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schizoid personality disorder
Clinical manifestations:
- features must be present since young adulthood to meet criteria for personality disorder [1]
- 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 [2]
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 [1,2]
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
General
cluster A personality disorder
References
- Geriatric Review Syllabus, 7th edition
Parada JT et al (eds)
American Geriatrics Society, 2010
- Geriatric Review Syllabus, 11th edition (GRS11)
Harper GM, Lyons WL, Potter JF (eds)
American Geriatrics Society, 2022
- Miller T
Schizoid Phenomena & Jones. Feb 20, 2023
https://www.quora.com/Do-individuals-with-Schizoid-personality-disorder-have-a-flat-or-blunted-affect