Schizoid Personality Disorder vs Schizophrenia: Breaking Down the Differences

Many people mistakenly use schizophrenia and schizoid personality disorder interchangeably. However, both are defined as psychotic disorders on the schizophrenia spectrum. While they are very similar and share some characteristics with all other schizophrenia spectrum disorders, there are differences in the manifestation, the length of onset, and the impact specific symptoms have.

Symptoms of the difference between schizophrenia and schizoid

Schizophrenia and schizoid personality disorder are defined by abnormalities in at least one but usually several of five key characteristics:

  1. Delusions
  2. Hallucinations
  3. Disorganized thinking and speech
  4. Abnormal motor behavior
  5. Negative symptoms

With schizophrenia vs. schizoid personality disorder, you’ll have significant differences in the severity of certain symptoms.

Key differences: Schizoid Personality Disorder vs. Schizophrenia:

– Nature of disorders

With schizophrenia vs. schizoid disorders, you have lots of subtypes. 

Schizoid Personality Disorder

Schizoid personality disorder, for example, has subtypes like:

  • Grandiose type
  • Jealous type
  • Persecutory type
  • Somatic type 
schizophrenia vs schizoid difference


Schizophrenia can be diagnosed after six months of continuous symptoms, but in many cases, individuals struggle with things like:

  • An initial episode with an acute episode
  • A partial remissions
  • A complete remission after their first episode
  • Multiple episodes, then a remission
  • Multiple episodes followed by partial remissions
  • Catatonia

Moreover, with schizophrenia, there is such variation in the severity that an assessment has to be taken using a 5-point scale for things like hallucinations, disorganized speech, negative symptoms, delusions, and abnormal psychomotor behavior.

– Onset

One difference between schizoid personality disorder vs. schizophrenia is the onset. 

Schizoid Personality Disorder

With a schizoid personality disorder, the presence of one or more delusions must persist for at least one month before a diagnosis can take place.


In order to be diagnosed with schizophrenia, continuous signs from the five categories must persist for at least six months and not be explained by other conditions. During this period, the symptoms are typically so severe that they interfere with daily function. 

– Hallucinations and delusions

Schizoid Personality Disorder

Another key difference is that hallucinations are not always present with a schizoid personality disorder, and even if they are, they are usually related to delusional themes like an individual having delusions of infestations and feeling the hallucinatory sensation of insects all over them.

With schizoid personality disorder, any delusions experienced don’t typically impair daily function, and they don’t result in bizarre behavior. 


Hallucinations and delusions are common and persistent, usually for six months. Someone struggling with schizophrenia might experience severe hallucinations and delusions that interfere with daily function and lead to:

  • Erratic behavior
  • Abnormal behavior
  • Disorganized behavior
  • Catatonic behavior
schizophrenia or schizoid disorder

– Social relationships

Schizoid Personality Disorder

Impairments in psychosocial functioning are usually more severe in schizophrenia than they are in schizoid disorder. However, because of the delusional beliefs associated with this disorder, it can significantly impact relationships and cause work problems because people are unable to view what are, in reality, irrational beliefs as irrational.


Similarly, with schizophrenia, these issues with social relationships and psychosocial functioning appear bizarre or odd, whereas with schizoid personality disorder, they don’t. It’s not uncommon for individuals to engage in antagonistic behavior, too. 

– Emotional expression

Schizoid Personality Disorder

Schizoid personality disorder causes problems with emotional expression, particularly where delusions are concerned. If someone holds onto delusional beliefs, it can be next to impossible for them to recognize any delusion as false, and therefore, they might find it difficult to express themselves emotionally.


Individuals struggling with schizophrenia often struggle with disorganized speech, which can take the form of frequent derailment or incoherence. For example, one client might ramble, talking about things related to hallucinations or delusions but never in a coherent fashion, jumping from topic to topic. Others can get derailed in the midst of answering a question or asking a question, frequently jumping from one thing to another.

– Cognitive Functioning

Schizoid Personality Disorder

Things like delusions can impair cognitive function, but it’s usually more impaired by negative symptoms such as depression or other mood disorders.


A big difference between schizophrenia and schizoid disorder comes down to the level of disturbance that symptoms can have. In someone struggling with schizophrenia, a significant portion of the time, things like delusions, disorganized behavior, disorganized speech, or hallucinations can severely impact cognitive functioning, making it difficult to:

  • Perform in the workplace
  • Maintain a job
  • Go to school
  • Do well academically
  • Maintain relationships
difference between schizoid and schizophrenia

What is the cause and risk factor difference between schizoid personality disorder and schizophrenia?

While there is a difference between schizoid personality disorder and schizophrenia with regard to symptoms, one area where there is a lot of crossover is the risk factors and causes. The causes of schizophrenia and schizoid personality disorder are not well understood, but four categories of potential causes and risk factors can contribute to the development of either schizoid personality disorder vs. schizophrenia:

  1. Brain chemistry changes can cause schizophrenia, such as abnormal dopamine or other neurotransmitter functions.
  2. Genetics plays one of the biggest roles in schizophrenia running in families. If your parents struggle with schizophrenia, you are also very likely to have it.
  3. Changes to the brain, such as shrinkage in the brain or a traumatic brain injury, can cause the development of either condition.
  4. Complications during pregnancy can also increase the risk, particularly prenatal exposure to toxins.

Note: Some research also suggests that, at least for schizoid personality disorder, having an abusive or emotionally detached parent can contribute to the development of the condition.

Treatment approaches for schizophrenia vs. schizoid

Both schizophrenia and schizoid personality disorder are conditions that you have to live with and learn to manage. At present, there is no cure or way to get rid of them. Thankfully, there are combinations of medication and therapy that can make this management process much easier.


Antipsychotic medications are usually prescribed to treat symptoms of disorganized thinking, delusions, or hallucinations. Some examples include:

  • Aripiprazole
  • Quetiapine
  • Haloperidol
  • Clozapine


Several forms of therapy can increase the effectiveness of medication and help improve symptom management on a daily basis, such as psychotherapy and family counseling. 

Psychotherapy might involve things like psychoeducation or cognitive behavioral therapy to help clients identify harmful negative thoughts and replace them with positive alternatives, acquire skills necessary to manage themselves daily, and improve social relationships. Tangentially, family counseling can offer similar resources for maintaining family communication and strengthening bonds. Family counseling typically involves other family members to provide everyone with education and tools to handle the condition moving forward.

Summing Up

Learning the difference between schizoid personality disorder vs. schizophrenia is essential to getting a correct diagnosis. In many cases, symptoms can overlap, and causes or risk factors can be very similar. However, the onset, duration, and severity of specific symptoms can help a mental health professional provide an accurate diagnosis and, subsequently, accurate treatment.