Schizotypal Personality Disorder

Schizotypal personalities are characterized by odd forms of thought, perception and beliefs. They may have bizarre mannerisms, an eccentric appearance, and speech that is excessively elaborate and difficult to follow. However, these cognitive distortions and eccentricities are only considered to be a disorder when the behaviors become persistent and very disabling or distressing.

In social interactions, schizotypals may react inappropriately, not react at all, or talk to themselves. They may believe that they have extra sensory powers or that they are connected to unrelated events in some important way. However, people with this disorder tend to avoid intimacy and typically have few close friends. Although schizotypals may marry and hold down jobs, they are prone to feel nervous around strangers (Dobbert 2007).

The Schizophrenic Continuum

Schizotypal disorder is considered part of the "schizophrenic spectrum" of mental illness, which also includes schizoid personality disorder and schizophrenia. Although schizophrenia is categorized as a psychotic disorder and both schizoid and schizotypal are Cluster A personality disorders, all three share symptoms, such as avoidance of social relations and flat emotional affect. An important difference is that people with schizoid personality don't typically experience the perceptual distortions, paranoia or delusions typical of schizotypal personality or the psychotic episodes of schizophrenia (Waldeck 2000).

Prevalence of Schizotypal Disorder

This disorder occurs more frequently in individuals who have an immediate family member with schizophrenia or other psychotic disorders. The incidence of schizotypal personality is estimated at 3% of the general population and appears to be slightly prevalent among men than women (Encyclopedia of Mental Disorders).

Diagnosis of Schizotypal Personality

According to the DSM-IV-TR (Diagnostic and Statistical Manual of Mental Disorders), a patient must fit the following criteria in order to be diagnosed with schizotypal personality disorder.

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
• odd beliefs or magical thinking that influences behavior and is inconsistent with subcultural norms
• unusual perceptual experiences, including bodily illusions
• odd thinking and over-elaborate speech
• suspiciousness or paranoid thought process
• inappropriate or constricted affect (externally displayed emotion or mood)
• behavior or appearance that is odd, eccentric, or peculiar
• lack of close friends other than first-degree relatives
• excessive social anxiety that does not diminish with familiarity and tends to be associated with paranoid fears

Treatment and Prognosis of Schizotypal Personality

Schizotypal patients rarely seek treatment for their personality disorder, but may voluntarily see a mental health professional for help with anxiety, depression, or other negative emotions.

Antipsychotic medications may be useful for some individuals, but, as with most personality disorders, psychotherapy is the preferred treatment. Therapy is not generally useful for restructuring the schizotypals personality, but for those higher-functioning individuals, therapy can help them control some of the bizarre thoughts and behaviors and increase their social skills.

Cognitive-behavioral therapy has been used to help schizotypal patients to learn to control some of their bizarre thoughts and behaviors. Watching themselves on videotape can facilitate patients' recognition of behavioral abnormalities, and abnormal speech habits can sometimes be improved through therapy (Encyclopedia of Mental Disorders).This Suite 101 article is a summary of Schizotypal Personality Disorder. The contents of this article are not meant to be used for diagnosis and are not a substitute for professional help and counseling.

Sources

American Psychiatric Association APA (2000) Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR).

Dobbert, D. (2007) Understanding Personality Disorders: An Introduction. Greenwood Press.

Waldeck, T. and Miller, L. S. (2000) Social Skills Deficits in Schizotypal personality Disorder. Psychiatry Research, 93.