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Self Study is a genre-bending work of autophilosophy. It opens a rare, rear window into the schizoid position of self-sufficient withdrawal and impassive indifference. This inability to be enriched by outer experiences feeds the relentless suspicion that hell is other people. Laying bare his life and work, Kishik engages with psychoanalysis, philosophy, and cultural inquiry to trace loneliness across the history of thought, leading to today’s shut-in society and the autonomous subject of liberal capitalism. What Is Autophilosophy? Love Made Hungry Exile from the World Pleasures and Persons Cancel Thyself Ante-Oedipus Twenty-First-Century Schizoid Man The Lost Object My Other Other Half How to Imagine a Form of Life The Child That Never Was Book Ends Notes Figures Bibliography David Kishik, Self Study: Notes on the Schizoid Condition (Berlin: ICI Berlin Press, 2023)

The study objective is to investigate clinical features of obsessive autoerotic behavior in men and to develop a complex of therapeutic interventions. Materials and methods Comparison and analysis of psychopathic characteristics of 60 patients were performed. The group 1 included 28 patients with schizoid personality disorder, the group 2 included 14 patients with obsessive compulsive disorder, the group 3 included 18patients with schizotypal disorder. Results. Presence of obsessive autoerotic behavior and its clinical and psychopathological features are considered an important criterion of mental pathology diagnosis. A program of effective therapy and rehabilitation for these disorders is proposed: in patients with schizoid personality disorder — serotoninergic antidepressants and low doses of antipsychotics; in patients with obsessive compulsive disorder — anxiolytics (for several subsequent weeks), selective serotonin reuptake inhibitors and low doses of antipsychotics; in patients with schizotypal disorder — atypical antipsychotics predominantly in combination with selective serotonin reuptake inhibitors. Social rehabilitation of patients is also necessary for all groups. It is directed towards learning social skills of appropriate interactions with the partner considering their needs, capabilities, personal preferences both in intimate relations and everyday life. Conclusion. Features of obsessive autoerotic behavior (pretentiousness, preferring these sexual activities to real sexual contacts with an available partner, persistent character et al.) can serve as a criterion for diagnosis of mental pathology and basis for therapy selection. In selection of medications, clinical manifestations of mental disorders are considered.

A new dimensional-based framework was proposed, the Hierarchical Taxonomy of Psychopathology (HiTOP). This study aimed to develop a specific version of the Dimensional Clinical Personality Inventory 2 (IDCP-2), focused on the assessment of the schizoid personality disorder (SZPD) according to the HiTOP. In stage 1, we developed a new factor to cover all SZPD traits, as presented in the HiTOP. Six factors (one new and five from the IDCP-2) composed the IDCP-SZPD. In stage 2, 434 adults from the community, aged from 18 to 67 years (M=31.6, SD=9.7), completed factors from three self-report measures: the IDCP-SZPD, PID-5, and FFaVA. The IDCP-SZPD factors and total score presented high reliability. Correlations and a bootstrap two-sample t-test comparison corroborated the expectations. Although we found evidence supporting the use of the IDCP-SZPD for the measurement of SZPD traits, further research is needed to verify the replicability of the present findings in samples composed of SZPD patients.

Purpose: psychopathological differentiation of gender identity disorder (GID) that occurs as part of depressive episode; creating a typology for developing diagnostic and prognostic criteria. Material and methods: 63 patients (46 women and 17 men) who applied to the FSBRI MHRC from 2016 to 2019 were examined by a clinical psychopathological method. All patients were diagnosed with a depression being part of schizotypal disorder or histrionic personality disorder or mixed histrionic and schizoid personality disorder. Results: Clinical and psychopathological analysis of gender identity disorder occurring as a part of depressive episode showed its heterogeneity, varying severity, as well as a diverse relationship with other psychopathological disorders, which required an in-depth and detailed study. We have identified the following typological varieties: type 1 — GID as a part of depersonalization disorders, type 2 — GID as a part of dysmorphophobic disorders, type 3 — GID as a part of histrionic disorders. Conclusions: The obtained results give us the opportunity to suggest that the diagnosis of the disease, in which the gender identity disorder is detected, can help predict its further course and possible outcomes.

Two clinical cases of adolescents with self-harming behavior in the framework of personal and affective disorders are presented.

Although widely conceived as distinct conditions, higher-functioning autism spectrum disorder (ASD) and schizoid personality disorder (schizoid PD) share similar clinical symptomatology. This study explored the relationship between the two disorders by collecting extensively validated measures of autistic trait burden (Social Responsive Scale, Second Edition) and schizoid PD affectation (Diagnostic Interview for Genetic Studies) from clinically ascertained verbal males with and without autism ages 12 to 25 years (N = 72) via parent, teacher, and self-report. Although only a small minority of adolescents with ASD met full diagnostic criteria for schizoid PD, participants with ASD endorsed a continuous distribution of schizoid PD traits that reflected a pronounced pathological shift in comparison with those in the control group, with one half of ASD males experiencing three or more Diagnostic and Statistical Manual of Mental Disorders, 4th Edition schizoid PD criterion items "often" or "almost always." Results suggest significant amplification of schizoid PD trait burden in adolescents with ASD. ASD-specific interventions should be considered for patients with schizoid PD with premorbid histories of ASD.

Lower serum levels of low-density lipoprotein cholesterol (LDL-C) have been suggested to indicate higher suicide risk and various psychiatric symptoms. Previously, we reported that lower serum LDL-C levels are associated with loneliness, social phobia, isolated life with little social support, and lower trust in others among young non-clinical females. Thus, we hypothesize that schizoid personality traits may be associated with lower serum LDL-C. We here verified this hypothesis using non-clinical data and clinical data with schizophrenia. Using the database from the Midlife in Japan (MIDJA), a cohort of residents living in Tokyo, we analyzed whether schizoid-related interpersonal characteristics were associated with LDL-C. In addition, we assessed the association between blood biomarkers including LDL-C and schizoid personality traits in 101 adult non-clinical volunteers. Finally, we evaluated the interaction between LDL-C and social decision making of patients with schizophrenia. In female non-clinical volunteers, serum LDL-C level was a predictive factor and negatively correlated with schizoid personality traits. Female patients with schizophrenia, whose serum LDL-C levels were lower, tended not to trust other females. The present findings suggest that LDL-C may influence schizoid personality traits in females, which provide a basis for further investigation into the biological aspects of schizoid personality disorder.

Schizoid personality disorder (SZPD) is a Cluster A personality disorder whose essential feature is a lifelong pattern of detachment from social relationships and a restricted range of emotional expression. Although SZPD has been in every edition of the Diagnostic and Statistical Manual of Mental Disorders, empirical research on this disorder is actually limited, due to the fact that SZPD is rarely encountered in clinical settings. In fact, individuals with SZPD rarely present for treatment, as their isolation is often ego-syntonic; therefore, the prevalence of SZPD is not clearly established. Suicide ideation may be a running theme for individuals with SZPD. However, suicidality in SZPD is actually an underestimated topic. Aiming to draw more attention to this underestimated issue, with this paper the authors intend to provide a list of studies on suicidality in individuals with SZPD or traits, in the form of a clinical mini-review. Reported studies show that an underlying SZPD, or the presence of schizoid traits too, appear to be definitely a major risk factor for completed suicide and serious suicide attempts. This maladaptive personality disorder seems to not allow the individual to ask for help and to deny him the comforts of intimacy. Therefore, clinicians should be aware that schizoid traits suchs as solitary lifestyle, loneliness, emotional detachment, and impaired communication ability, are features associated with a vulnerability to suicidal behavior. We recommend the clinical assessment of thi􀁖􀀃 􀁖􀁜􀁐􀁓􀁗􀁒􀁐􀁖􀂶􀀃 􀁆􀁒􀁑􀁖􀁗􀁈􀁏􀁏􀁄􀁗􀁌􀁒􀁑􀀏􀀃 􀁌􀁑􀀃 􀁒􀁕􀁇􀁈􀁕􀀃 􀁗o address patients with SZPD to most proper treatment.

Homicide is the most serious and costly criminal offense and better forensic and criminological understanding of homicidal ideation as a potential psychobehavioral precursor to homicidal conduct is critical. Using data from the 2016 Nationwide Emergency Department Sample (NEDS) from the Healthcare Cost and Utilization Project (HCUP) distributed by the Agency for Healthcare Research and Quality (AHRQ), we found 64,910 cases of homicidal ideation among a sample of 25.6 + million-a prevalence of 0.25%. Numerous conditions conferred increased substantially the likelihood of homicidal ideation including antisocial personality disorder (2406%), schizoaffective disorder (1821%), borderline personality disorder (1557%), paranoid personality disorder (1,504%), schizophrenia (1,143%), obsessive-compulsive personality disorder (921%), brief psychotic disorder (771%), unspecified psychosis (737%), avoidant personality disorder (596%), and schizoid personality disorder (571%), delusional disorder (546%), and other psychotic disorder (504%). Homicidal ideation is comorbid with serious psychiatric and behavioral problems and has important implications for offender typologies and homicidality.

Background Clinical and research findings have highlighted the role of interpersonal factors in suicidal behavior with high levels of intent and lethality. Schizoid personality disorder (SPD) is at the extreme end of interpersonal difficulties. Thus, we aimed to understand the contribution of SPD symptoms to suicide behavior and specifically to more lethal suicide attempts. Method Four groups were investigated (N = 338): medically serious suicide attempters, medically non-serious suicide attempters, psychiatric and healthy controls. SPD symptoms, mental pain variants, and clinical characteristics were assessed. Results Overall, attempters were characterized by higher levels of most SPD symptoms. Solitary lifestyle and emotional detachment were higher among medically serious suicide attempters relative to less-serious attempters. Emotional detachment doubled the risk for high lethality, beyond mental pain variables. Conclusions SPD symptoms of interpersonal difficulties and low levels of emotional expressions are important risk factors for more severe suicidal behavior. Implications for identification of at-risk groups for suicide are discussed.

Background: Despite the extensive research performed on prediction of psychosis from a Clinical High Risk for Psychosis state (CHR-P), the positive predictive value of the CHR-P designation remains unsatisfactory and further models including additional clinical and biological variables are required. Existing studies indicate that schizotypy assessed at baseline in “at-risk” individuals may be considered a predictor of transition from CHR-P to psychosis. This approach, however, is burdened with bias resulting from a possible overlap between current psychopathology and schizotypal features. No studies so far have assessed schizotypy in CHR-P from a developmental perspective. Aim: The aim of the study was to identify associations between a long-standing, parent-reported premorbid level of schizoid-schizotypal traits and the probability of psychotic transition in individuals with CHR-P. Methods: The mothers of 107 individuals diagnosed as presenting CHR-P with the use of Comprehensive Assessment of At Risk Mental States12/2006 were interviewed with the Scale for the Assessment of Premorbid Schizoid-Schizotypal Traits (PSST). Results: A high level of enduring schizotypy was found to be significantly associated with psychotic transition from CHR-P (HR: 1.78, 95% CI: 1.40–2.27, p

The present study examined the associations of positive, negative, and disorganized schizotypy dimensions assessed by the Multidimensional Schizotypy Scale with 5 interview-rated personality disorder diagnoses and traits in 151 young adults. As hypothesized, all 3 schizotypy dimensions were associated with impaired functioning. Positive schizotypy was associated with schizotypal and borderline personality traits; negative schizotypy was associated with schizotypal, schizoid, paranoid, and avoidant personality traits; and disorganized schizotypy was associated with paranoid, borderline, and avoidant personality disorder traits. Negative schizotypy predicted broad diagnoses of Cluster A personality disorders. Both negative and disorganized schizotypy predicted the broad diagnosis of any of the 5 personality disorders. The study further examined the association of the schizotypy dimensions with the individual personality disorder criteria to better understand the overall associations. Given the common origins and high comorbidity, we examined whether the schizotypy dimensions explained the association of borderline and schizotypal personality disorder traits. Positive and disorganized schizotypy fully mediated the association between borderline and schizotypal traits. In summary, the study replicated and extended previous findings that the schizotypy dimensions are uniquely associated with personality disorders and traits, as well as impaired functioning, in young adults. The study also provided additional support for the construct validity of the Multidimensional Schizotypy Scale and for the use of psychometric assessment of schizotypy. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Die Mentalisierungstheorie gewinnt in den letzten Jahren in der psychologischen Forschung immer mehr Bedeutung. Sie wurde durch Fonagy (1998) und andere ForscherInnen etabliert und stellt eine Weiterentwicklung der Bindungstheorie und der Theory of Mind dar. Als Mentalisierung wird dabei die Fähigkeit verstanden, die es ermöglicht, sich innere Zustände in Form von Gefühlen und Motiven im anderen und bei sich selbst vorstellen zu können (Fonagy, 2011). Sie bildet ein zentrales Element für soziale Interaktionen und tragfähige Bindungen. Die Forschung beschäftigte sich häufig mit der Mentalisierungsfähigkeit bei Personen mit Borderline-Persönlichkeitsstörung. Diese Studie möchte hingegen den Bezug zur schizoiden Persönlichkeitsstörung herstellen, da diese gekennzeichnet ist durch eine reduzierte emotionale Ausdrucksweise und einen unzureichenden menschlichen Kontakt, bei gleichzeitig hohem Wunsch nach Beziehung (Suslow & Arolt, 2009). So geht die vorliegende Arbeit der Frage nach, inwieweit sich die Mentalisierungsfähigkeit im therapeutischen Prozess bei PatientInnen mit schizoider Persönlichkeitsstörung verändert. Daran anschließend wird die Frage untersucht, ob sich die Allgemeinsymptomatik der PatientInnen verändert. Zu diesem Zweck wurde die Mentalisierungsfähigkeit von drei Patientinnen im Verlauf der Therapie mittels der Reflective Functioning Scale auf Grundlage von Transkripten eingeschätzt und miteinander verglichen. Die allgemeine Symptomatik der PatientInnen wird mithilfe der Symptom Checkliste 90-R ermittelt. Als Ergebnis konnte festgestellt werden, dass zwei der drei PatientInnen keine Veränderung der Mentalisierungsfähigkeit über den Therapieverlauf aufwiesen. Eine dieser PatientInnen zeigt starke Verbesserungen ihrer allgemeinen Symptomatik über alle drei Messzeitpunkte hinweg, wohingegen bei der anderen eine leichte Verschlechterung zu verzeichnen war. Die dritte PatientIn zeigt einen leichten Anstieg der Mentalisierungsfähigkeit, zu der eine langfristige Symptomverbesserung auch bis zur 1-Jahres-Katamnese kommt. Eine Antwort auf die Frage nach den Gründen für eine solche Stagnation der Mentalisierungsfähigkeit deutet sich, zumindest tendenziell, bereits an. Am wahrscheinlichsten scheint die Ursache im Zusammenhang mit strukturellen Benachteiligungen von Personen mit schizoider Persönlichkeitsstörung zu liegen, für die der soziale Kontext einer Therapie eine Stresssituation darstellt., Alexander Heinrich Dämmer, Masterarbeit Universität Klagenfurt 2021

The discovery of mummified bodies in domestic settings is not unusual in the medico-legal context. It is often a marker of social isolation, even in our urban modern society, and usually occurs among elderly people living alone or in precarious conditions. However, bereaved subjects can sometimes be found managing their grief by deliberately keeping the corpses of their loved ones at home. Investigation of these atypical cases can be challenging and often requires a multidisciplinary effort by different forensic specialists. We report two cases of people who lived for several months with the mummified remains of a relative. In both cases, the judge ordered a forensic psychiatry assessment of the survivors' competency and the reasons for this peculiar behavior, which is regarded as abnormal in our society. Case 1 describes a shared psychosis, which developed out of a condition of extreme seclusion of the entire family. Case 2 shows that even a mild personality disorder on which a series of traumatic events operates can trigger psychotic decompensation, causing extreme denial of the reality of death. The analysis of these cases contributes to our knowledge of the scantly studied phenomenon of "Living with the Dead" and raises questions about the psychopathology behind it. It is useful to identify subjects who are more prone to developing this "deviant" behavior, in order to distinguish people with mental illness from those who merely want to profit from the death of a loved one.

Social avoidance in young patients is a clinically worrisome phenomenon that characterizes impending schizophrenia, but that also constitutes a core phenomenon in avoidant personality disorder (AvPD), schizoid personality disorder (ScPD), and in autism spectrum disorder (ASD). Especially in the absence of any other clinically relevant phenomena, understanding the origins of social avoidance may be one the most challenging tasks in assessing whether adolescents and young adults are at risk for developing schizophrenia. Descriptive and psychometric assessments only allow to comment on the absence or the presence of this phenomenon, but do not capture the origins and the meaning of social avoidance. Based on a narrative review, we highlight the importance of a phenomenological approach to unveil the Gestalt of social avoidance in these mental disorders, including and appraisal of the underlying mental structures and attachment styles. The phenomenological approach allows to distinguish the Gestalt of social avoidance between AvPD, ScPD, ASD, and beginning schizophrenia, to ensure correct diagnostic labelling and optimal treatment, and to avoid unwarranted stigmatization.

Esophageal reconstruction with colonic or jejunal segment is a second choice treatment when the stomach is injured or not adequate for use. These reconstructions, whether pedicled or as free jejunal graft, are technically demanding and they are associated with high rate of morbidity and mortality. Complications are mainly due to insufficient blood supply and therefore anastomotic leak or stricture and graft necrosis. We describe the case of a 51-year-old psychiatric man with diagnosis of esophageal perforation after ingestion of metallic razor blades for suicide intent. The patient was treated at an outside hospital with endoscopic removal of the blades and apposition of endoscopic clips, be cause of esophageal mucosal perforation. Nevertheless, he developed a septic status caused by mediastinitis. The patient underwent several interventions to solve the sepsis and after complete recovery he was referred to our Department for esophageal reconstruction. During surgery we found that the stomach was unavailable for reconstruction, therefore a left colonic interposition pedicled on the left colic vessels was performed through the retrosternal route. During the postoperative course the patient developed acute respiratory failure and suppuration of the cervical wound. The postoperative course was complicated because of the poor compliance of the patient due to his psychiatric disorder. He was discharged in postoperative day (POD) 42 in good clinical conditions, on oral-only diet. Colonic interposition through the retrosternal route after esophagectomy is a technically demanding procedure, associated with high morbidity and mortality, but it is a feasible option when the stomach is not available for reconstruction.

Şizoid kişilik bozukluğunun (KB) tarihi psikolojinin erken dönemlerine kadar uzanır. Erken dönem teorisyenleri bütüncül bir şizoid kişilik tanımlamaktansa şizoid kişiliğin farklı yönlerini vurgulayan açıklamalarda bulunmuşlardır. Erken dönem teorisyenlerinden birisi olan Ribot (1986), şizoid kişiliğin bir özelliği olan “Anhedoni” kavramını ortaya atmıştır. Ribot’un bir trans hali olan ağrı hissetmeme durumu yani analjeziye atıfta bulunarak sunduğu anhedoni kavramı, zevki deneyimleme yetisinin zayıflaması, körelmesi ya da yitmesini ifade eder. Şizoid kişiliğe yakın bir başka tanımlama da Kraeplin’den (1896; akt. Zec, 1995) gelmiştir: “Demantia Praecox”. Kraeplin Prematür Demans (PD) anlamına gelen bu tanımlamayı şizofreni anlamında kullanmaktadır ve bu kavram çocuklukta arkadaşlık kurma kabiliyetine sahip olmayan sessiz, utangaç ve uysal bir öykü geçmişine sahip vakalara işaret eder. Birçok PD vakasını muayene eden Hoch (1909), bu hastaların bazılarının kendisinin “içine kapanmış (shut-in) kişilik” adını verdiği belli kişilik özellikleri taşıdığını fark etmiştir ve bu kişilik özelliklerine sahip olan hastaların manik bir PD’den çok daha sakin ve içe çekilmiş bir PD geliştirmeye eğilimli olduğunu yazmıştır. Kretschmer’e (1925; akt. Miller, Useda, Trull, Burr ve Minks-Brown, 2002) göre şizoid kişiliğin içe dönüklüğü, diğer insanlardan kopmuş olmalarının doğal sonucudur. Şizoid kavramını ilk kullanan araştırmacı şizofreninin de isim babası olan Blueler’dir (1908; akt. Millon, 1999/2019). Blueler, boyutsal bir bakış açısıyla ile şizoid kişiliğin herkeste bulunduğu ve şizofreni hastalarında bu özelliğin kritik boyutlara ulaştığı fikrini savunmuştur. Bleuler, orta şiddetteki şizoidleri içine kapanık, kayıtsız, şüpheci, tartışma kapasitesi olmayan, donukluklarıyla barışık kişiler olarak betimlemiştir.

Primary psychotic disorders include a wide variety of psychiatric disorders, including but not limited to schizophrenia spectrum disorders. In this chapter, I describe the clinical characteristics of psychiatric disorders where psychosis is an obligatory part of the symptom picture (i.e., schizophrenia spectrum disorders) or where psychosis is merely an ancillary but not core feature (i.e., psychotic mood disorder). Included in this chapter is catatonia because its recognition is important for treatment.

How does your personality affect how others treat you? Previous research suggests the characteristic patterns of social behavior in personality disorders can be captured using economic games. Here we test the opposite: whether personality disorders elicit characteristic patterns of social behavior from others. Participants read vignettes portraying individuals with one of eight DSM-5 personality disorders (plus a control vignette) then played either a Prisoner's Dilemma (Experiment 1) or Chicken (Experiment 2) game with a confederate said to have been interviewed and portrayed by each vignette. Experiment 1 found higher cooperation rates in response to the control vignette in comparison to all personality disorder vignettes. Experiment 2, found similar results, apart from the vignette depicting schizoid personality disorder. Findings suggest that people use information about personality to guide how they interact with others. They also illuminate the role others play in the difficult social situations those with personality disorders frequently experience.

Avoidant personality disorder (AVPD) is a relatively common disorder that is associated with significant distress, impairment, and disability. It is a chronic disorder with an early age at onset and a lifelong impact. Yet it is underrecognized and poorly studied. Little is known regarding the most effective treatment. The impetus for research into this condition has waxed and waned, possibly due to concerns regarding its distinctiveness from other disorders, especially social anxiety disorder (SAD), schizoid personality disorder, and dependent personality disorder. The prevailing paradigm subscribes to the "severity continuum hypothesis", in which AVPD is viewed essentially as a severe variant of SAD. However, areas of discontinuity have been described, and there is support for retaining AVPD as a distinct diagnostic category. Recent research has focused on the phenomenology of AVPD, factors of possible etiological significance such as early parenting experiences, attachment style, temperament, and cognitive processing. Self-concept, avoidant behavior, early attachments, and attachment style may represent points of difference from SAD that also have relevance to treatment. Additional areas of research not focused specifically on AVPD, including the literature on social cognition as it relates to attachment and personality style, report findings that are promising for future research aimed at better delineating AVPD and informing treatment.

Aim There is lack of research on the study of clinical personality traits in recent onset of psychosis (ROP) patients. The aims of this research were to study the relations among psychosocial, personality and clinical characteristics in ROP patients and also the effect that significant variables had on the different domains of Quality of Life (QoL). Methods Data for these analyses were obtained from 81 ROP patients. The Millon Clinical Multiaxial Inventory, the Positive and Negative Syndrome Scale and the World Health Organization Quality of Life Brief Scale were used to assess personality, symptoms and QoL. Results Correlations between the negative symptoms and the physical, psychological and social domains of QoL, and the disorganized symptoms and physical domain, were found. Furthermore, the physical, psychological and social relationship domains of QoL were lower in patients with schizoid traits and the psychological domain was lower in patients with depressive traits. In contrast, the psychological and social domains were higher in patients with histrionic traits, while the physical domain was higher for patients with narcissistic traits. Multiple linear regressions demonstrated that negative symptoms and narcissistic and depressive traits explained 16.9% of the physical domain. Narcissistic and depressive traits explained 15% of the psychological domain. Finally, the negative symptoms and histrionic traits explained 13.7% of the social domain. Conclusions QoL seems to be better explained by negative psychotic symptoms and some clinical personality traits. Our results support the importance of integrated intervention approaches that consider personality.