Schizoid Personality Disorder

Are you lately finding a dear friend appearing aloof and avoiding social activities without any apparent reason? Chances are that he or she is suffering Schizoid Personality Disorder. Read and find all about the causes, symptoms, diagnosis and treatment of this condition.

Schizoid Personality Disorder Definition

Commonly known as SPD, this is a psychiatric condition characterized by social isolation and prolonged indifference of a person towards others around him/her. The symptoms are often life-long.

Schizoid Personality Disorder ICD9 Code

The ICD9 Code for this syndrome is 301.20.

Schizoid Personality Disorder ICD10 Code

The ICD10 Code for this condition is F60.1.

Schizoid Personality Disorder Incidence

Picture 1 – Schizoid Personality Disorder

The incidence of the disease has been described to be approximately 1% of the general population. However, this has not been clearly established. Most cases of this disorder go unreported, as patients do not seek treatment and those around them fail to sense the presence of a psychiatric disorder. Naturally, its exact prevalence is not known.

Schizoid Personality Disorder Types

Theodore Milton, a noted American psychologist, had classified this condition into four types. These are:

Languid schizoid

It involves characteristics of depression.

Remote schizoid

It includes features of both Schizotypal and Avoidant personality syndromes.

Depersonalized schizoid

It is characterized solely by the features of Schizotypal Personality Syndrome.

Affectless schizoid

It is marked by characteristics of compulsive disorders.

Schizoid Personality Disorder Symptoms

The condition is typically characterized by:

• Aloofness
• Detachment
• Avoidance of social activities involving warm friendship
• Lack of enjoyment in close relationships, even with close friends and family members

SPD should not be confused with depression. People with this condition are neither depressed, nor dysphoric. They are merely indifferent and are either uninterested or puzzled by personal interactions and social relationships.

People with SPD are loners as they are incapable of intimacy. Their range of emotions and expression of feelings, both happiness and grief, are extremely limited. They appear cold and bland. Such individuals are not interested in friendship or sex. Family or close-knit groups do not have any meaning for them. It is only in very rare cases that such individuals are found to marry and have children.

Individuals affected with SPD are found to prefer solitary activities. They enjoy hobbies that can be pursued alone. They have a leaning towards abstract or mechanical jobs that can be done without any assistance. Many programmers, computer hackers, theoretical physicists and mathematicians are found to be schizoids.

Schizoids are indifferent to criticism or praise. The opinions of people have no meaning for them. They appear to be lost in complicated fantasies. Most of them have no friends other than parents and nearest blood relatives.

Schizoid Personality Disorder Traits

The American Psychiatric Association has published the Diagnostic and Statistical Manual of Mental Disorders (DSM) which clearly lays down the criteria that should be used for the diagnosis of SPD. It includes observation of traits like:

• Emotional detachment
• Inability to enjoy intimate relationships
• Enjoyment in solitary activities
• Little or no interest in having sexual experiences
• Finding pleasure in very few activities or none at all
• Rarely experiencing intense emotions
• Indifference to praise, criticism and social conventions
• Spending a lot of time in introspection and fantasies
• Having no confidantes or intimate friends apart from first-degree relatives

Schizoid Personality Disorder Causes

The exact causes of this condition are unknown as yet. The disease is suspected to be associated schizophrenia as it shares many of the risk factors of the latter. However, it is not as crippling as schizophrenia. It does not cause delusions, hallucinations or complete disassociation from reality.

Both genetics and environmental factors are supposed to play a role in the development of this disorder. According to healthcare providers, a desolate childhood with absence of warmth and emotion can contribute to the rise of the condition. It is particularly noticeable in individuals who have had close friends or strained relationship with family members during childhood.

The risk of development of SPD is found to be higher in people with a family history of schizophrenia or any other mental disorder of a more debilitating kind. Naturally, genetics is supposed to be a causative factor for this disorder.

The condition is also supposed to be associated with the gender of a person. This is due to the fact that the disease is found to arise in men more commonly than in women.

Schizoid Personality Disorder Diagnosis

The diagnosis of this condition involves observation of various aspects of behavior and appearance of patients, such as:

• Dress
• Orientation
• Speech
• Mannerism

A physical examination does not help detect the disorder in any way. However, it may be conducted to rule out presence of other conditions that may cause difficulties similar to symptoms of this disorder. Psychological testing, like MMPI or MMPI-2 (where MMPI stands for Minnesota Multiphasic Personality Inventory) can help in distinguishing this condition from other personality disorders.

As is the case with other types of personality syndromes, patients of SPD must turn 18 years old before the condition can be diagnosed in them.

Schizoid Personality Disorder Differential Diagnosis

The differential diagnosis of this syndrome involves distinguishing it from other mental conditions, such as:

• Autism
• Depression
• Asperger Syndrome
• Avoidant Personality Disorder
• Paranoid Personality Disorder
• Borderline Personality Disorder

The symptoms of SPD are quite similar to that of Schizotypal Personality Syndrome. The inability to begin or maintain an intimate, or at least friendly, relationship with another person is the most noticeable trait common to both conditions. However, there is a subtle difference between the two disorders. In patients of Schizotypal Personality Syndrome, inability to interact socially arises from an underlying fear of people. In SPD sufferers, on the contrary, inability to form relationships arises from a simple lack of desire. Individuals affected with SPD do not experience any urge to form new friendships.

Schizoid Personality Disorder Treatment

The treatment of this disorder is highly challenging. This is due to the fact that SPD patients are extremely unlikely to seek medical assistance on their own. Their inability to make friends can negate the possibility of anybody seeking medical attention on their behalf.

Picture 2 – Schizoid Personality Disorder Image

In cases where patients are able to seek professional medical assistance, treatment comprises of prescription medications. Anti-psychotic drugs, the same ones that are used to cure Schizophrenia, are prescribed most commonly. Talk therapy and behavioral therapy are other effective solutions. However, these can be difficult to implement until patients are willing to open themselves up to some form of interpersonal communication.

Medications are not usually very effective in curing SPD, except in cases where they are found to be good short-term cures for high anxiety. In some patients, small doses of psychostimulants, antidepressants and antipsychotics have been reported to be effective.

Schizoid Personality Disorder and Medications

There is no particular medication for the treatment of this condition. However, certain drugs may be prescribed to cure some of the symptoms and related ailments, such as depression and anxiety. Bupropion (Wellbutrin) can be used to address the mental inability to experience pleasure. Olanzapine (Zyprexa) or Risperidone (Risperdal) can be effective in curing problems of social interaction inability and flattened emotions.

Schizoid Personality Disorder and Psychotherapy

Psychotherapy is a mode of treatment that aims to cure mental problems by the use of psychological methods. In patients of SPD, a type of Psychotherapy known as Cognitive behavior therapy is used to alter the behaviors and beliefs that are characteristic of this problem. It has been found to be effective in developing the social skills of the sufferer and enhancing his/her sensitiveness to interpersonal cues. This form of treatment helps patients react properly in common social situations, such as welcoming guests, and makes them feel less anxious in dealing with others.

An experienced psychotherapist who has treated patients with SPD is adept at understanding the need for private thoughts and personal space of the individuals who come for treatment. They have the ability to reach out to patients without being pushy or too intrusive. A therapist with proper skill and patience can help an SPD patient make significant progress.

Schizoid Personality Disorder and Group Therapy

Group Therapy refers to a form of psychotherapy that involves interaction between a few individuals suffering from the same disorder, under the supervision of a therapist. Such an interaction is considered to have therapeutic benefits for patients. This mode of treatment can be more effective if patients interact with other members who are learning new interpersonal skills just like them. In SPD, just like in other similar conditions, Group therapy serves to enhance social motivation and provide patients with a support structure.

Schizoid Personality Disorder Prognosis

SPD is a chronic (long-term) disease that generally shows very little progress over a period of time. Unfortunately, isolation from society often prevents patients from seeking medical assistance that can improve the outcome. Most people with this condition can contribute to the society, although in a limited way. Fortunately however, the intensity of this condition typically reduces with advancing age. Many patients suffer from few of the worst symptoms of this disorder by the time they are in the fourth or fifth decade of their life.

Schizoid Personality Disorder Complications

Generally SPD may progress to schizophrenia in the second or third decade of the life of a patient. In many cases, the condition is found to worsen if the sufferer is forced to make changes in their social settings, work environment or lifestyle. Such changes can create more stress for patients and complicate the disorder.

People suffering from SPD are found to be at an increased risk of suffering from:

• Schizophrenia and other similar mental syndromes
• Drug addiction, particularly to psychedelic drugs
• Social phobia
• Major depression
• Alcohol addiction
• Panic disorders
• Anxiety disorders

Schizoid Personality Disorder Risk Factors

The development of personality is influenced by genetic as well as environmental factors, especially during childhood. The risk factors for SPD include:

• Experiencing a childhood filled with scorn and neglect
• Suffering maltreatment or child abuse
• Having one or more emotionally detached parents or guardian
• Having a parent or family member with SPD, schizophrenia or other similar personality disorders

Famous People with Schizoid Personality Disorder

There are not many famous people with this condition. This is mainly due to the fact that SPD patients tend to remain aloof and stay away from limelight. They are not involved in activities or professions that require them to mix with other people and work in collaboration. Even those who manage to become famous tend to hide this disease fearing social ridicule. However, there are some well-known people who have been suspected of having this syndrome. They include personalities like:

• Karl Marx
• Charles Darwin
• Peter Green
• Isaac Asimov

However, there is no absolute proof that these personalities actually had this condition. SPD is often confused for other mental disorders. As already said, most cases of this syndrome go unreported.

If you suspect any of your friends or family members to be displaying the symptoms of Schizoid Personality Disorder, get in touch with a psychiatrist. If you have been enjoying fantasies of causing harm to yourself or someone you know for quite some time, you should seek medical attention immediately. Timely medical treatment may check the condition and prevent its gradual deterioration.

References:

http://www.mdguidelines.com/schizoid-personality-disorder

http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001918/

http://www.mayoclinic.com/health/schizoid-personality-disorder/DS00865

http://www.webmd.com/mental-health/mental-health-schizoid-personality-disorder