Merck Manual

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Schizoid Personality Disorder (ScPD)


Mark Zimmerman

, MD, Rhode Island Hospital

Reviewed/Revised May 2021 | Modified Sep 2022
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Schizoid personality disorder is characterized by a pervasive pattern of detachment from and general disinterest in social relationships and a limited range of emotions in interpersonal relationships. Diagnosis is by clinical criteria. Treatment is with cognitive-behavioral therapy.

In schizoid personality disorder, the ability to relate to others meaningfully is limited.

About 3.1 to 4.9% of the general US population have schizoid personality disorder. It is slightly more common among men. Schizoid personality disorder may be more common among people with a family history of schizophrenia or schizotypal personality disorder.

Etiology of ScPD

Having caregivers who were emotionally cold, neglectful, and detached during childhood may contribute to the development of schizoid personality disorder by fueling the child's feeling that interpersonal relationships are not satisfying.

Symptoms and Signs of ScPD

Patients with schizoid personality disorder seem to have no desire for close relationships with other people, including relatives. They have no close friends or confidants, except sometimes a 1st-degree relative. They rarely date and often do not marry. They prefer being by themselves, choosing activities and hobbies that do not require interaction with others (eg, computer games). Sexual activity with others is of little, if any, interest to them. They also seem to experience less enjoyment from sensory and bodily experiences (eg, walking on the beach).

These patients do not seem bothered by what others think of them—whether good or bad. Because they do not notice normal clues of social interaction, they may seem socially inept, aloof, or self-absorbed. They rarely react (eg, by smiling or nodding) or show emotion in social situations. They have difficulty expressing anger, even when they are provoked. They do not react appropriately to important life events and may seem passive in response to changes in circumstances. As a result, they may seem to have no direction to their life.

Rarely, when these patients feel comfortable revealing themselves, they admit that they feel pain, especially in social interactions.

Symptoms of schizoid personality disorder tend to remain stable over time, more so than those of other personality disorders.

Diagnosis of ScPD

  • Clinical criteria (Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition [DSM-5])

For a diagnosis of schizoid personality disorder, patients must have a persistent pattern of

  • Detachment from and general disinterest in social relationships

  • Limited expression of emotions in interpersonal interactions

This pattern is shown by the presence of 4 of the following:

  • No desire for or enjoyment of close relationships, including those with family members

  • Strong preference for solitary activities

  • Little, if any, interest in sexual activity with another person

  • Enjoyment of few, if any, activities

  • Lack of close friends or confidants, except possibly 1st-degree relatives

  • Apparent indifference to the praise or criticism of others

  • Emotional coldness, detachment, or flattened affect

Also, symptoms must have begun by early adulthood.

Differential diagnosis

Clinicians should distinguish schizoid personality disorder from the following:

Treatment of ScPD

  • Social skills training

No controlled studies have been published about psychotherapies or drug therapy for schizoid personality disorder.

Generally, efforts to share interest in impersonal topics (eg, possessions, collections, hobbies) that appeal to people who prefer solitary pursuits can help establish a relationship with a patient and perhaps facilitate a therapeutic interaction.

Cognitive-behavioral approaches that focus on acquiring social skills may also help patients change. Because patients with schizoid personality disorder lack interest in other people, they may not be motivated to change.

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NOTE: This is the Professional Version. CONSUMERS: View Consumer Version
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