schizoid personality disorder
Last reviewed 01/2018
Schizoid personality disorder (ScPD) together with schizotypal (SPD) personality disorder and paranoid personality disorder belongs to the cluster A personality disorders.
- it is a rare disease with a prevalence of <1% in the general population
- in the homeless population the prevalence is higher (1,2)
People with schizoid personality disorder characteristically have little or no social involvement - they tend to be solitary, have no sense of humour, and are felt to be dull (2).
- the stereotype of this sort of person is tall, asthenic build, gawky appearance with ill-fitting, unfashionable clothes
ScPD is considered to be closely related to schizophrenia due to the following reasons:
- ScPD is frequently seen prior to schizophrenia onset
- a study carried out on patients with schizophrenia found that 85% of subjects showed premorbid personality disorders, including ScPD (27.5%) and SPD (12.5%)
- it also has a frequent comorbid association with schizophrenia
- the high transition rate to psychotic disorders
The Diagnostic and Statistical Manual of Mental Disorders, 4th ed., text rev. (DSM-IV-TR) criteria for diagnosis of Schizoid Personality Disorder are:
A. 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
B. Does not occur exclusively during the course of schizophrenia, a mood disorder with psychotic features, another psychotic disorder, or a pervasive developmental disorder and is not due to the direct physiological effects of a general medical condition.
Note: if criteria are met prior to the onset of schizophrenia, add “premorbid” (e.g., “schizoid personality disorder [premorbid]”) (2)
Reference:
- (1) Via E et al. Structural alterations of the pyramidal pathway in schizoid and schizotypal cluster A personality disorders. Int J Psychophysiol. 2016;110:163-170
- (2) Angstman KB, Rasmussen NH. Personality disorders: review and clinical application in daily practice. Am Fam Physician. 2011;84(11):1253-60.