A 44-year-old man lives alone, chose a night-shift warehouse job specifically to avoid coworkers, has never wanted close friendships, describes himself as indifferent to both praise and criticism, and appears emotionally cold on interview. He denies loneliness and functions adequately at work. There are no odd beliefs, no unusual perceptions, and no psychotic symptoms. The most likely diagnosis is:

• A Schizoid personality disorder ✓
• B Schizotypal personality disorder
• C Avoidant personality disorder
• D Paranoid personality disorder

Explanation

Lifelong detachment from social relationships, restricted emotional expression, indifference to praise or criticism, and genuine preference for solitary activity define schizoid personality disorder. The key discriminator against avoidant personality disorder is that this patient does not want relationships and feels no loneliness, whereas the avoidant patient longs for connection but fears rejection. Absence of magical thinking and odd perception excludes schizotypal personality disorder.

Reference: DSM-5-TR, 2022 ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.