Schizoid personality disorder can lead to schizophrenia

Schizoid personality disorder

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Written by Wiebke Posmyk • Medical editor

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People with schizoid personality disorder appear distant, cool, and indifferent to others - and at times like eccentrics. Even if both terms sound similar, the schizoid personality is not the same as a schizophrenia. Find out when to talk about schizoid personality disorder, whether it needs treatment and which therapy is suitable for it.

It is estimated that around 1 in 100 people has schizoid personality disorder. Characteristic of these people is their strangely aloof, withdrawn and unemotional manner. They have no particular passions or hobbies that they could be enthusiastic about. They are suspicious and closed towards others: They have only few social contacts and largely withdraw. People with schizoid personality disorder don't seem to care much about their fellow human beings. Nevertheless, they usually have an unconscious need for closeness - which they cannot, however, feel or express.

Schizoid personalities are loners. They perceive social ties to be insecure and unreliable. They prefer to be alone and do not share their feelings with others, or only to a limited extent. For example, they tend not to return a smile. This "wooden" and cool behavior can make your interlocutors very insecure and lead them to avoid contact in the future.

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Social rules are largely indifferent to schizoid personalities. They do not know how to behave in a socially appropriate manner. Accordingly, they are considered idiosyncratic or eccentric and easily offensive.

People with schizoid personality disorder are unable to build trust with others. They only enter into a partnership or a close friendship if their schizoid personality traits are rather mild (so-called schizoid personality style). To a greater extent, more intense social ties and sexuality are not possible.

Schizoid personality disorder: symptoms at a glance
People with schizoid personality disorder

  • appear distant, cool and callous. It is difficult for you to feel joy.
  • show themselves indifferent. They seem to have no interest in other people and do not make any effort to socialize.
  • find it difficult to empathize with others.
  • are loners. They have little social contact and are withdrawn.
  • do not know how to behave appropriately in social situations. They do not recognize social norms or rules or they are indifferent to them.

When does one speak of a schizoid personality disorder?

Whether temperamental, introverted or orderly: every person is unique. The personality is shaped by the individual perceptions, feelings, thoughts and behaviors. The main features of personality develop in childhood and remain largely constant from early adulthood.

If certain personality traits are so strong or weak that they deviate significantly from the norm, psychologists speak of a personality disorder. The salient features are very inflexible. That means: the person can only change or influence them within certain limits.

People who have few social contacts and who appear cool and aloof to others do not automatically have schizoid personality disorder. Rather, what is decisive for the diagnosis is

  • how pronounced the schizoid characteristics are,
  • whether they have existed and persist since childhood / adolescence and
  • how much the person's professional / social performance is restricted or how much they and / or those around them suffer as a result.

Schizoid Personality Disorder = Schizophrenia?

Schizoid personality disorder is not the same as schizophrenia. Schizophrenia is a psychosis. In the process, a person loses touch with reality at times - for example by hearing voices or feeling persecuted. A personality disorder is not a psychosis, but rather permanent, very pronounced personality traits that differ greatly from the norm.

Schizoid personality disorder in relationships and at work

Schizoid personality disorder does not necessarily lead to problems. Many of those affected are not burdened by the fact that they do not form deep bonds, because they do not feel the desire to do so. A (mildly pronounced) schizoid personality disorder can prove difficult in a partnership, for example if the partner suffers from the distant nature of the person affected. Difficulties can also arise in professional life because schizoid personalities find it difficult to adapt to social customs. This can be especially problematic when they have to work closely with other people.

Schizoid personality disorder: causes

Schizoid personality disorder is thought to result from a combination of different causes. Which personality traits are particularly pronounced in a person - and whether a schizoid personality disorder develops from them - depends on an interplay of different factors.

  • On the one hand, a hereditary predisposition plays a role. The genes determine to a large extent whether a person is more introverted or more sociable, more fearful or brave, etc. Family members of schizoid personalities are also more likely to suffer from mental illnesses such as B. Schizophrenia.
  • On the other hand, there are numerous external influences that affect personality development in childhood and adolescence. These include, for example, the social environment, the atmosphere at home or traumatic experiences. Many people with schizoid personality disorder grew up in difficult circumstances, such as in a home with little emotional warmth.

Depending on the point of view, psychologists set different priorities to explain the development of a schizoid personality disorder. From a behavioral point of view, schizoid personalities may have problems correctly interpreting and responding to other people's expressions of feeling. Their inability to get in touch with other people is compounded by their withdrawal behavior. Psychoanalysts tend to take into account the relationship with the parents or traumatic experiences. According to this, for example, a negative and unemotional atmosphere in the parental home could contribute to a person seeing relationships as unreliable - and increasingly distancing himself from other people.

Schizoid personality disorder: diagnosis

Schizoid personality disorder does not necessarily have to be treated. In particular, if the disorder is very pronounced, those affected see no reason to see a psychotherapist themselves.

Nevertheless, it is more common for schizoid personalities to seek psychotherapeutic help - for example because they have problems in their relationship. Conflicts in the relationship arise, for example, when the partner finds it difficult to deal with the distant, seemingly callous nature of the person concerned. But difficulties at work can also be an occasion for psychotherapy, because schizoid personalities often have problems integrating into a team. In addition, some struggle with depression or social anxiety.

An experienced psychotherapist usually succeeds in recognizing a schizoid personality disorder in the course of the therapeutic sessions. Not only the descriptions and behaviors of the patient give him important information - the information from people close to him, such as his or her partner, can also be helpful for him.

In addition, the psychotherapist can use various psychological tests. For example, a standardized structured interview (SKID): He asks questions on various topics. The patient's answers give him clues as to which personality traits are particularly pronounced and whether it could be a disorder. For a more detailed analysis, he then asks in-depth questions on specific subject areas.

Exclude other diseases

There are numerous mental illnesses that have characteristics similar to those of schizoid personality disorder. The psychotherapist must take this into account before making a diagnosis. A low-feeling, detached manner and social withdrawal can also be signs of Asperger's Syndrome, for example, which is one of the autism spectrum disorders. Another example is schizophrenia simplex: In this mild form of schizophrenia, the patients appear strange or "cranky" to outsiders, which can also occur with schizoid personality disorder. It must also be ruled out that the complaints / abnormalities have a physical cause - for example, brain damage. A medical examination may therefore be necessary.

Last but not least, people with schizoid personality disorder can also have characteristics of another personality disorder. For example, there is more overlap with paranoid personality disorder. People with paranoid personality disorder are overly suspicious of others and constantly expect to be attacked or threatened.

Schizoid personality disorder: therapy & course

The personality traits of a person are relatively stable and can therefore only be changed within certain limits. Therapy is not about "curing" a schizoid personality disorder. Rather, the patient should learn to interact better with other people and to make social contacts. It is important for these skills to be able to perceive and express one's own feelings better.

People with schizoid personality disorder have difficulty trusting and opening up to others. It is therefore of central importance for the success of the therapy whether the therapist succeeds in building a relationship of trust with the patient little by little.

Since schizoid personalities have few social contacts, they have little practice in dealing with other people. Therapy therefore also includes acquiring social skills.

Schizoid personality disorder: history

The strongly pronounced personality traits can further solidify in the course of life. The affected people then isolate themselves more and more from their social environment. They sometimes develop eccentric or bizarre-looking habits and are considered eccentric. Some people with schizoid personality disorder develop depression or anxiety, for example when they have to work closely with others in their job.

Schizoid personality disorder: case study

An anonymized case study from practice, made available by our expert Dr. Bernhard Riecke:

A university professor is admitted with the suspicion of a planned suicide attempt. He was standing at a high bridge and had the ambulance service bring him to the clinic without any problems.

At the first interview he seems a bit perplexed, but not suicidal. He explains his prolonged stay at the bridge with the fact that he has achieved what was expected of him in his life and that he now wants to make room for a more suitable partner for his cheerful wife.

His wife, a cheerful person who has known her husband since the "sandbox era", is dismayed and stresses that she has not noticed any changes in him. As always, he would have meticulously prepared his lectures and given them with a very positive response (which he denied) In retrospect, she could only see that he had recently withdrawn a little more to read in peace and quiet.

After four years of "trying" she was finally pregnant, but was waiting for a suitable moment to convey the good news to him. But actually there was no special moment for him. You never know if he's happy. In the many years together he would have always proven through his actions that he was very fond of her and would do anything for her, but he would never have said it. She knows that he has deep feelings, but "deep inside" and not recognizable to others.

Senf, W., et al .: Practice of Psychotherapy. Thieme, Stuttgart 2020

Personality disorders. Online information from neurologists and psychiatrists on the Internet: (accessed: April 29, 2020)

Payk, T., Brüne, M .: Checklist psychiatry and psychotherapy. Thieme, Stuttgart 2017

Möller, H., et al .: Dual Series Psychiatry, Psychosomatics and Psychotherapy. Thieme, Stuttgart 2015

Sachse, R: Clarification-oriented behavior therapy for schizoid personality disorder (PDF). Institute for Psychological Psychotherapy, online publication (March 2014)

additional Information

ICD-10 Diagnostic Key:

You can find the appropriate ICD-10 code for "Schizoid Personality Disorder" here:

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Last content check:06.05.2020
Last change: 11.11.2020