Schizoid Personality Disorder - Treatment

Treatment

Schizoid personality disorder has negative symptoms similar to those of schizophrenia, such as anhedonia, blunted affect and low energy, and atypical antipsychotics may have efficacy in alleviating them. Those who do seek treatment have the option of medication or therapy. The medication most recently used to treat the negative symptoms is risperidone. Before this, there was no psychotropic medication that made an impact on the negative symptoms. Low doses of risperidone or olanzapine also work for the social deficits and blunted affect, Wellbutrin (bupropion) for anhedonia.

The use of SSRIs, TCAs, MAOIs, low dose benzodiazepines and beta-blockers may help social anxiety in the SPD. However, social anxiety may not be a main concern for the people who have SPD. Supportive psychotherapy is also used in an inpatient or outpatient setting by a trained professional that focuses on areas such as coping skills, improvement of social skills and social interactions, communication, and self-esteem issues. Mark Zimmerman suggested the following questions for evaluation of patients with SPD:

• Do you have close relationships with friends or family? If yes, with whom? If no, does this bother you?
• Do you wish you had close relationships with others?
• Some people prefer to spend time alone, others prefer to be with people. How would you describe yourself?
• Do you frequently choose to do things by yourself?
• Would it bother you to go a long time without a sexual relationship? Does your sex life seem important or could you get along as well without it?
• What kind of activities do you enjoy?
• Do you confide in anyone who is not in your immediate family?
• How do you react when someone criticizes you?
• How do you react when someone compliments you?

In the assessment process, note if these individuals make eye contact, smile or express affect nonverbally.

People with SPD have a tendency to miss differences that causes an inability to pick up environmental cues and limits their experience. The perception of varied events only increases their fear for intimacy and limits them in their interpersonal relationships. Also because of their aloofness, this barrier does not allow them to use their social skills and behavior to help them pursue relationships.

Socialization groups may help these people with SPD. Educational strategies in which people who have SPD identify their positive and negative emotions also are effective. Such identification helps them to learn about their own emotions and the emotions they draw out from others and to feel the common emotions with other people with whom they relate. This can help people with SPD create empathy with the outside world.