DEFINITION:
The phrase “schizoid personality disorder (StPD)” refers to a form of severe mental illness marked by a blurring of the line between fantasy and reality.
The disordered thinking associated with SPD may involve such elements as strange beliefs, paranoia, social anxiety, and transient episodes of psychosis stopping short of full-blown delusions or hallucinations.
From a behavioral perspective, StPD sufferers exhibit peculiar or eccentric mannerisms and behaviors, which are often described as “absent,” “bizarre,” or “self-estranged.”
StPD is usually described as lying on the “schizophrenia spectrum.” Since, by definition, patients with StPD do not experience the full-blown hallucinations and delusions that characterize chronic schizophrenia, the two maladies should not be confused with each other.
ETYMOLOGY:
The phrase StPD was introduced into the medical literature by the American psychiatrist Robert L. Spitzer (1932–2015) in the third edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-III), published in 1980. Spitzer was deeply involved in the preparation of DSM-III.
The English term “schizotypal” consists of the following two elements:
(1) “Schizo,” which Spitzer took from the term “schizophrenia,” which, in turn, was coined by the Swiss psychiatrist Eugen Bleuler (1857–1939) in 1908. (For further details, see the Glossary entry, schizophrenia.)
Bleuler had taken “schizo” from the ancient Greek verb, schizō, schizein, meaning “to split,” “to cleave,” “to rend asunder,” or “to separate”; and
(2) “Typal,” which Spitzer took from the English noun “type,” which is attested from the fifteenth century.
“Type” derives, via Middle English, from Late Latin. The Late Latin word itself derives from the Greek noun tupos, meaning a “blow” or the “mark made by a blow,” and, by extension, a “stamp,” “impression,” “figure,” or “pattern.”
For the etymology of the term “personality,” see the Glossary entry, personality.
For the etymology of the term “disorder,” see the Glossary entry, borderline personality disorder.
DISCUSSION:
Sufferers from StPD may be preoccupied with unusual daydreams, susceptible to magical thinking, or believe they can read the thoughts of others. However, psychotic episodes tend to be transient, rather than chronic (as in schizophrenia).
The symptoms characteristic of StPD typically first appear in childhood. Although they may fluctuate greatly in degree of severity, they usually do not go into permanent remission. The two traits associated with StPD which are least likely to go into remission are eccentric ideation and paranoia.
StPD sufferers may have severe difficulty in social functioning. For example, statistics show that they are more likely than members of the general population to lack a college education and to be unemployed.
Individuals with relatives on the schizophrenia spectrum are at an elevated risk of being diagnosed with StPD. Thus, there seems to be a genetic component to the etiology of the condition.
According to the American psychologist Theodore Millon (1928–2014), StPD is one of the easiest personality disorders to diagnose, but one of the hardest to treat.