Shut in or split up? A commentary on Dr. Nirestean and colleagues' ‘Schizoid personality disorder — the peculiarities of their interpersonal relationships and existential roles’.

Comments on an article by Aurel Nirestean et al. (see record 2012-03494-007). Nirestean et al. were very good at transmitting to the reader the complexity of Mr. P’s situation, unfortunately, they were not able to provide a description of the clinical course that could help the reader to rule out the possible pathoplastic effect of the Axis I disorders on Mr. P’s interpersonal and social and occupational problems. Nirestean et al. reported that Mr. P achieved lower than it was expected according to his potential, but they did not provide enough elements to let the reader understand what the cause of this underachievement was. Nirestean et al. vividly presented some alternative models of schizoid personality disorder (SPD). Nirestean et al. suggest that the Diagnostic and Statistical Manual (DSM-IV) models and other models of SPD may be interchangeably used in describing and understanding SPD. Nirestean et al. convincingly remind us that the use of constructs with the same name, but which were designed to describe very different clinical phenomena, may lead to diagnostic uncertainty and treatment impasse. Nirestean et al. convincingly showed that Mr. P suffered from SPD but frequently stressed his detachment from relationships.