Schizoid personality disorder


  • A pattern of detachment from social relationships and a restricted range of emotional expression

Clinical Features

  • Four (or more) of the following criteria, beginning in early adulthood and present in a variety of contexts:[1]
    • Neither desires nor enjoys close relationships, including being part of a family.
    • Almost always chooses solitary activities.
    • Has little, if any, interest in having sexual experiences with another person.
    • Takes pleasure in few, if any, activities.
    • Lacks close friends or confidants other than first-degree relatives.
    • Appears indifferent to the praise or criticism of others.
    • Shows emotional coldness, detachment, or flattened affectivity.
  • Does not occur exclusively during the course of schizophrenia, a bipolar disorder or depressive disorder with psychotic features, another psychotic disorder, or autism spectrum disorder and is not attributable to the physiological effects of another medical condition

Differential Diagnosis

Psychiatric Disorders with Psychotic Symptoms



  • Clinical diagnosis; however if entertaining other organic causes may initiate workup below

General ED Psychiatric Workup


  • Ask for clarification of any unclear terminology, be genuinely curious
  • Know patient may underreport symptoms due to desire to end social interaction with you
  • Referral for outpatient psychiatric treatment, which can include psychotherapy, antidepressants, anti-psychotics and anti-anxiety medications


  • Discharge

See Also

External Links


  1. American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Publishing.