The idea of suicide is a driving force against the persons schizoid defenses. Often among people with SzPD, there is a rationally grounded and reasoned position on why they want to die, and this "suicidal construct" takes a stable position in the mind. A mini-review indicates that SzPD or schizoid traits are a major risk factor for both suicide attempts and suicide. Schizoids tend to hide their suicidal thoughts and intentions. Demonstrative suicides or suicide blackmail, as seen in cluster B personality disorders such as borderline, histrionic or antisocial, are extremely rare among schizoid individuals.In cases with schizoid disorder, the characteristics of the premorbidities (emotional coldness, autism, inability to have fun) also affected suicidal behaviour. Their suicides were always genuine in nature, well-planned, and it was only by chance that these patients survived (usually the fatal outcome was prevented by the sudden appearance of others). They denied the existence of suicidal experiences earlier, but argued that in the current circumstances, suicide seemed to them the most appropriate way out. This "suicidal construction" was well-reasoned and took a stable position in the mind. Important in all these cases was the absence of any significant anti-suicidal factors (most were found in a situation of relative social isolation; there were no professional and personal interests). The high ability to introspect in these cases only increased the isolation from reality and made the choice in favour of suicide more reasonable.As in other clinical mental health settings, among suicidal inpatients, individuals with SzPD are not as well-represented as some other groups.
One study found that significantly fewer boys with SzPD had alcohol problems than a control group of non-schizoids. Another study evaluating personality disorder profiles in substance abusers found that substance abusers who showed schizoid symptoms were more likely to abuse one substance rather than many, in contrast to other personality disorders such as borderline, antisocial or histrionic, which were more likely to abuse many.American psychotherapist Sharon Ekleberry states that the impoverished social connections experienced by people with SzPD limit their exposure to the drug culture and that they have limited inclination to learn how to do illegal drugs. Describing them as "highly resistant to influence", she additionally states that even if they could access illegal drugs, they would be disinclined to use them in public or social settings, and because they would be more likely to use alcohol or cannabis alone than for social disinhibition, they would not be particularly vulnerable to negative consequences in early use. Suicide
Suicide may be a running theme for schizoid individuals, in part due to the knowledge of the large-scale ostracism that would result if their idiosyncratic views were revealed and their experience that most, if not all people, are unrelatable or have polar opposite reactions to them on societally sensitive issues, though they are not likely to actually attempt it. They might be down and depressed when all possible connections have been cut off, but as long as there is some relationship or even hope for one the risk will be low.