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:
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)."
Differential Diagnosis
Some disorders
have similar or even the same symptom. The clinician, therefore,
in his diagnostic attempt has to differentiate against the
following disorders which he needs to rule out to establish
a precise diagnosis.
Cause:
People with
schizoid personality disorder do not have schizophrenia; but
it is thought that many of the same risk factors in schizophrenia
may be factors causing schizoid personality disorder. People
with this disorder are able to function in everyday life, but
will not develop meaningful relationships with others. Controversially,
there is some evidence to indicate that schizoid personality
disorder may be the beginning of schizophrenia, or even a very
mild form of it.
Treatment:
People with
this disorder rarely seek treatment. The treatment can be difficult
due to their initial reduced capacity or desire to form a relationship
with a health professional.
Counseling
and Psychotherapy [ See
Therapy Section ]:
Group therapy
in people with schizoid personality disorder is another potentially
effective form of treatment. Although patients may initially
withdraw from the therapy group, they often become more participatory
as a comfort level is gradually established. Protected by the
therapist who must safeguard schizoids from criticism from other
group members, patients have the opportunity to conquer fears
of intimacy by engaging in communication and making social contact
in a supportive atmosphere.
The social
consequences of serious mental disorders—family disruption,
loss of employment and housing—can be calamitous. Comprehensive
treatment, which includes services that exist outside the formal
treatment system, is crucial to ameliorate symptoms, assist
recovery, and, to the extent that these efforts are successful,
redress stigma. Consumer self-help programs, family self-help,
advocacy, and services for housing and vocational assistance
complement and supplement the formal treatment system. Consumers,
that is, people who use mental health services themselves, operate
many of these services. The logic behind their leadership in
delivery of these services is that consumers are thought to
be capable of engaging others with mental disorders, serving
as role models, and increasing the sensitivity of service systems
to the needs of people with mental disorders.
Pharmacotherapy
[ See
Psychopharmacology Section ] :
Medications
are not usually recommended as treatment for schizoid personality
disorder. However, they are sometimes used for short-term treatment
of extreme anxiety states associated with the disorder.Psychotherapy
Individual therapy that successfully attains a long-term trust
level can be useful in some cases of schizoid personality disorder
by providing an outlet for patients to transform their false
perceptions of friendships into a genuine relationship. As a
therapist-client relationship develops, the patient may begin
to reveal imaginary friendships and terrors of dependency. Individual
psychotherapy can gradually effect the formation of a true relationship
between therapist and patient.
Neither desires nor enjoys close relationships, including
being part of a family almost always chooses solitary activities.