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According to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), the essential feature of schizoid personality disorder is a persistent detachment from social relationships and limited emotional expression in social settings. It may also be particularly difficult for individuals who suffer with schizoid personality disorder to express anger. These individuals are rather passive and have trouble responding in an appropriate manner to important life events. This makes the lives of these individuals appear aimless; however, they may excel greatly in their careers if their work conditions allow or require them to work in their own bubble.

Diagnostic Criteria for Schizoid Personality Disorder DSM-5 301.20 (F60.1)

Individuals with schizoid personality disorder experience these feelings of detachment in a variety of contexts, which are indicated by at least four of the following:

  • He or she doesn’t want nor enjoys close relationships.
  • He or she almost always chooses independent activities.
  • The individual has little interest to no interest in becoming sexually active with another person.
  • He or she doesn’t take pleasure in many or any activities.
  • The individual lacks close friends other than immediate relatives.
  • He or she is unmoved by praise or criticism.
  • The individual shows emotional detachment and/or coldness.

If these symptoms occur only during the course of another psychotic or personality disorder, or can be attributed to the effects of another medical condition, then a schizoid personality disorder diagnosis should not be made.

Who Is at Risk of Developing Schizoid Personality Disorder DSM-5 301.20 (F60.1)?

The National Comorbidity Survey Replication estimates a prevalence of 4.9%, while the 2001-2002 National Epidemiologic Survey on Alcohol and Related Conditions suggests a prevalence of 3.1%—either way, schizoid personality disorder is not very common. The only individuals at a higher risk of developing the disorder are those who have family members with schizophrenia or schizotypal personality disorder. Additionally, this disorder is diagnosed just slightly more frequently in males and could possibly cause them more impairment than females.

Schizoid personality disorder may be first noticed in childhood and/or adolescence, as marked by isolation, a lack in friendships, and poor performance at school. These obvious differences may put the child at greater risk of being bullied or teased.

Differential Diagnosis

Individuals may react to new situations by secluding themselves and avoiding social interaction. This does not, however, mean that they have schizoid personality disorder—it may simply mean they’re uncomfortable and still getting used to these changes. The following might also explain symptoms that align with schizoid personality disorder:

  • Other mental disorders with psychotic symptoms: The presence of psychotic symptoms can differentiate delusional disorder, schizophrenia, and others from schizoid personality disorder. For example, delusions and hallucinations may occur in these disorders during a period of psychotic symptoms, but are not present during schizoid personality disorder.
  • Autism spectrum disorder: It can be rather difficult to differentiate autism spectrum disorder from schizoid personality disorder. But it can be distinguished due to autism’s more severe symptoms of impaired social interaction and stereotyped behaviors.
  • Personality change due to another medical condition: Another medical condition may cause similar symptoms to emerge in an individual.
  • Substance use disorders: Substance use and abuse can also cause similar symptoms and must be distinguished from those of schizoid personality disorder.
  • Other personality disorders: Many other personality disorders are characterized by the same features. Therefore, it is important to pay close attention to the differences in order to make an accurate diagnosis. It is possible for multiple diagnoses to be made, if an individual’s features and symptoms meet criteria for more than one personality disorder.
  • Abnormal personality traits: Sometimes certain individuals simply prefer to be alone. Schizoid personality disorder should only be considered if this or other related traits cause functional impairment or subjective distress.

Treatment for Schizoid Personality Disorder DSM-5 301.20 (F60.1)

Sometimes individuals with schizoid personality disorder prefer dealing with their problems on their own or only with the help of their family. Despite this common preference, there are multiple treatment options for these individuals:

  • Psychotherapy or talk therapy: This form of therapy can help you develop better, closer relationships with your friends, family members, and beyond. Therapists understand your difficulties, are great listeners, and will help you work through your problems at a pace you feel comfortable with.
  • Group therapy: Individuals with schizoid personality disorder can help one another or those with similar issues to practice better interpersonal skills. Group therapy can also provide an individual with a strong support system.
  • Medication: There is not a specific medicine used to treat schizoid personality disorder, but certain drugs can help the individual cope with related issues such as anxiety or depression.

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