Internet Addiction Disorder and Schizoid Personality Traits in Monozygotic Twins: A case report

35^th Euro Congress on Psychiatrists and Psychologists

June 16-17, 2025 Webinar

Shikha Khairwal

Department of Psychiatry, IHBAS,India

Posters & Accepted Abstracts: Clinical Neurology & Neurosurgery

Abstract :

Introduction: Internet addiction disorder (IAD) is an emerging behavioral addiction, often associated with significant impairment in social, occupational, and psychological functioning. This case report presents the clinical course and management of IAD in two monozygotic 20-year-old male twins with concurrent schizoid personality traits. Case Presentation: Mr. S and Mr. S, 20-year-old monozygotic twin males, presented with excessive phone usage (16–17 hours daily), social withdrawal, poor self-care, and declining academic performance over the past five years. Their mother had a history of schizophrenia, but both exhibited a premorbid temperament characterized by introversion, emotional detachment, and a preference for solitary activities. Mental status examination revealed a shallow affect, preoccupation with phone retrieval, impaired personal judgment, and poor insight (grade 1/5), with no perceptual abnormalities.A diagnosis of Internet Addiction Disorder (ICD-11: 6C5Y, Other Specified Disorders Due to Addictive Behaviours) was established. Initial treatment with fluoxetine 20 mg and behavioral therapy failed due to non-compliance and lack of improvement. Subsequent psychological interventions were met with poor engagement. Due to persistent dysfunction, inpatient admission was planned. Treatment was shifted to bupropion 150 mg OD, titrated to 150 mg BD, alongside mobile phone restriction, occupational therapy for activity rescheduling, and regular psychotherapy sessions. The Internet Addiction Test (IAT) confirmed frequent usage, while the International Personality Disorder Examination (IPDE) identified Cluster A traits, suggestive of schizoid personality disorder. Despite these interventions, both patients remained reluctant toward change, demonstrating minimal improvement. The case highlights the challenges of managing behavioral addictions in individuals with underlying personality pathology. Conclusion: This case highlights the challenges of managing internet addiction disorder, particularly in the presence of schizoid personality traits. The treatment resistance observed underscores the need for tailored therapeutic strategies in similar cases.

Biography :

Shikha Khairwal is a dedicated mental health professional associated with the Department of Psychiatry at the Institute of Human Behaviour and Allied Sciences (IHBAS), India. With a strong academic background and clinical experience, she is actively involved in the assessment, diagnosis, and management of a wide range of psychiatric disorders. Her areas of interest include adult psychiatry, neuropsychiatric conditions, and mental health policy development. Shikha is passionate about promoting mental health awareness and has participated in several community outreach programs aimed at reducing stigma and improving access to care. At IHBAS, she contributes to interdisciplinary treatment teams and supports ongoing research and training efforts in psychiatry. Known for her patient-centered approach and evidence-based practice, she is committed to improving mental health outcomes through both clinical service and public education. Shikha continues to engage with national and international psychiatric forums to stay updated with emerging trends in the field.