schizoid personality disorder

Clinical manifestations

• features must be present since young adulthood to meet criteria for personality disorder
• disinterest in social relationships (socially detached personality)
• social isolation & occasionally odd behaviors
• elderly: poor, strained or absent relationship with caregivers
• a loss of affect, difficulty showing emotions

Differential diagnosis

• schizophrenia
  • flat affect*, disorganized thought or speech, delusions, or hallucinations
• schizotypal personality disorder
  • eccentric, magical beliefs, bizarre statements, requests
• antisocial personality disorder
  • consistent disregard for rights of others
  • violation of the rights of others

* apparently 'affect remaining largely flat' is not a flat affect more characteristic of schizophrenia

Management

• assess for & treat comorbid psychosis
• do not force social interactions
• offer support & problem-solving assistance
• do no challenge paranoid ideation
• solicit & empathize with emotions, turmoil, fear

More general terms

• cluster A personality disorder