Schizoid personality disorder: management and patient care

By Cristiano Antonino Last updated Jun 18, 2023

The essential characteristics of Schizoid Personality Disorder are an intrinsic difficulty in establishing social relationships and, above all, an absence of the desire to establish them, which differentiates it from avoidant personality disorder, which instead suffers from isolation

The patient with Schizoid Personality Disorder

Individuals with schizoid disorder appear indifferent to opportunities to establish or not establish close relationships and do not seem to derive much satisfaction from being part of a family or other social group.

Others are seen as intrusive and unrewarding and relationships as unstable and undesirable.

These individuals are often described as socially detached and isolated.

People with schizoid personality disorder structure their lives in such a way as to limit interactions with others and therefore choose particular occupations that require minimal social contact.

They see themselves as observers rather than participants in the world around them.

They prefer to spend time alone rather than being with other people.

Due to their lack of social skills and desire for sexual experiences, individuals with schizoid disorder have few close friends or confidants.

Individuals with schizoid personality disorder often appear indifferent to the approval or criticism of others and do not seem to care what others may think of them.

They have a narrow affectivity, showing neither strong positive nor negative emotions.

They may have particular difficulty expressing anger, even in response to direct provocation, and this contributes to the impression that they lack emotion.

They often react passively to adverse circumstances and have difficulty responding appropriately to important life events.

Therapy in Schizoid Personality Disorder

Therapy of schizoid disorder is very difficult, as the sufferer does not recognise the need for it and rarely asks for help.

The borderline with schizophrenia is very slight and the differential diagnosis between personality disorder and psychosis is difficult.

Treatment can make use, albeit partially, of the neuroleptic drugs used for schizophrenia and other psychotic syndromes and medium- to long-term (1 to 2 years) cognitive-behavioural psychotherapeutic support.

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