What Is Schizoid Personality Disorder?

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Schizoid personality disorder is a Cluster A personality disorder defined by coldness and detachment in personal relationships, a limited range of emotional expressions, and a solitary lifestyle. Schizoid personality disorder can include constant daydreaming, but unlike schizophrenia, the daydreaming of schizoid personality disorder does not include hallucinations or a complete disconnect with reality.

Schizoid personality disorder can be difficult to treat because of social isolation and lack of thorough research on the condition. Since it is a chronic disorder, schizoid personality disorder usually does not improve with time. However, it can be managed; treatment options are available, and they include medication for symptoms, therapy, and pursuing detached relationships, such as those in a group or intellectual settings.

Lonely young woman sitting in dark room

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Schizoid Personality Disorder Symptoms

While all Cluster A personality disorders include being cold and distant while finding it difficult to relate to others, what sets schizoid personality disorder apart is a rich inner world and extreme introversion. The most common symptoms of schizoid personality disorder are:

  • Lack of interest in or pleasure from human relationships
  • Seeming cold or distant when around other people
  • Self-isolation
  • Extreme fear of intimacy
  • Secrecy
  • Lack of response to praise or criticism
  • Lack of interest in sexual activity with others

Daydreaming

Some people with schizoid personality disorder might constantly daydream, which helps them escape their surroundings and other people. However, these daydreams are not hallucinations of things that are not there or delusions that completely detach from reality, as they can be with schizophrenia.

Schizoid PD vs. Schizotypal PD and Schizophrenia

Schizoid personality disorder can be confused with schizotypal personality disorder, which includes odd behaviors and thoughts that are not severe enough to be categorized as schizophrenia. Schizophrenia, on the other hand, includes hallucinations like hearing voices that aren't there, intense paranoia, and finding it difficult to process information and communicate.

Causes of Schizoid Personality Disorder

Personality disorders occur when a person displays repeated behaviors that go against the social expectations of their culture. These behaviors can interfere with work, relationships, and overall fulfillment.

There aren't yet any clear known causes of schizoid personality disorder. However, there are life circumstances and biological factors that can contribute to the condition's development.

Childhood Abuse

People with schizoid personality disorder are more likely to have experienced neglect or abuse in childhood, including:

  • Lack of regular parental supervision   
  • Harsh punishment    
  • Physical and verbal abuse     
  • Sexual abuse

A person who was abused as a child might associate social interaction with rejection and shame, and this can lead to developing symptoms of schizoid personality disorder. Also, childhood sexual abuse can increase the chances of wanting to avoid closeness with people while also finding it difficult to feel emotions fully.

Prenatal Risk Factors

There are risk factors for schizoid personality disorder that occur before birth. These include:

  • Low birth rate or not getting enough calories while growing in the womb
  • Premature birth, which is when birth happens before 37 weeks

Biological Risk Factors

Schizoid personality disorder has been linked to other biological risk factors:

  • While there are not many studies on the link between serotonin (the brain hormone that regulates mood) and schizoid personality disorder, selective serotonin reuptake inhibitors (SSRIs), which are antidepressants that increase serotonin levels, have been shown to help with some symptoms.
  • The balance between testosterone, the primary sex hormone in cisgender males, and estrogen, the primary hormone in cisgender females (who also have a bit of testosterone), might affect whether or not someone displays schizoid personality traits.

Traumatic Brain Injury

Head injury can slightly increase the chance of developing schizoid personality disorder, especially when the impact is around the frontal lobe, limbic system, and parietal lobe—all of which are brain regions that help you feel physical sensations and process your emotions.

Cultural Considerations

Understanding the culture of someone with schizoid personality disorder can be one way to diagnose them or to determine the roots of their behavior.

For instance, cultures that really value individuality and self-reliance might have higher rates of schizoid personality disorder. On the other hand, if a person lives in a culture that emphasizes community and togetherness, being extremely self-centered could express itself as schizoid personality disorder.

How Schizoid Personality Disorder Is Diagnosed

Diagnosing schizoid personality disorder can be difficult because of its isolating nature and the need for a specialist to observe a person for a long period of time. A person's cultural and social background, genetic and brain factors, and the similarities between schizoid personality disorder symptoms and symptoms of other mental health conditions also have to be considered.

7 Diagnostic Criteria of Schizoid Personality Disorder

According to the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders (DSM-5), there are seven criteria for a schizoid personality order diagnosis:

  1. Lack of social interest
  2. Tendency to self-isolate
  3. Little or no interest in sexual experiences with other people
  4. Little interest in activities
  5. A lack of closeness with anyone who is not family
  6. No reaction to praise or criticism
  7. Coldness and detachment, or a "flat" effect

Overlapping Symptoms of Schizoid Personality Disorder and other Disorders

Symptoms of schizoid personality disorder can look like other conditions that are also marked by social confusion and isolation. This can complicate the path toward a diagnosis. These conditions include:

  • High functioning autism spectrum disorder (ASD): ASD is a developmental disorder that affects communication and social skills while at times making a person sensitive to stimuli, such as light and sounds. People with ASD might avoid eye contact or seem preoccupied with their own inner world.
  • Complex post-traumatic stress disorder (C-PTSD): C-PTSD can occur when someone experiences long-term and repeated trauma, such as childhood abuse or war. Symptoms of C-PTSD include isolating oneself from loved ones and feeling detached from your surroundings.
  • Other cluster A personality disorders: Paranoid personality disorder is when a person cannot form relationships because of irrational suspicions and anger. With schizotypal personality disorder, a person is also afraid of intimacy and avoids closeness. However, this disorder also includes eccentric behavior and confusing communication.

Difficulty Diagnosing Schizoid Personality Disorder

Diagnosing schizoid personality disorder can be difficult because those with the disorder tend to isolate themselves. This can make it difficult for a healthcare provider to observe them long-term to determine if they express symptoms of the disorder. Also, getting close to a psychotherapist might not seem appealing to someone who prefers to avoid personal connection.

People with schizoid personality disorder tend to avoid diagnosis and treatment, but considering the greater risk of suicide that is part of the condition, it's advised they get help.

Treatment and Management

Schizoid personality disorder is often underdiagnosed and left untreated, but medications to manage symptoms, therapy, and group activities might help.

  • Medication: While there is no one medication prescribed for schizoid personality disorder, medications could help with managing its symptoms. For instance, medications that help with the psychological effects of schizophrenia might also help with schizoid personality disorder. Stimulants, which are medications that energize people, and antidepressants for low moods can also help with the lack of motivation and pleasure that those with schizoid personality disorder can feel.
  • Therapy: Therapy might not help someone with schizoid personality disorder, since the patient might not be open to a personal connection. However, psychodynamic therapy, which involves analyzing your own emotions and actions with the help of an expert, might help.
  • Group activities: People with schizoid personality disorder might consider joining group activities to develop connections with others. Some with the disorder might decide to be honest with others about not being able to meet emotional expectations while accepting their own limitations. Others with the disorder might limit social interaction to intellectual and work activities.

Summary

Schizoid personality disorder is defined by wanting to remain isolated, not feeling pleasure from personal interactions, and having a small range of emotional reactions. The disorder can have a negative effect on a person's motivation, personal satisfaction, social skills, and understanding of their surroundings. It can also increase the risk of suicide.

Diagnosing schizoid personality disorder can be a difficult task considering its self-isolating nature. Also, a person's cultural environment and other disorders with similar symptoms can also complicate diagnosis.

No specific treatment for schizoid personality disorder exists, but medication to address symptoms, therapy, group activities, and managing social expectations can help. Schizoid personality disorder is a chronic disorder, which makes it lifelong; but with a bit of patience and resolve, management is possible.

A Word From Verywell

If you think you are living with schizoid personality disorder, addressing how you feel around and about people can be a great first step, as can searching for a therapist in your area. If therapy and medication are not available to you, you might consider getting involved in groups that share your interests while managing emotional expectations from yourself or others.

If you have a loved one with symptoms of schizoid personality disorder, try to manage your expectations of their emotions while encouraging them to honor their feelings about people. You might also suggest they address their symptoms with the help of a therapist or support group.

Treating schizoid personality disorder can take some patience, but options are available and worth the effort.

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