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)

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