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Schizotypal Personality Disorder

Schizotypal Personality Disorder is one of the disorders in ‘Cluster A’ of the category of Personality Disorders. Like patients with schizoid personality disorder, patients with a schizotypal personality are socially and emotionally detached. Additionally, they display an oddity of thinking and perception that is somewhat similar to schizophrenia. Schizotypal Personality Disorder is sometimes diagnosed in people with schizophrenia before they begin to exhibit full-blown symptoms of schizophrenia, but most adults with Schizotypal Personality Disorder do not develop Schizophrenia. Some patients with schizotypal personality exhibit symptoms of magical thinking believing that a particular thought or action can control someone or something. Patients may believe that they can cause harm to others by simply thinking vengeful thoughts. They may also exhibit paranoid behavior and ideas. Schizotypal personality disorder includes deficient interpersonal relationships, disturbances in thinking, odd appearance, and eccentric behavior. Patients may talk to themselves, and believe they have extra sensory abilities or that unrelated events relate to them, and are of great importance. The patient may often digress while speaking.

Their speech may be convoluted and hard to follow, and they may use odd words and descriptions, and juvenile vocabulary when communicating. Schizotypal patients are hypersensitive to criticism, resist intimacy and typically have few, if any, close friends. They may feel anxious around strangers although they might marry and be productive at work in spite of their odd behavior, dress and appearance.

The disorder is more prevalent in males, and appears by early adulthood. The cause is unknown, but there is an increased incidence in patients with a family history of Schizophrenia.

What are the symptoms?

• Odd behavior, dress, speech patterns, thoughts and perceptions
• Is suspicious or paranoid of others
• Few friends, is not comfortable with intimacy
• Stiff and awkward with others, appears cold or distant
• Speech is convoluted, hard to follow
• Patient is often described as ‘odd’ or ‘eccentric’
• Uncomfortable or anxious in social situations
• Misinterprets reality, distorted perceptions, magical thinking
• Believes he has special powers, is overly superstitious
• Symptoms do not stem from other disorders like Schizophrenia, Mood Disorder, Psychotic Disorder, Pervasive Developmental Disorder

Idiosyncratic Personality Type is a non-pathological form of this disorder and does not require treatment.

How is it diagnosed and treated?

Doctors will perform a physical and mental evaluation to rule out other causes of symptoms. At least five of the following signs must be present to diagnose Schizotypal Personality Disorder:

• Indifferent to or detached from social relationships
• Eccentric behavior and speech
• Suspicion or paranoia
• Few friends or close associations
• Magical thinking not consistent with cultural norms
• Distorted thinking and perception
• Narrow or inappropriate emotional display
• Social Anxiety
• Other disorders (e.g. delusional disorders, schizophrenia, mood disorder, substance abuse) do not apply

Treatment(s) can include:

• Psychosocial treatment, psychotherapy
• Cognitive Behavioral Therapy
• Group Therapy
• Hospitalization in severe cases
• Medication as appropriate: anti-psychotic

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