Clinical manifestations of schizoid personality disorder are diverse and can change over a period of time. [7] The most characteristic aspect of this disorder which is very prominent is that the affected individuals appear detached and are loners. People suffering from this condition are prone to:

1. Longstanding emotional detachment from social relation and refrain from emotional intimacy. Enjoy spending time alone and indulge in activities which do not require other people.
2. Be alone and are unable to express themselves emotionally.
3. Have few or no friendships, avoid marriage or dating.
4. Appear indifferent and cold towards others.
5. Unable to respond or react in social situations.

Most of these personality disorders begin in early adulthood and become noticeable during personal or social situations. Schizoid personality disorder is a part of the schizophrenic spectrum which includes schizophrenia and schizotypal personality disorder. Schizoid personality disorder is almost similar in its presentation to the other two, but varies in two main aspects. Firstly, schizoid personality disorder patients are in touch with reality and speak in a reasonable way. Hallucinations and delusions are common in the other two disorders but not in this condition.

• Disability

  Although not generally associated with intellectual disability, the severe social disability and, in many cases, associated mental health and other medical problems, result in disability throughout life. [ssoar.info]

  Please enable JS and disable any ad blocker [psychiatrictimes.com]

  Lifetime paranoid, schizoid, antisocial, histrionic, avoidant, dependent, and obsessive-compulsive PDs were examined, as assessed by the Alcohol Use Disorders and Associated Disabilities Interview Schedule-DSM-IV version (AUDADIS-IV). [doi.org]

  Schizoid personality disorder is not as disabling as schizophrenia. It doesn't cause the disconnection from reality (in the form of hallucinations or delusions) that occurs in schizophrenia. [nlm.nih.gov]

  Nursing Jobs Nursing & Travel Hospitals Organizations Education Resources Nursing Theories Nursing Specialties Medical Issues Mental Health Nurse Leaders Services for Nurses Nurses with a Disablity Law and Ethics Nursing & Media Nursing History Student [nurses.info]

• Pain

  The author suggests that as a consequence this ambiguity the person could conclude that the less painful solution is being alone in order to avoid painful social interactional ambivalence. [doi.org]

  We ask about general symptoms (anxious mood, depressed mood, fatigue, pain, and stress) regardless of condition. Last updated: May 28, 2019 [patientslikeme.com]

• Developmental Disorder

  Mouridsen, Bente Rich and Torben Isager, Body mass index in male and female children with pervasive developmental disorders, Pediatrics International, 50, 4, (569-571), (2008). [doi.org]

  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 [behavenet.com]

• Weakness

  Their social skills are often weak and they do not show a need for attention or acceptance. They are perceived by others as humorless and distant and often are termed "loners." [4degreez.com]

  Biophysical Level (S) Apathetic Mood (e.g., is emotionally unexcitable, exhibiting an intrinsic unfeeling, cold and stark quality; reports weak affectionate or erotic needs, rarely displaying warm or intense feelings, and apparently unable to experience [millonpersonality.com]

  Dependent personality disorder You may: feel needy, weak and unable to make decisions or function properly without help or support allow others to assume responsibility for many areas of your life agree to things you feel are wrong or you dislike to avoid [mind.org.uk]

  Character Weaknesses and Vices* prefers to be alone prefers solitary activities emotionally constricted indifferent to sex no close friends* aloof indifferent to opinion * Derived from Michael Stone's (pg. 22) list of the "personality traits" of DSM-III-R [ptypes.com]

• Underweight

  The association of body weight (five categories: underweight [body mass index [BMI] n = 43,093). [doi.org]

  The link between SPD and being underweight may also point to the involvement of biological factors.In general, prenatal caloric malnutrition, premature birth and a low birth weight are risk factors for being afflicted by mental disorders and may contribute [en.wikipedia.org]

• Schizoid Personality Disorder

  Familial Pattern Schizoid personality disorder is more common among biological relatives of those with schizophrenia or schizotypal personality disorder. [web.archive.org]

  Symptoms of schizoid personality disorder tend to remain the same over time, more so than those of other personality disorders. [msdmanuals.com]

  RESULTS: The exposed cohort had a significantly greater risk (relative risk = 2.01) of schizoid personality disorder. [ncbi.nlm.nih.gov]

• Suggestibility

  Guntrip 11 suggests that the early childhood experiences of schizoids often are marked by alternating experiences of intrusion and abandonment. [doi.org]

  It is suggested that Asperger's syndrome is a distinct syndrome from either schizoid or schizotypal personality disorder, but may be a risk factor for the development of schizoid personality disorder. [ncbi.nlm.nih.gov]

  Klein suggests that patients must take the responsibility to place themselves at risk and to take the initiative for following through with treatment suggestions in their personal lives. [en.wikipedia.org]

• Anger

  Please answer … Read More Anger Test This test will help find your anger level. Answer below questions honestly and the anger test will check if your … Read More Psychopath Test Here is an online version of a psychopathic personality test. [illnessquiz.com]

  They feel socially isolated, hurt, angry, and take that anger out on society. But schizoids have little anger toward society or hurt relationships. They don’t care about relationships and would prefer just to be left alone. [angelfire.com]

  […] interaction with others in order to enjoy experiences or live their lives Almost always choose solitary activities Even-tempered, dispassionate, calm, unflappable, and rarely sentimental Rarely, if ever, claim or appear to experience strong emotions, such as anger [psychpage.com]

  […] prefer to be alone Aren't interested in physical contact and sex—they often don't date or marry Don't seem to care what other people think of them Seem cold and aloof because their face rarely changes to show happiness or sadness Have problems expressing anger [msdmanuals.com]

• Social Isolation

  Abstract Several scales are described for measuring aspects of eccentricity and social isolation; in particular, for assessing schizoid and schizotypal personality and for rating abnormal non-verbal expression. [ncbi.nlm.nih.gov]

  From the aloof detachment that makes it difficult to have positive social experiences to the later signs of the disorder like social isolation, there are many indicators that someone may have a problem with schizoid personality disorder. [gomentor.com]

  They highly value their privacy and social isolation. Places to find schizoids Many work jobs that allow them to be alone for long periods of time. [angelfire.com]

  The social isolation that characterizes schizoid personality disorder also makes it difficult to find support and assistance. [psychology.about.com]

  Schizoid personality disorder is a mental condition in which a person has a lifelong pattern of indifference to others and social isolation. Cause of this disorder is unknown. [nlm.nih.gov]

• Anxiety Disorder

  Diagnosis Increases Your Chances of Developing… Alcohol dependence A drug abuse problem Schizotypal personality disorder or schizophrenia Generalized anxiety disorder Panic disorder Social anxiety disorders Depression Personality disorders Getting Ready [luxury.rehabs.com]

  Social anxiety disorders The category of social anxiety disorders contains social phobia and avoidant personality disorder ( e5 ). [doi.org]

• Neglect

  Sexual and emotional abuse/neglect might cause deep feelings of inner emptiness and a blurred and/or confused identity that can be observed in many patients with SPD 18. [doi.org]

  Hypersensitive since childhood and being neglected or avoided since then. [symptoma.com]

  Children who have cold or neglectful parents or caregivers may be more likely to get schizoid personality disorder as adults. Doctors treat schizoid personality disorder with: Therapy to help with social skills NOTE: This is the Consumer Version. [msdmanuals.com]

  Loneliness : Despite the appearance of emotional coldness and aloofness, the sufferer of schizoid personality disorder might be acutely sensitive to neglect by other people and may feel extremely lonely. [healthhype.com]

• Confusion

  Both these disorders are regularly confused with Schizophrenia although they are not the same. Schizophrenia is a chronic illness for which there is no cure and symptoms usually get worse over time. [louisebehiel.com]

  Schizoid personality disorder is confused with schizophrenia disorder but schizoid personality disorder is different, you can learn more about schizophrenia disorder here. [illnessquiz.com]

  Personality disorders begin to develop early in childhood, often as a way of coping with trauma, abuse, confusion, or a psychologically unhealthy environment. [schizophrenic.com]

• Apathy

  Rate this definition: Schizoid personality disorder Schizoid personality disorder is a personality disorder characterized by a lack of interest in social relationships, a tendency towards a solitary lifestyle, secretiveness, emotional coldness and apathy [definitions.net]

  Those afflicted usually drift towards a solitary lifestyle, which includes secretiveness, emotional coldness, and apathy. They may demonstrate an elaborate internal fantasy world. [treatment4addiction.com]

  This preference is not due to anxiety about being in social situations or paranoia but rather stems from an inner emptiness and apathy towards social situations. [albertellis.org]

  On the other hand, their lack of constructive connection and emotional apathy frequently places them in a situation where they can easily be manipulated by other individuals (Martens, 2010). [theravive.com]

• Personality Change

  It is uncommon for them to be diagnosed in childhood or adolescence, because a child or teen is under constant development, personality changes, and maturation. [psychcentral.com]

  Differential Diagnosis It is important to make a distinction between SPD and other similar disorders such as schizophrenia, other cluster A personality disorders, or a personality change occurring as a result of an illness or substance use. [theravive.com]

  change due to another medical condition, substance use disorders, autism spectrum disorder, other personality disorders and personality traits [5] Medication Low dose benzodiazepines, β-blockers, nefazodone, bupropion, low dose of risperidone or olanzapine [en.wikipedia.org]

• Irritability

  Vitamin B-12 deficiency may cause irritability, delusions, and paranoia. His reduced appetite and loss of hair and weight may be associated with iron deficiency anaemia. He is hypervigilant and does not seem to need much sleep. [blogs.discovermagazine.com]

  […] is a hypothetical profile, in terms of the five-factor model of personality, for Schizoid Personality Disorder (speculatively constructed from McCrae, 1994, pg. 306): High Neuroticism Chronic negative affects, including anxiety, fearfulness, tension, irritability [ptypes.com]

  I'm led to believe it's not just me - an ex ladyfriend of mine said it quite irritated her to hear women's magazines and so on bang on about orgasms so much as if that was all it was about. [boards.straightdope.com]

A complete psychological assessment is involved, which also includes a complete physical examination and a review of personal and medical history. Sometimes reference to a psychiatrist will be required. Childhood history also needs to be analyzed [8]. To diagnose an individual with schizoid personality disorder, at least four of the following criteria from the Diagnostic & Statistical Manual of Mental Disorders (DSM) published by the American Psychiatric Association should be met. These are:

1. Patients distance themselves from close relationships including their own family members. They do not marry or date other people and feel they are functionally best when they are alone.
2. Desire solitude and prefer to do activities alone without depending on anyone. They will enjoy playing games alone on the computer or some mathematical calculation games which does not require any other person.
3. Have no interest in the opposite sex and have no sexual desires.
4. Be unable to enjoy any emotions which people normally do on a daily basis. They experience no pleasure in any activity and appear dull or lifeless.
5. Lack close friends or a good social circle. Very bad in interpersonal relationships.
6. Apathetic towards positive or negative comments. Praise or criticism makes no difference to them and they show no response or reaction to either. They are indifferent to what other people think about them.
7. Emotional detachment is one of the most prominent symptoms wherein they are unable to express themselves emotionally. Due to this they appear bland, dull and are considered social misfits. They are unable to reciprocate communication gestures either by a smile or a nod. Emotional expression is severely restricted in these individuals.

These are the important diagnostic criteria to judge and evaluate such cases. Elimination of other medical conditions with similar symptoms should be done.

The most important aspect of treatment is the acknowledgement of the condition by the patient. Often treatment is discontinued by the patient due to failure to maintain a relationship with the therapist. Treatment options are variable and the outcome is also varied due to the complexity of patient's nature. Different therapies include:

• Psychotherapy (individual therapy)- Patients on their own will never come for such sessions unless under the pressure of a family member. Short term therapies should be designed to solve immediate problems of the patient. The therapist should understand the patient's limitations in maintaining a social distance and that he/she is most likely to terminate this therapy. Therapist should bear this in mind while treating such patients. Simple cognitive behavioral therapy in the form of cognitive exercises to improve social behavior and to remove certain irrational and illogical thoughts. Everything possible should be done to let the patient speak, including the implementation of social skills training and psychosocial rehabilitation programs [9].
• Group therapy- After sessions of individual therapy, the patient can begin group therapy. This therapy should not be the initial choice of treatment as the patient can terminate it abruptly. Thus, after acquiring certain social confidence and skills from individual therapy, they may tolerate such therapy better. Patience should be shown with the patients and they should not be forced into participation.
• Medications- They are often the last option. Long-term medications should be avoided and given only for acute symptom relief. There is no particular single drug for schizoid personality disorder, but if the patient shows symptoms of depression a selective serotonin reputable inhibitor may be given. Antipsychotics are not routinely given except in certain cases.[10]

Most of the cases are considered untreatable and each case can follow various patterns and can have variable outcomes .The psychosocial environment appears important in the prognosis. Since this disorder is chronic, the life of the affected individuals appears lifeless or directionless which generally does not become better with time. Due to lack of insight, patients deny they are ill and refrain from seeking help and support. This probably is the most difficult aspect of schizoid personality disorder to treat.
Due to inability to maintain social relationships, these patients may abruptly stop taking medications. Cases with mild level of social impairment can improve with treatment and therapy, if we try to focus the treatment on maintaining relationships pertaining to patient's employment.
A relapse of social isolation is very possible even though treatment ends. Since this is a prolonged disorder, patients can go into depression very easily.

No single cause has been identified to date. A number of possible causes have been implicated and are the subject of research. Many hypotheses [2] and theories have been formulated regarding this condition, and numerous studies have underlined the influence of both genetic and environmental factors. The roots of this disease seem to originate from the childhood of the affected individual, in circumstances such as the influence of unemotional parents, family ruptures, neglected upbringing or living in families socially withdrawn. Child abuse can also significantly contribute to this condition.

There is a lack of emotional stimuli from childhood as well as lack of attention, love and care which seems to trigger this condition. Due to lack of communication and stimuli these children do not understand the importance of interpersonal relationships and interaction with others. Many studies show a higher prevalence of this condition in relatives of people with schizophrenia. There are certain risk factors which increases the chances of developing this condition such as:

• The presence of family member is affected by schizoid personality disorder or schizophrenia [3].
• Having unemotional and detached parents.
• Hypersensitive since childhood and being neglected or avoided since then.
• Suffering any kind of child abuse

Thus, there is no single cause of this condition, but a rather complex play of various factors which tends to be passed on from one generation to another.

Amongst personality disorders, schizoid personality disorder is quite uncommon in clinical settings. There is very limited information on the epidemiology [4] of this condition as many cases go undiagnosed. According to certain studies, schizoid personality disorder may be more common than other mental conditions , but due to its presentation, it may go unnoticed and not reported. There is no genetic variation in the incidence of this condition [5]. Schizoid personality disorder affects less than about 3-4% of the general population and tends to affect males more than females.

Schizoid personality disorder is mainly detected in young adults, as we cannot diagnose this condition in adolescents when the personality has not fully formed yet [6]. The condition has a familiar pattern and tends to affect biological relatives of those suffering from either schizophrenia or schizoid personality disorder.
Environmental or developmental factors may account for the variability in the onset of the condition. Patients with the disorder are more likely to be unmarried or single and have no or low sex drive. This is due to lack of interest in emotional intimacy.

Recent work has emphasized the importance of the interaction of both genetic and non-genetic factors in the disease expression. Individuals may carry a genetic predisposition, but this vulnerability is not manifested unless others factors intervene.

• Genetics- many single gene or polygenic theories have been proposed in the pathophysiology of schizoid personality disorder.
• Neuroanatomy- several neuroanatomical abnormalities have been reported in this condition. They can be detected in the frontal, temporal and parietal lobes. These can occur due to injury or trauma; thus, it is also known as a neurodevelopmental disorder resulting from neuronal injury occurring early in life that interferes with normal brain maturation. Encephalitis can also produce these abnormalities.
• Neurochemistry-the most widely accepted theory for the pathophysiology of this personality disorder was a functional hyperactivity in the amine system. Reduced levels of monoamine oxidase (MAO) and serotonin levels are also observed in this condition. Recent hypothesis also include the role of other neurotransmitter systems in the pathophysiology of schizoid personality disorder.

Emphasis should be given to early identification of high risk individuals who can develop these personality disorders. Since the cause of this condition is obscure, there are no definite preventive methods. Certain services should be made available for determining and identifying children from broken families, or vulnerable parents and counseling and rehabilitation should be provided.
This personality disorder can be prevented by education of the masses of the importance of love, care and attention amongst parents and children. People need to be first educated about such cases in order to detect them.

Schizoid personality disorder is one of the lesser known and lesser common mental health conditions, wherein the affected individuals tend to have an emotional detachment and indifference towards others. They lead an isolated life and are socially withdrawn. They rarely show any emotions and appear aloof and cold towards other individuals. This mental disorder mainly manifests itself as an abnormal behavioral pattern [1] and these individuals cannot adapt or change their behavior under personal or social situations. This condition is often confused with schizophrenia, but they are different mental conditions, although both show many similarities. The cause of this condition is not clearly understood and there seems to be a role of both genetic as well as environmental factors. It tends to affect males more than females and may be seen in families with schizophrenia. Even though the affected individuals are lonely, it is difficult for them to acknowledge this fact and still prefer solitude. Interpersonal relationships are difficult for them and they even prefer to work alone. They shun crowds and sometimes appear invisible and enjoy being in their own thoughts and world. Therapy in the form of counseling and family support may seem to help. In certain cases medications are also given.

Schizoid personality disorder is a type of mental disorder in which an affected individual will refrain from social contact and avoid any close relationships. They appear as loners who do not like personal interactions. This disorder has no known cause and is believed to originate from a combination of genetic as well as environmental factors .Environmental factors mainly include any history of family ruptures, neglected upbringing, abuse or any kind of mental trauma. This tends to start in early adulthood and affects men more than women. The most common presentation of this condition is emotional detachment, failure to interact socially, no interest in sex or marriage and preference for solitude.
These cases go unnoticed due to the fact that the affected individuals refuse to acknowledge their condition or confide in no one or seek help from no one. It is important that such conditions be detected early so that appropriate therapy can be implemented. It is important for family members to help such patients take timely treatment and provide ample moral support.
Treatment is mainly psychotherapy which includes group therapy as well. Medications are normally given as a last option. Relapses are quite common.
There is no known prevention other than early detection, education and counseling.

1. Shedler J, Westen D. Refining personality disorder diagnosis: integrating science and practice. Am J Psychiatry. 2004 Aug;161(8):1350-65.
2. Akhtar, S. Schizoid Personality Disorder: A Synthesis of Developmental, Dynamic, and Descriptive Features. Am J Psychother. 1987 OCt; 41(4):499–518.
3. Gask L, Evans M, Kessler D; Personality disorder. BMJ. 2013 Sep 10;347:f5276.
4. Kirkbride J, Coid JW, Morgan C, et al. Translating the epidemiology of psychosis into public mental health: evidence, challenges and future prospects. J Public Ment Health. 2010 Jun;9(2):4-14.
5. Weissmann, M. M. The epidemiology of personality disorders. A 1990 update. Journal of Personality Disorders (Spring issue, Suppl.): 1993;44–62.
6. R.L. Jenkins, S. Glickman. The Schizoid Child. American Journal of Orthopsychiatry. 1946 Apr;16 (2): 255–61.
7. J. J. Nannarello, Schizoid. Journal of Nervous and Mental Disease, 1953;118, p. 237-249.
8. Stein DJ. Borderline personality disorder: toward integration. CNS Spectr. 2009 Jul;14(7):352-6.
9. J. Seinfeld- The Empty Core: An Object Relations Approach to Psychotherapy of the Schizoid Personality. Jason Aronson. 1991. p. 101.
10. Soloff PH. Psychopharmacology of borderline personality disorder. Psychiatr Clin North Am. 2000 Mar;23(1):169-92.