SCHIZOID PERSONALITY-DISORDER - A REVIEW OF CURRENT STATUS AND IMPLICATIONS FOR DSM-IV

Schizoid personality disorder (SZD) is one of three Diagnostic and Sta tistical Manual of Mental Disorders, 3rd edition, revised (DSM-III-R) ''odd cluster'' personality disorders (including schizotypal personali ty disorder [SPD] and paranoid personality disorder [PPD]) characteriz ed by phenomenological similarities to schizophrenia. SZD is distingui shed from the other two personality disorders by the prominence of soc ial, interpersonal, and affective deficits (i.e., ''negative symptoms' ') in the absence of psychoticlike cognitive/perceptual distortions. D espite a rich and extensive clinical and theoretical tradition regardi ng the schizoid character, its pre-DSM-III status was handicapped by c onsiderable heterogeneity and lack of clear operationalized criteria f or the disorder. The architects of DSM-III attempted to subdivide and sharpen the boundaries of this heterogeneous area by the addition of S PD and PPD within the odd cluster, and the avoidant personality disord er (AVD) within the ''anxious'' cluster. The narrowing of the SZD diag nosis by reassignment into these additional diagnoses, however, raises additional questions on the location of its diagnostic boundaries, an d even whether the diagnosis remains a valid and separate entity. Evid ence of extensive criteria overlap and comorbidity with other personal ity disorders are of particular concern in this regard. The low preval ence rates of DSM-III SZD further complicate attempts at addressing th ese issues empirically. Although modifications of the diagnostic crite ria in DSM-III-R appear to have increased the sensitivity and prevalen ce of the diagnosis, the scarcity of empirical data on either DSM-III or DSM-III-R SZD remains a significantly limiting factor in resolving these concerns.