suffers from a co-morbid substance use disorder
Patients with antisocial, borderline, or schizotypal personality disorders are likely to have substance use disorders, but not patients with schizoid personality disorder.
Chooses solitary activities
Odd thinking and speech
Schizotypal personalities have this along with magical thinking and ideas of reference. They may become withdrawn due to the lack of acceptance.
Reckless disregard for safety of others
Reckless disregard for safety of others is typical of antisocial personality disorders.
Uses physical appearance to draw attention
Using physical appearance to draw attention is more typical of histrionic disorder.