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Schizotypal Personality Disorder


A pervasive pattern of social and interpersonal deficits marked by acute discomfort with, and reduced capacity for, close relationships as well as by cognitive or perceptual distortions and eccentricities of behavior, beginning by early adulthood and present in a variety of contexts, as indicated by five (or more) of the following:

  • Ideas of reference (excluding delusions of reference) odd beliefs or magical thinking that influences behavior and is inconsistent with subcultural norms (e.g., superstitiousness, belief in clairvoyance, telepathy, or "sixth sense"; in children and adolescents, bizarre fantasies or preoccupations).

  • Unusual perceptual experiences, including bodily illusions odd thinking and speech (e.g., vague, circumstantial, metaphorical, overelaborate, or stereotyped).

  • Suspiciousness or paranoid ideation inappropriate or constricted affect behavior or appearance that is odd, eccentric, or peculiar.

  • Lack of close friends or confidants other than first-degree relatives excessive social anxiety that does not diminish with familiarity and tends to be associated with paranoid fears rather than negative judgments about self .

  • Does not occur exclusively during the course of Schizophrenia, a Mood Disorder With Psychotic Features, another Psychotic Disorder, or a Pervasive Developmental Disorder.

  • The disturbance is not due to the direct physiological effects of a substance (e.g., a drug of abuse, a medication) or a general medical condition.


Note: If criteria are met prior to the onset of Schizophrenia, add "Premorbid," e.g., "Schizotypal Personality Disorder (Premorbid)."

Associated Features:
  • Depressed Mood

  • Odd/Eccentric/Suspicious Personality

Differential Diagnosis

Some disorders have similar or even the same symptom. The clinician, therefore, in his diagnostic attempt has to differentiate against the following disorders which he needs to rule out to establish a precise diagnosis.

Cause:

The cause is unknown, but there is an increased incidence in relatives of schizophrenics.

Treatment:

Some people may be helped by antipsychotic medications, but in many cases therapy is preferred. Schizotypal patients rarely initiate treatment for their particular disorder, seeking relief from depressive symptoms instead. Some people may be helped by antipsychotic medications, but in many cases therapy is preferred. Patients severely afflicted with the disorder may require hospitalization to help them form social contacts and thereby overcome fears of relationships as well as to provide therapy. Schizotypal Personality Disorder patients do not often demonstrate significant progress. Treatment should therefore help patients establish a satisfying solitary existence.

Counseling and Psychotherapy [ See Therapy Section ] :

Behavioral modification, a “cognitive-behavioral” treatment approach can allow Schizotypal Personality Disorder patients to remedy some of their odd thoughts and behaviors. Recognizing abnormalities by viewing videotapes and improving speech habits with the help of a therapist are two effective methods of treatment.

Pharmacotherapy [ See Psychopharmacology Section ] :

Medication can be used for treatment of this disorder's more acute phases of psychosis. These phases are likely to manifest themselves during times of extreme stress or life events with which they cannot adequately cope. Psychosis is usually transitory, though, and should effectively resolve with the prescription of an appropriate anti-psychotic.


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