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Schizotypal Personality Disorder

I. Overview of Mental Illness
Schizotypal disorder is characterized by eccentric behaviour and anomalies of
thinking and affect which resemble those seen in schizophrenia, though no definite
and characteristic schizophrenic anomalies occur at any stage. The symptoms may
include a cold or inappropriate affect; anhedonia; odd or eccentric behaviour; a
tendency to social withdrawal; paranoid or bizarre ideas not amounting to true
delusions; obsessive ruminations; thought disorder and perceptual disturbances;
occasional transient quasi-psychotic episodes with intense illusions, auditory or other
hallucinations, and delusion-like ideas, usually occurring without external
provocation. There is no definite onset. The evolution and course are usually those of
a personality disorder. (World Health Organization, 2010)
Individuals with Schizotypal Personality Disorder grow up being socially and
emotionally withdrawn and odd or eccentric. The core features of this disorder are:
(1)detachment (suspiciousness, social withdrawal, intimacy avoidance, inability to
feel pleasure, restricted emotional expression), and (2) irrationality (eccentricity, odd
beliefs, perceptual distortions). This disorder is only diagnosed if: (1) it begins no
later than early adulthood, (2) these behaviors occur at home, work, and in the
community, and (3) these behaviors lead to clinically significant distress or
impairment in social, occupational, or other important areas of functioning. This
disorder should not be diagnosed if its symptoms occur exclusively during the course
of a Psychotic Disorder, Autism Spectrum Disorder, or if it is attributable to Substance
Use Disorder another medical condition. (Long, 2015)
Individuals with Schizotypal Personality Disorder have acute discomfort
with close relationships. Thus these individuals have few close friends and little
desire for sexual intimacy. They have little reaction to emotionally arousing situations,
and restricted emotional expression. Thus they may appear indifferent or cold. They
may have social withdrawal with avoidance of social contacts and activity. Individuals
with this disorder may have undue suspiciousness and feelings of persecution. They
may have excessive social anxiety with these paranoid fears.

and insensitive. overtly drab. They may have odd speech (e. depressive. alienated from self and others. Sense of strangeness and nonbeing. overelaborate. circumstantial. . and tangential thoughts. deadens excess sensitivity..e. Warily apprehensive. dependent features. they may have ideas of reference and odd beliefs that are almost delusions. This behavior represents an extreme or significant deviation from the way in which the average individual in a given culture Subtype Insipid schizotypal Timorous schizotypal relates to others. Like all personality disorders. including bodily illusions. Schizotypal Personality Disorder is a deeply ingrained and enduring behaviour pattern. barren. inexpressive. intentionally blocks. However.g. It includes schizoid. shrinking. vague. or grossly disorganized/catatonic behavior). hallucinations. guarded. reverses. delusions. A structural exaggeration of the active-detached pattern.Individuals with Schizotypal Personality Disorder do not have psychotic symptoms (i. suspicious. or disqualifies own thoughts. Description Personality Traits A structural exaggeration of the passive-detached pattern. they may have unusual perceptual experiences. negativistic (passive-aggressive) features. This behaviour pattern tends to be stable. indifferent. internally bland. sluggish.. Likewise. or stereotyped) that is almost grossly disorganized. obscured. watchful. vague. disorganized speech. that are almost hallucinations. It includes avoidant. manifesting as an inflexible response to a broad range of personal and social situations.

trauma/maltreatment history (especially early childhood neglect) can lead to the development of schizotypal traits. These children may appear odd or eccentric and attract teasing. these schizotypal features may be caused by transient emotional turmoil. social anxiety. Schizophreniform Disorder. Over time. this disorder may actually develop into Brief Psychotic Disorder. .Causes 1. schizotypal personality disorder may also be considered an "extended phenotype" that helps geneticists track the familial or genetic transmission of the genes that are implicated in schizophrenia. Social and Enviromental: There is now evidence to suggest that parenting styles. Rates of schizotypal personality disorder are much higher in relatives of individuals with schizophrenia than in the relatives of people with other mental illnesses or in people without mentally ill relatives. and these features disappear when the turmoil resolves. For other adolescents. Genetics: Although listed in the DSM-IV-TR on axis II. Complications In response to stress. Delusional Disorder or Schizophrenia. 2. Neglect or abuse. or family dysfunction during childhood can increase the risk of developing schizotypal personality disorder. Course of the Disease Schizotypal Personality Disorder may first appear in childhood and adolescence with solitariness. schizotypal personality disorder is widely understood to be a "schizophrenia spectrum" disorder that is on axis I. children learn to interpret social cues and respond appropriately but for unknown reasons this process does not work well for people with this disorder. With some adolescents. early separation. underachievement in school. and almost half of individuals with this disorder go on to develop a psychotic disorder. peculiar thoughts and language. If the psychotic episode lasts longer. hypersensitivity. individuals with Schizotypal Personality Disorder may experience very brief psychotic episodes (lasting minutes to hours). Technically speaking. poor peer relationships. trauma. and bizarre fantasies. these schizotypal features persist into adulthood.

" Prevalence Schizotypal personality disorder occurs in 0. dissociative. and visa versa. derealization.6%-4. Familial Pattern Schizotypal personality disorder is more common among first-degree biological relatives of those with schizophrenia.3% of patients with Schizotypal Personality Disorder develop psychosis.6%) personality disorder and major depressive disorder (92. Comorbid personality disorders may. This disorder occurs slightly more commonly in males. avoidant (96. Outcome This disorder is chronic. in fact. account for much of the morbidity attributed to axis I disorders in research and clinical practice. Signs and Symptoms control experiences) Intimacy Avoidance Social Withdrawal Lacking Suspiciousness . In a two-year follow-up study 48. Social Skill Behavior Beliefs Schizotypal Eccentric (odd.8%).3%). unusual. "High percentages of patients with schizotypal (98. thought- Intimacy Sociability Emotional Expression Trust II. bizarre) Odd (paranoid.2%). borderline (98.Comorbidity Personality disorders are an overlooked and underappreciated source of psychiatric morbidity.6% of the general population.8%) exhibited moderate (or worse) impairment or poor (or worse) functioning in at least one area. bizarre not amounting to Perception delusions) Perceptual Distortions (depersonalization. and obsessive-compulsive (87.

Treatment Psychotherapy . metaphorical. III. telepathy. beginning by early adulthood and present in a variety of contexts. According to American Psychiatric Association. or stereotyped). circumstantial. or "sixth sense".g. superstitiousness. belief in clairvoyance. Behavior or appearance that is odd. in children and adolescents. as indicated by five (or more) of the following:   Ideas of reference (excluding delusions of reference).Criteria for the Diagnosis of Schizotypal Personality Disorder.g. and reduced capacity for. Lack of close friends or confidants other than first-degree relatives. or other important areas of functioning. Unusual perceptual experiences. occupational. Suspiciousness or paranoid ideation. close relationships as well as by cognitive or perceptual distortions and eccentricities of behavior. Enduring pattern of inner experience and behavior must deviate markedly from the expectations of the individual's culture.      overelaborate.. including bodily illusions. Excessive social anxiety that does not diminish with familiarity and tends to  be associated with paranoid fears rather than negative judgments about self.. This enduring pattern is inflexible and pervasive across a broad range of personal and social situations. eccentric. Schizotypal personality disorder is characterized by a pattern of social and interpersonal deficits marked by acute discomfort with. Inappropriate or constricted affect. or peculiar. vague. Odd beliefs or magical thinking that influences behavior and is inconsistent with subcultural norms (e. This enduring pattern leads to clinically significant distress or impairment in social. Odd thinking and speech (e. bizarre fantasies or   preoccupations).

The patient often reports feelings of being "different" and not "fitting in" with others easily.g haloperidol and thiothixine) Self-Help There are not any self-help support groups or communities that we are aware of that would be conducive to someone suffering from this disorder. though. Medications Medication can be used for treatment of this disorder's more acute phases of psychosis. As with Avoidant Personality Disorder. Social skills training and other behavioral approaches which emphasize the learning of the basics of social relationships and social interactions may be beneficial. Psychosis is usually transitory. the clinician must exercise care in therapy to not directly challenge delusional or inappropriate thoughts. supportive. (e. While individual therapy is the preferred modality at the onset of therapy. As with Delusional Disorder and Paranoid Personality Disorder.As with most personality disorders. though. These phases are likely to manifest themselves during times of extreme stress or life events with which they cannot adequately cope. There is no simple solution to this problem. and client-centered environment should be established with initial rapport. which may be difficult to form or find in smaller communities. schizotypal personality disorder is best treated with some form of psychotherapy. Such approaches . Such a group should be for this specific disorder. the individual lacks an adequate social support system and usually avoids most social interactions because of extreme social anxiety. A warm. Individuals with this disorder usually distort reality more so than someone with Schizoid Personality Disorder. it may be appropriate to consider group therapy as the client progresses. usually because of their magical or delusion thinking. and should effectively resolve with the prescription of an appropriate anti-psychotic.

Berger.htm . 2016 at https://www. 5th ed. 2. Schizotypal Personality Disorder.com/disorders/sx33t.nlm. References: 1. American Psychiatric Association. (2014). Schizotypal Personality Disorder. 2016). 2016 at http://psychcentral.would likely not be very effective because a person with this disorder is likely to be mistrustful and suspicious of others and their motivations. Psych Central Stuff. F.gov/medlineplus/ency/article/001525.nih. making group help and dynamics unlikely and possibly harmful.htm 3. (January 01. VA: American Psychiatric Publishing. Diagnostic and statistical manual of mental disorders. (2013). Retrieved February 22. Arlington. Retrieved February 22.