Schizoid Personality Disorder (SPD) is a pervasive pattern of detachment from social relationships and a restricted range of facial expression. It is often confused with being avoidant. Avoidant individuals usually have friends, but schizoid people are considered loners and are almost completely isolated.

Schizoid Personality Disorder (SPD) is estimated that less than 1% of the world population suffers from SPD. There is no difference observed in terms of prevalence between men and women. SPD is found to stem from childhood and can persist as a lifelong behavior. It is unclear however how SPD forms but current literature suggests that SPD is inherited. Unfortunately, no genetic causes have been identified so far. 

Isolation is the main feature of a schizoid patient. They rarely maintain close relationships, if at all. They commonly prefer working alone, often choosing a career where they are by themselves. Thus, they don’t really require social and emotional bonds. They have no desire for sexual activity let alone having a partner, and they don’t respond to criticism or praise. 

Other associated features that are common to a schizoid patient are the following:

• Difficulty expressing anger;
• Lives directionless, drifts in their goals;
• Lack of social skills;
• Underachiever in school;
• Discomfort with human interaction, introverted, constricted affect;
• Seen as eccentric.

According to DSM V to clinically diagnose SPD there must be four or more of seven criteria: 

• Neither desires nor enjoys close relationships, including being part of a family;
• Almost always chooses solitary activities;
• Has little, if any, interest in having sexual experiences with another person;
• Takes pleasure in few, if any, activities;
• Lacks close friends or confidants other than first degree relatives;
• Appears indifferent to praise or criticism of others;
• Shows emotional coldness, detachment, or flattened affect.

Treatment

There is no treatment option currently approved for managing SPD. This is also due to the fact that this mental health disorder is less studied. However, for schizoid patients who also suffer with depression, the schizoid disorder can be co-managed together with antidepressant medication. 

Cognitive based therapy and psychodynamic therapy were employed in certain studies, but no reliable evidence showing that these approaches work have been found.

To prevent progression of symptoms, it is best to go to a mental health professional and commit to a long-term plan that these professionals offer. 

Family members must be included in the treatment plan that the doctors or professionals would provide as they can be a source of education and support when the symptoms occur.

References

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). https://doi.org/10.1176/appi.books.9780890425596

Fariba KA, Madhanagopal N, Gupta V. Schizoid Personality Disorder. [Updated 2022 Jun 9]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK559234/