Table of contents:
- Schizoid personality disorder and differential diagnosis
- Symptoms and disorders associated with schizoid personality disorder
- Criteria for the diagnosis of Schizoid Personality Disorder
The essential characteristic of schizoid personality disorder is a general pattern of distancing from social relationships and restriction of emotional expression at the interpersonal level. This pattern begins in early adulthood and occurs in various contexts.
Subjects with schizoid personality disorder show no desire for intimacy, seem indifferent to opportunities for personal relationships, and do not seem to be very satisfied with being part of a family or social group (Criterion A1). They prefer to spend time on themselves rather than being with other people. They are usually socially isolated or lonely and almost always choose solitary activities or hobbies that do not require interactionswith other people (Criterion A2). They prefer mechanical or abstract tasks such as computer or mathematical games. They may show very little interest in having sexual experiences with another person (Criterion A3) and they like very little or no activities (Criterion A4). There is usually a reduction in the sensation of pleasure from sensory, bodily or interpersonal experiences, such as walking on a beach in the sun or making love. These individuals do not have close friends or trusted persons, except for a first degree relative (Criterion A5).
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- Symptoms and disorders associated with schizoid personality disorder
- Criteria for the diagnosis of Schizoid Personality Disorder
Schizoid personality disorder and differential diagnosis
Subjects with schizoid personality disorder tend to appear indifferent to the approval or criticism of others and show no concern about what others may think of them (Criterion A6). They can withdraw from the normal niceties in social interaction and often do not respond adequately to social norms, so they appear socially inept or superficial and self-absorbed. They usually show a soft appearance without observable emotional reactivity and with few gestures or reciprocal facial expressions, such as smiles or nodding (Criterion A7). They report that they rarely experience strong emotions such as anger or joy. They often show restricted affectivity and are cold and distant. However, on the rare occasions that these individuals feel,Even if temporarily comfortable talking about themselves, you can recognize that they have unpleasant feelings, especially when it comes to social interactions.
Schizoid Personality Disorder should not be diagnosed if the behavior pattern appears exclusively during the course of schizophrenia, a mood disorder with psychotic symptoms, another psychotic disorder, or a pervasive developmental disorder, or if it is due to the effects direct physiological effects of a neurological or other disease (eg, temporal lobe epilepsy) (Criterion B).
Differential diagnosis
Schizoid personality disorder can be distinguished from delusional disorder, schizophrenia, and mood disorder with psychotic symptoms by being characterized by a period of persistent psychotic symptoms (eg, delusions and hallucinations). To make a further diagnosis of schizoid disorderPersonality disorder, the personality disorder must have been on before the psychotic symptoms began and must persist when the psychotic symptoms are in remission. When an individual has a chronic psychotic disorder on Axis I (eg, schizophrenia) that was preceded by a schizoid personality disorder, the schizoid personality disorder should be recorded on Axis II, followed in parentheses by premorbid.
There may be great difficulty in distinguishing individuals with schizoid personality disorder from those with mild forms of autistic disorder and Asperger's disorder.
Mild forms of autistic disorder and Asperger's disorder are distinguished by more severe impairment of social interaction and by stereotyped behaviors and interests.
Schizoid personality disorder is to be distinguished from a personality change due to a general medical condition, in which the traits appear due to the direct effects of a disease of the central nervous system. It must also be differentiated from symptoms that may develop in association with chronic substance use (eg, unspecified cocaine-related disorder).
Schizoid personality disorder can be confused with other personality disorders that have some characteristics in common. Therefore, it is important to differentiate these disorders based on differences in their characteristic features. However, if an individual has personality characteristics that meet the criteria for one or more personality disorders in addition to Schizoid Personality Disorder, all of those disorders can be diagnosed.
Although characteristics of social isolation and restricted affectivity are common to schizoid, schizotypal, and paranoid personality disorders, schizoid personality disorder can be differentiated from schizotypal personality disorder by lack of perceptual distortions and paranoid personality disorder. for lack of suspicion and paranoid ideation. The social isolation of schizoid disorderPersonality disorder may differ from that seen in avoidant personality disorder, which is due to fear of being overwhelmed or not knowing what to do, and excessive anticipation of rejection. In contrast, people with schizoid personality disorder have greater detachment and a very limited desire to become familiar with others. Subjects with obsessive-compulsive personality disorder may also show a social distancing that arises from devotion to work and discomfort with emotions, but they have an internal capacity to relate. Lonely individuals can display personality traits that can be considered schizoid.They only constitute a schizoid personality disorder when these traits are inflexible and maladaptive and cause functional impairment or subjective distress.
Symptoms and disorders associated with schizoid personality disorder
Subjects with schizoid disorderPersonality may have special difficulties expressing anger, even in response to direct provocation, contributing to the impression that they are unemotional. Sometimes their lives seem to be going nowhere and they leave their goals to chance. These individuals tend to react passively to adverse circumstances and have difficulty responding adequately to important life events. Due to their lack of social skills and lack of desire for sexual experiences, individuals with this disorder have few friends, they rarely date someone, and they rarely marry. Work activity may be impaired, especially if interpersonal involvement is required,although subjects with this disorder can cope well when working in conditions of social isolation. Individuals with this disorder may experience very brief psychotic episodes (lasting minutes or hours), especially in response to stress. In some cases, schizoid personality disorder may appear as the premorbid antecedent of delusional disorder or schizophrenia.
Sometimes, individuals with this disorder have a major depressive disorder.
Schizoid personality disorder is most often seen concurrently with personality, schizotypal, paranoid, and avoidance disorders.
Symptoms dependent on culture, age and sex
Subjects from various types of cultural backgrounds can display defensive behaviors and interpersonal styles that can be wrongly classified as schizoid. For example, people who have moved from a rural to an urban setting may react with an emotional chill that can last several months and manifest itself in solitary activities, restricted affectivity, and other communication deficits. Immigrants from other countries are sometimes mistakenly viewed as cold, hostile, or indifferent.
Schizoid personality disorder can become apparent for the first time in childhood or adolescence through lonely attitudes and behaviors, poor relationships with peers, and poor school performance, which marks these children or adolescents as different and makes them subjects of teasing.
Schizoid personality disorder is diagnosed a little more frequently and can cause more disability in males.
Prevalence
Schizoid personality disorder is rare in the clinical setting.
Family pattern
Schizoid personality disorder may be more prevalent in relatives of individuals with schizophrenia or schizotypal personality disorder.
Criteria for the diagnosis of Schizoid Personality Disorder
A general pattern of distancing from social relationships and restriction of emotional expression at the interpersonal level, beginning in early adulthood and occurring in a variety of contexts, as indicated by four (or more) of the following: ni wants or enjoys personal relationships, including being part of a family almost always chooses solitary activities has little or no interest in having sexual experiences with another person enjoys little or no activities does not have close friends or trusted people, other than First-degree relatives are indifferent to praise or criticism from others shows emotional coldness, distancing or flattening of affectivity B.
These features do not appear exclusively in the course of schizophrenia, a mood disorder with psychotic symptoms, or another psychotic disorder and are not due to the direct physiological effects of a general medical condition.
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