Schizoid personality disorder

•Social withdrawal
•Introvert
•Eccentric.

Epidemiology:

0.5-1% in general population

Clinical features:

1. Reserved, unsociable.
2. Rarely tolerate eye contact.
3. Give short answers.
4. Appear uneasy when asked about feelings.
5. Invest much energy in abstract ideas.
(Mathematics or philosophy)
6. Speech slow & monotonous (lacks emotions)
7. Do not express joy, anger, sadness or other emotions.
8. May make emotional attachments with animals or inanimate objects.
9. Engage in excessive day dreaming

ICD-10 criteria: (F60.1)

1.Few, if any activities, provide pleasure.


2. Emotional coldness, detachment or flattened affectivity.


3. Apparent indifference to either praise or criticism.


4. Little experience in having sexual experience.


5. Preference for solitary activities.


6. Excessive preoccupation with fantasy and introspection.


7. Lack of close friends.


8. Marked insensitivity to prevailing social norms & conventions.

Course:

• If social circumstances are favourable, Some achieve social & vocational adaptation.
• Sometimes act as a precursor of schizophrenia.

Differential Diagnosis:

Schizophrenia
Schizotypal Personality disorder
Paranoid Personality disorder
Obsessive compulsive personality disorder
Avoidant personality disorder

Treatment:

1.Pharmacotherapy:
•Low dose antipsychotics.
•Antidepressants
•Psychostimulants
2.Psychotherapy
3.Social skills training.

Reference:

  • New Oxford Textbook of Psychiatry(2nd edition).
  • ICD-10 Classification of Mental and Behavioural Disorders.

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