Schizoid and paranoid personality disorders have key differences. Paranoid personality disorder (PPD) leads people to think that others are trying to harm them, while schizoid personality disorder leads to a preference for being alone and a lack of interest in others.

Personality disorders are a type of mental disorder involving long-term, rigid thought and behavior patterns that differ from the norm in a particular culture.

Personality disorders fall into different “clusters” of disorders that share similar characteristics. Mental health professionals define schizoid and paranoid personality disorders as Cluster A.

Cluster A personality disorders generally involve unusual thoughts and behavior patterns. Despite being in the same cluster of personality disorders, schizoid and paranoid disorders have various key differences.

This article explains how to recognize schizoid personality disorder and paranoid personality disorder, how they differ, and the ways in which mental health professionals treat each condition.

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According to the National Institute of Mental Health (NIMH), around 9.1% of people over 18 years of age in the United States live with a personality disorder. Research suggests that the prevalence of schizoid personality disorder is less than 1%.

The main feature of schizoid personality disorder is significant difficulty forming social relationships. The exact causes of schizoid personality disorder are unknown. It may be an inheritable condition, according to some experts.

Experiences in childhood may also contribute to the development of the condition.

This may include situations, such as having a caregiver that is neglectful, emotionally cold, or detached. This can fuel a childhood belief that interpersonal relationships are not satisfying, leading to schizoid personality disorder.

People with schizoid personality disorder rarely report to a healthcare or mental health professional themselves, as they often cannot acknowledge a problem. Typically, a family member will prompt the visit.

An individual may receive a schizoid personality disorder diagnosis if they develop another psychiatric condition such as depression as a result of the disorder.

Learn more about schizoid personality disorder.


People with schizoid personality disorder rarely maintain close relationships, preferring to spend time alone. They may appear aloof, distant, or uninterested in relationships, activities, praise, or criticism.

Emotional flatness is another feature of schizoid personality disorder, and people with it often do not express strong negative or positive thoughts.

An estimated 1.21–4.4% of people have PPD. This means that it is among the most common personality disorders, according to research from 2017.

PPD means that a person has a deep-rooted and consistent mistrust of others, often feeling like they are experiencing oppression or that others are targeting them. This differs from the paranoid delusions that people with schizophrenia often experience.

According to the United Kingdom’s National Health Service (NHS), delusions involve bizarre, incorrect, or unrealistic views or stances. These include paranoid delusions, such as suspecting that a family member or friend is chasing, poisoning, monitoring, or plotting against them.

Physical abuse during childhood, neglect, trauma, and brain injury might have links to the development of PPD, and stress can trigger symptoms or make them more severe.

Learn more about PPD.


People with PPD may believe the following despite a lack of evidence:

  • People are lying to them or trying to manipulate them.
  • They are unable to trust close friends or those around them.
  • They cannot share personal information with others for fear of misuse.
  • Innocent or well-intentioned remarks have malicious intent.
  • Their partner is having an affair.

They may often feel irritable, find fault in others, and feel like others treat them unjustly. Early definitions of PPD suggest that it might also lead to inflated self-esteem in some people.

People with PPD might be hypervigilant, meaning that they anticipate threats at any time.

According to the NHS, many personality orders may cause the following in those living with their effects:

  • overwhelming feelings of anxiety, low self-worth, irritability, or distress
  • emotional or social disconnection
  • avoiding others
  • erratic or unusual behavior
  • finding it hard to maintain relationships with friends, partners, professional carers, or children

Personality disorders commonly lead to related mental health conditions such as depression or substance use disorder.

People with these disorders might experience difficulty in regulating negative emotions, leading to self-harm, drug misuse, or threatening other people.

Both disorders may also occur due to other psychological conditions, such as schizophrenia. A healthcare professional needs to rule these conditions out when diagnosing a personality disorder.

Other key differences

As cluster A personality disorders, the effects of schizoid personality disorder and PPD may overlap.

However, according to a 2017 review, people with PPD may be more likely to experience extreme resentment and sudden, severe periods of anger. Those with schizoid personality disorder may show little emotion.

Individuals with PPD might also be extremely sensitive to criticism or feedback, reading malicious intent where there is none. Schizoid personality disorder may lead to a disregard of either criticism or praise from others.

Learn more about cluster A personality disorders.

Personality disorders are long-term and often require management or treatment for life. However, no proven treatment is available for either PPD or schizoid personality disorder.

No medications have approval from the Food and Drug Administration (FDA) to treat PPD, and no clinical trials have taken place for PPD treatments.

There are few studies on schizoid personality disorder, so information on treatment is limited. People with PPD often do not participate in research due to mistrust, so conclusions about the success of certain treatments are limited.

Another potential barrier to treatment for many people with cluster A personality disorders is that they do not seek diagnosis by choice. They may also not stick with treatment, either due to ambivalence or mistrust of clinicians or clinical processes.

Some people with personality disorders find that psychotherapy treatment helps people adjust to relationships and social life. However, more research is necessary to identify a particular type of psychotherapy that is proven to reduce symptoms or improve quality of life.

Medications might help to treat mental complications that develop due to these personality disorders, such as depression.

Learn more about treatment for schizoid personality disorder.

The following are answers to some questions people frequently ask about schizoid personality disorder.

What is someone with schizoid personality disorder like?

A 2022 review suggested that people with schizoid personality disorder may appear to be aloof, isolated, and distant. They do not experience strong emotions, are usually indifferent to positive or negative feedback, and do not seek personal or sexual relationships.

What is the difference between schizoid personality disorder and schizophrenia?

People with schizophrenia often experience hallucinations and delusions, along with confused and disorganized thought patterns. There are often periods in which symptoms of schizophrenia reduce followed by acute periods of increased symptoms.

Schizoid personality disorder, on the other hand, is ongoing and does not lead to delusions or hallucinations. However, both conditions can cause emotional flatness, a loss of interest in socializing, and a tendency to withdraw from the world.

Schizoid personality disorder and paranoid personality disorder (PPD) are both cluster A personality disorders. They can both lead to a withdrawal from social life, low self-worth, and unusual behaviors. No proven treatment is available for either.

However, schizoid personality disorder causes a complete loss of interest in relationships and a distant demeanor. PPD leads to an ongoing state of mistrust and suspicion that creates the impression that other people intend to cause harm or are implying malice through criticism or feedback.

PPD may lead to episodes of extreme anger and resentment, whereas schizoid personality disorder may mean that a person feels few positive or negative emotions.