Шизоидные расстройства: Шизоидное расстройство личности — причины, симптомы, лечение

Замкнутость, рассеяность и нежелание проводить время в шумных компаниях – такие черты присущи примерно 25% всего населения земного шара. Для кого-то такое состояние является временным, а вот если у человека расстройство личности шизоидного типа, то желания что-то менять у него просто не возникнет. По мнению психологов, людей с шизоидными чертами становится все больше и это может стать одной из проблем современного общества.

Содержание статьи:

Шизоидный тип личности или шизоидное расстройство личности

Шизоидный тип личности или шизотимики – это особый склад характера, при котором человек стремится больше времени проводить в тишине и одиночестве, его можно назвать интровертом или замкнутым и застенчивым. Но при этом он ведет обычный образ жизни, спокойно обращается с окружающими и полностью адекватен.

Такое деление в зависимости от типа темперамента проводится согласно классификации Э. Кречмера. Он выделяет 3 основных типа темперамента: шизотимик, иксотимик, циклотимик.

Шизотимики также делятся на несколько типов. Самыми распространенными считаются сенситивный и экспансивный типы.

Сенсетивный шизоид отличается высокой чувствительностью к окружающему, ранимостью и повышенной восприимчивостью ко всему. Такие люди с большим подозрением относятся к незнакомым людям, общаются только с ограниченным кругом и могут годами помнить даже незначительные обиды. Именно такие люди могут требовать компенсацию морального вреда, так как для них грубость или крик могут стать серьезным испытанием для здоровья.

Экспансивный тип отличает безразличие к чувствам окружающих, холодность, неспособность к проявлению чувств. Такие люди кажутся окружающим сухими, бессердечными и излишне принципиальными.

Шизоидное расстройство личности – это психопатология, которая проявляется нежеланием человека общаться с кем-либо даже при необходимости, нарушением эмоционального восприятия и склонностью «уходить в себя». Такое поведение не дает ему нормально социализироваться и вести обычный образ жизни.

При шизоидном типе личности человеку может потребоваться помощь психолога, но его проблемы ничем не отличаются от тех, которые возникают у людей с другим типом характера, например, у циклотимиков. А при появлении симптомов шизоидной психопатии нужно как можно скорее обращаться к врачу, так как это может быть дебютом шизофрении или другого психического расстройства.

Причины

Предугадать, у кого может развиться шизоидное расстройство личности заранее нельзя. Считается, что основной причиной развития шизоидного типа личности является особенности развития нервной системы – чрезмерная чувствительность нервных окончаний, повышенная активность определенных участков мозга и снижение активности других участков. Шизоидная психопатия может возникнуть из-за наследственной предрасположенности, различных заболеваний головного мозга и других подобных причин. Точная причина ее развития, также, как и других психических заболеваний, до сих пор неизвестна.

Спровоцировать проявление уже имеющихся черт шизоида или формирование шизоидного типа характера могут следующие факторы:

• Ощущение собственной ненужности и брошенности – если ребенком в семье не занимались или постоянно упоминали о том, что он не запланирован, был не нужен и создал много проблем родителям.
• Деспотизм родителей.
• Недостаток внимания, близости со стороны родителей.
• Психологические травмы в детском возрасте – смерть родителей или близких людей, развод, переезд и так далее.
• Агрессивность родителей.
• Неумение родителей сдерживать свои эмоции – если на ребенка с детства «сливают эмоции», он не может предугадать поведение родителей, их реакцию.
• Гиперопека.

Симптомы

Шизоидный тип характера формируется постепенно, но первые признаки заболевания можно заметить уже в возрасте 3-4 лет. Дети с таким типом характера не стремятся к общению с окружающими, они могут холодно и отстраненно относится к окружающим, включая родителей или быть болезненно привязанными к определенному человеку. Общение с другими людьми, в том числе и с детьми, их мало интересует, они не обращают внимание на то, какое впечатление производят на окружающих, могут игнорировать требования или только формально им подчиняться.

В зависимости от выраженности таких черт, шизотимики могут полностью скомпенсироваться, «перерасти» эти «странности» к 7-10 годам или в дальнейшем эти особенности становятся все более заметными, поведение сильнее отличается от общепринятого и у них может развиться психопатия шизоидного типа. Для выявления типа личности проводятся специальные тесты, ориентированные на разный возраст.

Шизоидное расстройство личности проявляется следующими признаками:

• Замкнутость и необщительность – основной признак шизоида.
• Отсутствие эмпатии – шизоиду трудно понять и распознать проявления чувств других людей. Шизоидный характер – это невнимательность к окружающим, эмоциональная холодность и склонность считать переживания других – надуманными.
• Ограниченность круга общения – как правило, близко общаются люди шизоидного типа с несколькими людьми. Может быть выраженная привязанность к родителям, больше к матери, к 1-2 друзьям детства или своему партнеру. Другие люди, даже с течением времени, в этот круг не включаются.
• Свое виденье мира – характерны специфический взгляд на вещи, неспособность изменить свою точку зрения и нежелание менять свои убеждения. Шизоид находится в «своей реальности» и часто отказывается изменить ее даже, если «реальность» полностью изменилась. Это может выражаться не соблюдением нравственных норм и правил и вызывающим или странным поведением.
• Склонность к определенному виду деятельности – это может быть умственная деятельность или механическая. Как правило, шизоиды отличаются высоким уровнем интеллекта, способностью к личностному росту и работоспособностью.

Симптомы шизоидного расстройства личности отличаются крайним проявлением всего вышеописанного. Отмечается выраженное оскудение эмоций, отсутствие интереса к окружающему, активное избегание любых контактов с окружающими и полное погружение в «себя» и «свой мир».

Психопатия шизоидная – это отказ от контакта с окружающим миром, следование собственным правилам и неприятие существующей реальности. Люди с таким синдромом замыкаются в себе, могут отказаться выходить из дома и совершать любые действия, связанные с уходом за собой или выполнением каких-либо обязанностей.

Диагностика и лечение

Шизотимики редко обращаются за помощью к психологам и психотерапевтам, обычно это делают их близкие люди и родственники, которые понимают, что ситуация со временем только ухудшается и человеку требуется помощь специалистов. Диагностика шизоидного расстройства личности проводится с помощью опроса, личного наблюдения врача и проведения специальных тестов.

При выраженных шизоаффективном расстройстве личности психотерапевт или психиатр может назначить седативные препараты, антидепрессанты или нейролептики. Они могут помочь скорректировать поведение шизоида, но не избавят его от основных проявлений.

Основное лечение шизоидного расстройства личности – это психотерапия, направленная на приобретение необходимых социальных навыков и налаживания отношений с другими людьми. Проводить такие занятия нужно с как можно более раннего возраста, особенно эффективны они для детей школьного возраста и подростков.

90000 Schizoid personality disorder — Symptoms and causes 90001

90002 Overview 90003 90004 Schizoid personality disorder is an uncommon condition in which people avoid social activities and consistently shy away from interaction with others. They also have a limited range of emotional expression. 90005
90004 If you have schizoid personality disorder, you may be seen as a loner or dismissive of others, and you may lack the desire or skill to form close personal relationships.Because you do not tend to show emotion, you may appear as though you do not care about others or what’s going on around you. 90005
90004 The cause of schizoid personality disorder is unknown. Talk therapy, and in some cases medications, can help. 90005 90010 Products & Services 90011 Show more products from Mayo Clinic

90002 Symptoms 90003 90004 If you have schizoid personality disorder, it’s likely that you: 90005
90016
90017 Prefer being alone and choose to do activities alone 90018
90017 Do not want or enjoy close relationships 90018
90017 Feel little if any desire for sexual relationships 90018
90017 Feel like you can not experience pleasure 90018
90017 Have difficulty expressing emotions and reacting appropriately to situations 90018
90017 May seem humorless, indifferent or emotionally cold to others 90018
90017 May appear to lack motivation and goals 90018
90017 Do not react to praise or critical remarks from others 90018
90033
90004 Schizoid personality disorder usually begins by early adulthood, though some features may be noticeable during childhood.These features may cause you to have trouble functioning well in school, a job, socially or in other areas of life. However, you may do reasonably well in your job if you mostly work alone. 90005
90036 Schizotypal personality disorder and schizophrenia 90037
90004 Although a different disorder, schizoid personality disorder can have some similar symptoms to schizotypal personality disorder and schizophrenia, such as a severely limited ability to make social connections and a lack of emotional expression.People with these disorders may be viewed as odd or eccentric. 90005
90004 Even though the names may sound similar, unlike schizotypal personality disorder and schizophrenia, people with schizoid personality disorder: 90005
90016
90017 Are in touch with reality, so they’re unlikely to experience paranoia or hallucinations 90018
90017 Make sense when they speak (although the tone may not be lively), so they do not have conversational patterns that are strange and hard to follow 90018
90033
90036 When to see a doctor 90037
90004 People with schizoid personality disorder usually only seek treatment for a related problem, such as depression.90005
90004 If someone close to you has urged you to seek help for symptoms common to schizoid personality disorder, make an appointment with a health care or mental health professional. 90005
90004 If you suspect a loved one may have schizoid personality disorder, gently suggest that the person seek medical attention. It might help to offer to go along to the first appointment. 90005

90002 Causes 90003 90004 Personality is the combination of thoughts, emotions and behaviors that makes you unique.It’s the way you view, understand and relate to the outside world, as well as how you see yourself. Personality forms during childhood, shaped through an interaction of inherited tendencies and environmental factors. 90005
90004 In normal development, children learn over time to accurately interpret social cues and respond appropriately. What causes the development of schizoid personality disorder is unknown, although a combination of genetic and environmental factors, particularly in early childhood, may play a role in developing the disorder.90005

90002 Risk factors 90003 90004 Factors that increase your risk of developing schizoid personality disorder include: 90005
90016
90017 Having a parent or other relative who has schizoid personality disorder, schizotypal personality disorder or schizophrenia 90018
90017 Having a parent who was cold, neglectful or unresponsive to emotional needs 90018
90033

90002 Complications 90003 90004 People with schizoid personality disorder are at an increased risk of: 90005
90016
90017 Developing schizotypal personality disorder, schizophrenia or another delusional disorder 90018
90017 Other personality disorders 90018
90017 Major depression 90018
90017 Anxiety disorders 90018
90033

90086

90004
Aug.17 2017
90005.90000 Risk Factors, Symptoms & Diagnosis 90001 90002 Schizoid personality disorder is a type of eccentric personality disorder. A person with this disorder behaves differently from most other people. This may include avoiding social interactions, or seeming to be aloof or lacking personality. However, people with this disorder are able to function fairly well in society. 90003 90002 This condition is usually diagnosed in early adulthood. Symptoms include: 90003 90006 90007 being detached 90008 90007 preferring to be alone 90008 90007 avoiding social situations 90008 90007 not desiring relationships 90008 90007 seeming dull or indifferent 90008 90007 inability to enjoy activities 90008 90007 trouble relating to others 90008 90007 lacking motivation 90008 90023 90002 Most people with this condition have a relative with schizophrenia, schizoid personality disorder, or schizotypal personality disorder.Other risk factors include: 90003 90006 90007 environmental factors, which seem to have the most impact during childhood 90008 90007 experiencing abuse or neglect as a child 90008 90007 having an emotionally detached parent 90008 90023 90002 This disorder occurs more commonly in men than women. 90003 90002 Your doctor will begin with a complete physical examination. This looks for any physical conditions that may be causing your symptoms. Your doctor may also refer you to a mental health professional.90003 90002 A mental health professional will complete a psychiatric assessment. This may involve filling out questionnaires about your symptoms and thoughts. You will also have an interview with the mental health professional. They will ask you questions about your childhood, relationships, and job history. Your responses will help the mental health professional give a diagnosis. They may also create a treatment plan for you, if you’re interested in pursuing treatment. 90003 90002 Many people choose not to seek treatment because this includes interacting with others.However, treatment can be successful if you have a desire to change. 90003 90006 90007 90044 Cognitive behavioral therapy 90045 is designed to change behavior. It can be a successful treatment for this condition because it teaches you how to change your thoughts about and behaviors in social situations. This may change reluctance to pursue social relationships. 90008 90007 90044 Group therapy 90045 is another option that can help you practice your social skills. This will help you become more comfortable in social situations.90008 90007 90044 Medication 90045 is generally not used unless other treatment methods are not working. There are no FDA-approved medications to treat personality disorders. However, medications may be used to treat other conditions that occur along with personality disorders, such as depression or anxiety. Bupropion may be used to increase feelings of pleasure. Antipsychotic medications can be used to treat feelings of indifference. 90008 90023 90002 This is a chronic condition that has no cure.Some people with the disease may not be able to hold a job or be in a relationship with other people. However, many people are able to hold jobs and live fairly normal lives. If you’re living with schizoid personality disorder, speak with your doctor about creating a treatment plan for you. 90003.90000 Schizoid Personality Disorder Symptoms And How It’s Treated 90001
90002 By: Nadia Khan 90003

90002 Updated March 05, 2020 90003

90002 Medically Reviewed By: Emily Genever 90003
90002
Those
who
have
schizoid
personality
disorder
tend
to
have
no
idea
that
there
is
anything
wrong
with
them.
That
does not
mean
their
disorder
does not
interfere
with
their
life,
however.In
fact,
the
main
component
of
the
disorder
is
that
the
individual
suffering
from
it
has
very
little
emotion
and
a
lot
of
difficulty
interacting
with
others
in
professional
and
social
ways.
This
can
result
in
difficulty
that
they
may
not
even
realize
because
they
have
no
interest
in
those
kinds
of
relationships.
But
there’s
a
whole
lot
more
to
the
disorder
as
well. 90003
90002
90011 90012
Source:
rawpixel.com 90013 90003
90015
What
is
Schizoid
Personality
Disorder? 90016
90002
When
it
comes
to
schizoid
personality
disorder,
however,
it’s
important
to
not
get
caught
up
in
the
similarity
between
the
word
and
some
of
the
common
connotations
that
go
along
with
it.The
truth
is,
this
personality
disorder
is
characterized
by
a
lack
of
emotion
and
a
lack
of
interaction,
which
can
be
contrary
to
what
many
of
us
think
of
when
it
comes
to
a
personality
disorder.
Whereas
we
tend
to
think
of
disorders
like
bipolar
disorder
where
the
manic
phases
represent
extreme
emotion
or
even
depression
lows
here
represent
extreme
emotions
as
well,
those
with
schizoid
personality
disorder
may
display
little
to
no
emotion. 90003
90002
Unlike
those
with
depression
however,
who
want
to
join
in
but
do not
know
how,
those
with
schizoid
personality
disorder
actually
have
a
complete
indifference
to
the
types
of
social
relationships
that
many
of
us
take
for
granted,
from
professional
to
personal.They
have
little
interest
in
forming
friendships
or
even
acquaintanceships
and
prefer
to
be
left
alone
to
their
own
devices
instead.
When
they
are
brought
into
conversations
or
situations
where
they
need
to
interact,
they
have
little
to
no
emotion
about
those
situations. 90003
90002
90011 90012
Source:
rawpixel.com 90013 90003
90002
While
this
may
seem
like
no
big
deal,
as
the
individual
with
the
disorder
sees
no
problem
with
it,
the
lack
of
social
interaction
and
relationships
can
actually
cause
problems
for
them
in
their
life.This
can
interfere
with
their
ability
to
have
any
type
of
healthy
relationships
or
can
make
work
more
difficult
for
them.
They
tend
to
be
loners,
after
all,
and
prefer
to
work
and
do
all
other
things
entirely
by
themselves
or
with
animals
rather
than
other
people. 90003
90028
Signs
and
Symptoms
of
Schizoid
Personality
Disorder 90029
90002
So
how
do
you
know
if
someone
in
your
life,
or
even
you,
actually
has
this
disorder?
While
any
disorder
is
going
to
be
slightly
different
from
one
person
to
the
next,
there
are
a
number
of
similarities
between
those
who
do
have
this
disorder,
making
it
easier
to
identify.The
important
point
is
that
any
personality
disorder
is
characterized
by
continued
occurrence
of
these
symptoms
rather
than
sporadic.
Everyone
enjoys
being
alone
once
in
a
while,
but
someone
with
schizoid
personality
disorder
does
nothing
else,
for
example.
If
the
symptoms
have
persisted
extensively,
then
it
may
be
time
to
speak
with
a
healthcare
professional
to
find
out
more. 90003
90002
90011 90012
Source:
rawpixel.com 90013 90003
90037
90038
Finds
little
pleasure
in
activities 90039
90038
Has
no
interest
or
enjoyment
in
relationships 90039
90038
Does
not
appear
to
enjoy
even
familial
relationships 90039
90038
Seems
detached
from
their
surroundings
or
aloof
to
those
around
them 90039
90038
Avoids
social
situations
wherever
possible 90039
90038
Avoids
any
situation
that
requires
interaction
with
others 90039
90038
Prefers
solitary
activities 90039
90038
Has
little
to
no
interest
in
sexual
interaction 90039
90038
Shows
little
attention
or
care
to
both
praise
and
criticism 90039
90038
Seems
detached,
cold
or
indifferent
to
situations
where
emotion
is
likely 90039
90038
Mood
seems
to
have
very
little
difference
from
one
day
to
the
next 90039
90038
Shows
relationships
only
with
immediate
relatives 90039
90062
90002
Unlike
with
many
other
mental
disorders,
those
who
have
schizoid
personality
disorder
do
not
have
a
break
from
reality.They
understand
the
world
that
they
live
in
and
their
place
in
it.
They
have
neither
an
inflated
or
deflated
ego
that
keeps
them
from
forming
relationships.
Instead,
they
simply
feel
no
interest
in
these
things.
Where
many
of
us
reach
out
to
others
to
form
relationships
as
a
way
to
spend
time
and
have
fun,
these
individuals
are
more
likely
to
enjoy
time
spent
by
themselves
than
that
spent
with
other
people. 90003
90065
Treatment
for
Schizoid
Personality
Disorder 90066
90002
So
what
happens
when
the
treatment
starts
for
schizoid
personality
disorder?
Well,
this
disorder
is
very
similar
to
treatment
for
other
types
of
mental
health
disorders.Medication
and
therapy
are
often
the
most
prevalent
methods
of
dealing
with
the
disorder
itself
and
any
side
effects
that
may
go
along
with
it.
Unfortunately,
many
people
who
have
this
disorder
never
seek
out
treatment
because
they
do
not
experience
the
loneliness
or
envy
that
typically
goes
along
with
complete
isolation.
Instead,
they
feel
completely
comfortable
with
it
and
this
keeps
them
from
seeking
any
changes
to
their
live
to
resolve
it. 90003
90002
90011 90012
Source:
rawpixel.com 90013 90003
90002
Medication
can
be
used
if
an
individual
has
anxiety
or
depression,
though
these
are
not
common
side
effects
for
someone
who
is
suffering
from
this
disorder.Instead,
those
who
have
these
types
of
side
effects
are
generally
facing
a
slightly
different
personality
disorder.
Still,
if
side
effects
persist
or
occur
during
treatment
it
is
possible
for
medication
to
be
prescribed
as
a
short
term
solution
to
those
side
effects.
Generally,
treatment
with
therapy
or
even
support
groups
will
be
a
better
method
of
caring
for
someone
who
does
display
the
symptoms
of
this
disorder. 90003
90002
Support
groups
can
help
an
individual
with
this
disorder
because
they
introduce
conversation
and
compatibility
in
different
ways.A
non-intrusive
style
of
support
group
is
essential
because
this
is
going
to
help
the
individual
to
become
more
comfortable
being
around
other
people
without
feeling
as
though
they
are
being
invaded
or
their
wants
and
needs
taken
over.
It
is
important
to
introduce
new
people
somewhat
slowly
and
introduce
social
situations
of
any
kind
slowly
as
well,
as
these
can
be
overwhelming
to
someone
who
is
not
comfortable
in
these
situations. 90003
90002
One-on-one
therapy
can
often
be
difficult
for
someone
with
this
disorder
because
it
requires
interaction
with
the
other
person.For
more
immediate
concerns
or
short
term
problems
this
can
be
successful
but
the
support
groups
seem
to
work
more
commonly.
Still,
individual
therapy
sessions
can
help
the
individual
by
presenting
a
single
relationship
to
build
at
a
time
and
to
work
towards
before
introducing
new
people
or
a
more
intense
or
even
dedicated
setting.
Instead
of
attempting
to
make
friends,
the
individual
is
in
a
relaxed
environment
where
they
can
speak
with
a
professional
without
any
kind
of
fear
or
anxiety
which
may
develop
or
arise
at
any
point
during
the
treatment
process.90003
90002
90081
What
a
Diagnosis
Means
for
You 90082 90003
90002
So
what
happens
if
you
are
diagnosed
with
schizoid
personality
disorder?
Well,
the
first
thing
you’ll
want
to
do
is
talk
with
your
health
care
professional
and
find
out
more
about
the
disorder
itself.
Chances
are
you’ve
noticed
that
you
feel
more
comfortable
alone
and
that
you
find
little
to
no
interest
in
being
around
other
people.
You
may
not
have
thought
there
was
anything
wrong
with
this,
however.
Forming
friendships
and
more
permanent
relationships
can
be
beneficial
to
your
personal
life
however
and
even
being
able
to
form
work
friendships
and
relationships
can
be
beneficial
to
your
professional
life.90003
90002
90012
90013 90011 90012
Source:
rawpixel.com 90013 90003
90002
Therapy
will
generally
be
a
good
idea
as
well
and
will
help
you
learn
more
about
developing
relationships
that
are
healthy
and
successful.
Working
on
emotional
responses
and
interactions
is
important
as
well
and
through
a
type
of

group
therapy,
all
of
these
things
can
be
worked
on
and
introduced
slowly.
You
will
be
able
to
gradually
become
more
comfortable
with
the
other
people
in
the
group
and
through
that
method,
will
be
able
to
continue
developing
more
successful
relationships
even
outside
the
group
as
the
therapy
continues.90003
90002
No
matter
what
you
may
think,
schizoid
personality
disorder
can
definitely
be
treated
and
though
it
can not
be
completely
cured,
you
will
be
able
to
develop
more
successful
interactions
and
a
better
way
of
working
with
other
people.
This
can
lead
to
dramatic
improvements
in
your
professional
and
personal
life
as
well
as
in
your
family
life.
By
building
relationships
you
will
be
able
to
improve
your
quality
of
life
greatly.
The
first
thing,
however,
is
finding
a
professional
that
can
help
you
on
your
path
to
success.BetterHelp
is
one
way
that
you
can
get
the
assistance
you
need
and
start
on
your
treatment
path
more
quickly. 90003
90002
BetterHelp
offers
in
home
therapy
where
you
can
log
on
to
the
website
and
find
a
therapist
that
you
are
most
comfortable
with.
Then
you’ll
be
able
to
interact
with
them
and
carry
on
therapy
sessions
right
in
your
own
home.
This
can
increase
your
own
comfort
and
it
can
make
treatment
a
whole
lot
easier,
especially
for
someone
working
through
schizoid
personality
disorder.
The
important
thing
is
making
sure
that
you
are
comfortable
every
step
of
the
way
and
that
you
continue
to
grow
and
develop
throughout
the
therapy
process.Before
you
know
it
you’ll
have
the
skills
you
need
to
create
and
build
relationships
and
enjoy
them. 90003

.90000 Wikizero — Schizoid personality disorder 90001 90002 Personality disorder involving social isolation and emotional coldness 90003 90004 90005 90006 90007 Schizoid personality disorder 90008 90009 90006 90011 90012 90013 90009 90006 90011 People with schizoid personality disorder often prefer solitary activities. 90013 90009 90006 90020 Pronunciation 90008 90022 90009 90006 90020 Specialty 90008 90027 Psychiatry 90013 90009 90006 90020 Symptoms 90008 90027 Pervasive emotional detachment, reduced affect, lack of close friends, apathy, anhedonia, unintentional insensitivity to social norms, asexuality, preoccupation with fantasy, 90034 [1] 90035 autistic thinking without loss of skill to recognize reality 90034 [2] 90035 90013 90009 90006 90020 Usual onset 90008 90027 Late childhood or adolescence 90034 [1] 90035 90013 90009 90006 90020 Duration 90008 90027 Long term 90013 90009 90006 90020 Types 90008 90027 Languid schizoid, remote schizoid, depersonalized schizoid, affectless schizoid (Millon’s subtypes) 90034 [3] 90035 90013 90009 90006 90020 Risk factors 90008 90027 Family history 90034 [4] 90035 90013 90009 90006 90020 Diagnostic method 90008 90027 Based on symptoms 90013 90009 90006 90020 Differential diagnosis 90008 90027 Other mental disorders with psychotic symptoms (schizophrenia, delusional disorder, and a bipolar or depressive disorder with psychotic features), personality change due to another medical condition, substance use disorders, autism spectrum disorder, other personality disorders and personality traits 90034 [5] 90035 90013 90009 90006 90020 Treatment 90008 90027 Not yet studied.90034 [6] 90035 90013 90009 90006 90020 Medication 90008 90027 Not general practice but may include low dose benzodiazepines, β-blockers, nefazodone, bupropion, low dose of risperidone or olanzapine 90034 [7] 90035 90013 90009 90006 90020 Prognosis 90008 90027 Typically poor 90034 [8] 90035 90034 [9] 90035 90034 [10] 90035 90013 90009 90006 90020 Frequency 90008 90027 0.8% 90034 [4] 90035 90034 [8] 90035 90034 [11] 90035 90013 90009 90124 90125 90002 90127 Schizoid personality disorder 90128 ( , often abbreviated as 90127 SPD 90128 or 90127 SzPD 90128) is a personality disorder characterized by a lack of interest in social relationships, a tendency toward a solitary or sheltered lifestyle, secretiveness, emotional coldness, detachment and apathy.Affected individuals may be unable to form intimate attachments to others and simultaneously possess a rich and elaborate but exclusively internal fantasy world. 90034 [6] 90035 90034 [12] 90035 Other associated features include stilted speech, a lack of deriving enjoyment from most activities, feeling as though one is an «observer» rather than a participant in life, an inability to tolerate emotional expectations of others , apparent indifference when praised or criticized, a degree of asexuality and idiosyncratic moral or political beliefs.90034 [13] 90035 Symptoms typically start in late childhood or adolescence. 90034 [6] 90035 90003 90002 The cause of SPD is uncertain, but there is some evidence of links and shared genetic risk between SPD, other cluster A personality disorders (such as schizotypal personality disorder) and schizophrenia. Thus, SPD is considered to be a «schizophrenia-like personality disorder». 90034 [4] 90035 90034 [14] 90035 It is diagnosed by clinical observation, and it can be very difficult to distinguish SPD from other mental disorders (such as autism spectrum disorder, with which it may sometimes overlap).90034 [15] 90035 90034 [16] 90035 90003 90002 The effectiveness of psychotherapeutic and pharmacological treatments for the disorder have yet to be empirically and systematically investigated. This is largely because people with SPD rarely seek treatment for their condition. 90034 [6] 90035 Originally, low doses of atypical antipsychotics were also used to treat some symptoms of SPD, but their use is no longer recommended. 90034 [17] 90035 The substituted amphetamine bupropion may be used to treat associated anhedonia.90034 [7] 90035 However, it is not general practice to treat SPD with medications, other than for the short-term treatment of acute co-occurring disorders (e.g. depression). 90034 [18] 90035 Talk therapies such as cognitive behavioral therapy (CBT) may not be effective, because people with SPD may have a hard time forming a good working relationship with a therapist. 90034 [6] 90035 90003 90002 SPD is a poorly studied disorder, and there is little clinical data on SPD because it is rarely encountered in clinical settings.Studies have generally reported a prevalence of less than 1% 90034 [4] 90035 90034 [11] 90035 (a few estimates, however, have been as high as 4%). 90034 [5] 90035 It is more common in males than in females. 90034 [11] 90035 SPD is linked to negative outcomes, including a significantly compromised quality of life, reduced overall functioning even after 15 years and one of the lowest levels of «life success» of all personality disorders (measured as «status, wealth and successful relationships «).90034 [8] 90035 90034 [9] 90035 90034 [10] 90035 Bullying is particularly common towards schizoid individuals. 90034 [3] 90035 90034 [19] 90035 Suicide may be a running mental theme for schizoid individuals, though they are not likely to actually attempt one. 90034 [20] 90035 Some symptoms of SPD (e.g. solitary lifestyle and emotional detachment), however, have been stated as general risk factors for serious suicidal behaviour. 90034 [21] 90035 90003 90188 Signs and symptoms [edit] 90189 90002 People with SPD are often aloof, cold and indifferent, which causes interpersonal difficulty.Most individuals diagnosed with SPD have trouble establishing personal relationships or expressing their feelings meaningfully. They may remain passive in the face of unfavorable situations. Their communication with other people may be indifferent and terse at times. Schizoid personality types are challenged to achieve the ability to assess the impact of their own actions in social situations. 90034 [22] 90035 90003 90002 When someone violates the personal space of an individual with SPD, it suffocates them and they must free themselves to be independent.People who have SPD tend to be happiest when in relationships in which their partner places few emotional or intimate demands on them and does not expect phatic or social niceties. It is not necessarily people they want to avoid, but negative 90195 or 90196 positive emotional expectations, emotional intimacy and self-disclosure. 90034 [23] 90035 Therefore, it is possible for individuals with SPD to form relationships with others based on intellectual, physical, familial, occupational or recreational activities, as long as there is no need for emotional intimacy.Donald Winnicott explains this is because schizoid individuals «prefer to make relationships on their own terms and not in terms of the impulses of other people.» Failing to attain that, they prefer isolation. 90034 [24] 90035 In general, friendship among schizoids is usually limited to one person, often also schizoid, forming what has been called a union of two eccentrics; «Within it — the ecstatic cult of personality, outside it — everything is sharply rejected and despised». 90034 [25] 90035 90003 90002 Although there is the belief people with schizoid personality disorder are complacent and unaware of their feelings, many recognize their differences from others.Some individuals with SPD who are in treatment say «life passes them by» or they feel like living inside of a shell; they see themselves as «missing the bus» and speak of observing life from a distance. 90034 [26] 90035 90034 [27] 90035 90003 90002 Aaron Beck and his colleagues report that people with SPD seem comfortable with their aloof lifestyle and consider themselves observers, rather than participants, in the world around them. But they also mention that many of their schizoid patients recognize themselves as socially deviant (or even defective) when confronted with the different lives of ordinary people — especially when they read books or see movies focusing on relationships.Even when schizoid individuals may not long for closeness, they can become weary of being «on the outside, looking in». These feelings may lead to depression or depersonalisation. If they do, schizoid people often experience feeling «like a robot» or «going through life in a dream». 90034 [28] 90035 90003 90002 According to Guntrip, Klein and others, people with SPD may possess a hidden sense of superiority and lack dependence on other people’s opinions. This is very different from the grandiosity seen in narcissistic personality disorder, which is described as «burdened with envy» and with a desire to destroy or put down others.Additionally, schizoids do not go out of their way to achieve social validation. 90034 [29] 90035 90034: 60 90035 Unlike the narcissist, the schizoid will often keep their creations private to avoid unwelcome attention or the feeling that their ideas and thoughts are being appropriated by the public. 90034 [29] 90035 90034: 174 90035 90003 90002 The related schizotypal personality disorder and schizophrenia are reported to have ties to creative thinking, and it is speculated that the internal fantasy aspect of schizoid personality disorder may also be reflective of this thinking.90034 [30] 90035 90034 [31] 90035 90034 [32] 90035 Alternatively, there has been an especially large contribution of people with schizoid symptoms to science and theoretical areas of knowledge, including maths, physics, economics, etc. At the same time, people with SPD are helpless at many practical activities due to their symptoms. 90034 [33] 90035 90003 90234 Secret schizoids [edit] 90235 90002 Many schizoid individuals display an engaging, interactive personality, contradicting the observable characteristic emphasized by the DSM-5 and ICD-10 definitions of the schizoid personality.Guntrip (using ideas of Klein, Fairbairn and Winnicott) classifies these individuals as «secret schizoids», who behave with socially available, interested, engaged and involved interaction yet remain emotionally withdrawn and sequestered within the safety of the internal world. 90034 [20] 90035 90034: 17 90035 90034 [34] 90035 Klein distinguishes between a «classic» SPD and a «secret» SPD, which occur «just as often» as each other. Klein cautions one should not miss identifying the schizoid person as a result of the patient’s defensive, compensatory interaction with the external world.He suggests one ask the person what his or her subjective experience is, to detect the presence of the schizoid refusal of emotional intimacy and preference for objective fact. 90034 [20] 90035 90003 90002 Frequently, a schizoid individual’s social functioning improves, sometimes dramatically, when the individual knows he or she is an anonymous participant in a real-time conversation or correspondence, e.g. in an online chatroom or message board. Indeed, it is often the case the individual’s online correspondent will report nothing amiss in the individual’s engagement and affect.90034 [90195 citation needed 90196] 90035 A 2013 study looking at personality disorders and Internet use found that being online more hours per day predicted signs of SPD. Additionally, SPD correlated with lower phone call use and fewer Facebook friends. 90034 [35] 90035 90003 90002 Descriptions of the schizoid personality as «hidden» behind an outward appearance of emotional engagement have been recognized since 1940 with Fairbairn’s description of «schizoid exhibitionism», in which the schizoid individual is able to express a great deal of feeling and to make what appear to be impressive social contacts yet in reality gives nothing and loses nothing.Because they are «playing a part», their personality is not involved. According to Fairbairn, 90195 the person 90196 disowns the part he is playing, and the schizoid individual seeks to preserve his personality intact and immune from compromise. 90034 [36] 90035 The schizoid’s false persona is based around what those around them define as normal or good behaviour, as a form of compliance. 90034 [29] 90035 90034: 143 90035 Further references to the secret schizoid come from Masud Khan, 90034 [37] 90035 Jeffrey Seinfeld 90034 [38] 90035 and Philip Manfield, 90034 [23] 90035 who give a description of an SPD individual who «enjoys» public speaking engagements but experiences great difficulty in the breaks when audience members would attempt to engage him emotionally.These references expose the problems in relying on outer observable behavior for assessing the presence of personality disorders in certain individuals. 90003 90234 Schizoid fantasy [edit] 90235 90002 A pathological reliance on fantasizing and preoccupation with inner experience is often part of the schizoid withdrawal from the world. Fantasy thus becomes a core component of the 90195 self in exile 90196, though fantasizing in schizoid individuals is far more complicated than a means of facilitating withdrawal.90034 [20] 90035 90034: 64 90035 90003 90002 Fantasy is also a relationship with the world and with others by proxy. It is a substitute relationship, but a relationship nonetheless, characterized by idealized, defensive and compensatory mechanisms. This is self-contained and free from the dangers and anxieties associated with emotional connection to real persons and situations. 90034 [20] 90035 Klein explains it as «an expression of the self struggling to connect to objects, albeit internal objects.Fantasy permits schizoid patients to feel connected, and yet still free from the imprisonment in relationships. In short, in fantasy one can be attached (to internal objects) and still be free. «90034 [20] 90035 This aspect of schizoid pathology has been generously elaborated in works by RD Laing, 90034 [22] 90035 Donald Winnicott 90034 [39 ] 90035 and Ralph Klein. 90034 [20] 90035 90034: 64 90035 90003 90234 Sexuality [edit] 90235 90002 People with SPD are sometimes sexually apathetic, though they do not typically suffer from anorgasmia.Their preference to remain alone and detached may cause their need for sex to appear to be less than that of those who do not have SPD. Sex often causes individuals with SPD to feel that their personal space is being violated, and they commonly feel that masturbation or sexual abstinence is preferable to the emotional closeness they must tolerate when having sex. 90034 [40] 90035 Significantly broadening this picture are notable exceptions of SPD individuals who engage in occasional or even frequent sexual activities with others.90034 [40] 90035 90003 90002 Fairbairn notes that schizoids can fear that in a relationship, their needs will weaken and exhaust their partner, or their idiosyncratic views will drive the partner away, so they feel forced to disown them, adopt a persona and move to satisfy solely the needs of the partner. The net result of this is a loss of dignity and sense of self within any relationship they enter, eventually leading to intolerable frustration and friction. Appel notes that these fears result in the schizoid’s negativism, stubbornness and reluctance to love.Thus, a central conflict of the schizoid is between an immense longing for relationships but a deep anxiety and avoidance of relationships, manifested by the choosing of the «lesser evil» of abandoning others. 90034 [29] 90035 90034: 100 90035 90003 90002 Harry Guntrip 90034 [41] 90035 90034: 303 90035 describes the «secret sexual affair» entered into by some married schizoid individuals as an attempt to reduce the quantity of emotional intimacy focused within a single relationship, a sentiment echoed by Karen Horney’s «resigned personality», who may exclude sex as «too intimate for a permanent relationship, and instead satisfy his sexual needs with a stranger», separating sex from long-term relationships.»Conversely, he may more or less restrict a relationship to merely sexual contacts and not share other experiences with the partner.» 90034 [42] 90035 Jeffrey Seinfeld, professor of social work at New York University, has published a volume on SPD 90034 [38] 90035 90034: 104 90035 that details examples of «schizoid hunger», which may manifest as sexual promiscuity. Seinfeld provides an example of a schizoid woman who would covertly attend various bars to meet men for the purpose of gaining impersonal sexual gratification, an act which alleviated her feelings of hunger and emptiness.90003 90002 Salman Akhtar describes this dynamic interplay of overt versus covert sexuality and motivations of some SPD individuals with greater accuracy. Rather than following the narrow proposition that schizoid individuals are either sexual or asexual, Akhtar suggests that these forces may 90195 both 90196 be present in an individual despite their rather contradictory aims. 90034 [13] 90035 A clinically accurate picture of schizoid sexuality must therefore include the overt signs: «asexual, sometimes celibate; free of romantic interests; averse to sexual gossip and innuendo», as well as possible 90195 covert 90196 manifestations of «secret voyeuristic and pornographic interests; vulnerable to erotomania; and tendency towards perversions «, 90034 [13] 90035 although none of these necessarily apply to all people with SPD.90003 90002 Individuals with SPD have long been noted to have an increased rate of unconventional sexual tendencies and paraphilias, such as fetishism, preoccupations with body parts, transvestic fetishism, voyeurism, hebephilia or bestiality, though these are rarely acted upon. Instead, they often form part of their fantasies. They tend to be stronger with increased severity of the disorder and may be seen as part of the fundamental emotional and moral rift between themselves and others that leads them to avoid relationships.The schizoid is however often labelled asexual or presents with «a lack of a sexual identity». Kernberg states that this apparent lack of a sexuality does not represent a lack of sexual definition but rather a combination of several strong fixations to cope with the same conflicts. 90034 [29] 90035 90034: 125 90035 People with SPD are often able to pursue their fantasies with fetish pornography readily available on the Internet while remaining completely unengaged with the outside world. People with SPD may often gravitate towards sexually immature or unavailable partners to ease any fears about expected sexual contact.Since there is no desire for genital sex, the relationship is based around other themes. 90034 [29] 90035 90034: 127 90035 90003 90234 Akhtar’s profile [edit] 90235 90002 American psychologist Salman Akhtar provided a comprehensive phenomenological profile of SPD in which classic and contemporary descriptive views are synthesized with psychoanalytic observations. This profile is summarized in the table reproduced below that lists clinical features that involve six areas of psychosocial functioning and are organized by «overt» and «covert» manifestations.90003 90002 «Overt» and «covert» are intended to denote seemingly contradictory aspects that may both simultaneously be present in an individual. 90034 [13] 90035 These designations do not necessarily imply their conscious or unconscious existence. The covert characteristics are by definition difficult to discern and not immediately apparent. Additionally, the lack of data on the frequency of many of the features makes their relative diagnostic weight difficult to distinguish at this time. However, Akhtar states that his profile has several advantages over the DSM in terms of maintaining historical continuity of the use of the word 90195 schizoid 90196, valuing depth and complexity over descriptive oversimplification and helping provide a more meaningful differential diagnosis of SPD from other personality disorders .90034 [13] 90035 90003 90002 Some evidence suggests the cluster A personality disorders have shared genetic and environmental risk factors, and there is an increased prevalence of schizoid personality disorder in relatives of people with schizophrenia and schizotypal personality disorder. 90034 [4] 90035 Twin studies with schizoid personality disorder traits (e.g. low sociability and low warmth) suggest these are inherited. Besides this indirect evidence, the direct heritability estimates of SPD range from 50 to 59%.90034 [43] 90035 90034 [44] 90035 To Sula Wolff, who did extensive research and clinical work with children and teenagers with schizoid symptoms, «schizoid personality has a constitutional, probably genetic, basis.» 90034 [45] 90035 The link between SPD and being underweight may also point to the involvement of biological factors. 90034 [3] 90035 90034 [46] 90035 90003 90002 In general, prenatal caloric malnutrition, premature birth and a low birth weight are risk factors for being afflicted by mental disorders and may contribute to the development of schizoid personality disorder as well.Those who have experienced traumatic brain injury may be also at risk of developing features reflective of schizoid personality disorder. 90034 [47] 90035 90034 [48] 90035 90034 [49] 90035 90003 90002 Other historical researchers had hypothesized excessively perfectionist, 90034 [50] 90035 unloving or neglectful parenting could play a role. 90003 90188 Diagnosis [edit] 90189 90234 DSM-5 criteria [90235.