A 38-year-old man comes to the office for evaluation of discomfort in his wrists. He thinks his symptoms may be related to "typing all day, every day." The patient is a software engineer and prefers to work remotely from home to "avoid wasting time talking and interacting with coworkers." He rarely leaves his apartment and spends his spare time on his computer, reading online forums about space exploration and the possibility of alien life. When asked about relationships he says, "I've always liked being on my own." He spent a large portion of his childhood disassembling and rebuilding electronic devices and had few friends. His affect appears constricted and his responses to questions are limited. Which of the following is the most likely personality disorder in this patient?

Question

A 38-year-old man comes to the office for evaluation of discomfort in his wrists.  He thinks his symptoms may be related to "typing all day, every day."  The patient is a software engineer and prefers to work remotely from home to "avoid wasting time talking and interacting with coworkers."  He rarely leaves his apartment and spends his spare time on his computer, reading online forums about space exploration and the possibility of alien life.  When asked about relationships he says, "I've always liked being on my own."  He spent a large portion of his childhood disassembling and rebuilding electronic devices and had few friends.  His affect appears constricted and his responses to questions are limited.  Which of the following is the most likely personality disorder in this patient?

Quizplus · Accepted Answer

11ec160b_363a_628d_9249_35b5f0d0d430_MD0001_00 This patient's preference for working on his own, disinterest in relationships, and constricted range of affect are suggestive of schizoid personality disorder. Individuals with this disorder have a persistent pattern of social detachment, preference for solitary activities, and limited emotional expressivity when interacting with others. They have few close relationships, usually only with family members, and show little interest in intimacy or sexual experiences. Individuals with schizoid personality disorder may have occupational difficulties as they can appear indifferent to feedback and tend to prefer working alone. (Choice A) Antisocial personality disorder involves a pattern of violating the rights of others and engaging in unlawful behaviors (eg, physical aggression, property destruction) without feeling remorseful for transgressions. (Choice B) Individuals with avoidant personality disorder also have limited social interactions, but they strongly desire relationships and social acceptance. They tend to avoid socialization due to fear of rejection and feelings of inadequacy. (Choice C) Obsessive-compulsive personality disorder involves a pattern of fixation with orderliness, control, and perfectionism resulting in interpersonal inflexibility and moral rigidity. (Choice D) Individuals with paranoid personality disorder also have few relationships and avoid social interactions, but this stems from suspiciousness and distrust of others' intentions rather than disinterest. (Choice F) Although individuals with schizoid personality disorder and schizotypal personality disorder lack close friends and can be socially awkward, those with schizotypal personality disorder have a long-standing pattern of eccentric behaviors, perceptual disturbances, and magical thinking (eg, clairvoyance, telepathy). Educational objective: Schizoid personality disorder consists of a persistent pattern of social detachment, preference for solitary activities, and constricted range of affect in social interactions. __________ References: Review of pharmacologic treatment in cluster A personality disorders. (http://www.ncbi.nlm.nih.gov/pubmed/29955451)

A 38-Year-Old Man Comes to the Office for Evaluation of Discomfort