From the Research
The best management approach for schizoid personality disorder is a combination of psychotherapy, particularly cognitive behavioral therapy (CBT), and supportive interventions, as evidenced by a recent case report 1. This approach focuses on gradually building trust and addressing the patient's difficulty with social connections, while respecting their need for emotional distance. The therapy should be conducted in a non-confrontational manner, slowly encouraging social engagement, with group therapy introduced cautiously as the patient progresses. Key aspects of the therapeutic approach include:
- Establishing a consistent therapeutic relationship that acknowledges the patient's autonomy
- Providing tools to function better in social situations they find necessary
- Using techniques such as debates, images to reparentalize, assignment of tasks, use of humor, and social skills training While no medications specifically treat schizoid personality disorder, selective serotonin reuptake inhibitors (SSRIs) like sertraline or escitalopram may help with comorbid anxiety or depression, and low-dose antipsychotics might occasionally be used for severe symptoms of social detachment, but with caution due to side effects 2, 3. It's essential to note that treatment success depends on patience from both therapist and patient, with therapy potentially continuing for years with gradually decreasing frequency of sessions. A recent scoping review 2 highlights the complexity and lack of clear evidence-based recommendations for the treatment of schizotypal personality disorder, but the most recent and highest quality study 1 supports the use of CBT in managing schizoid personality disorder.