Schizotypal Personality Disorder

Schizotypal personality disorder is a psychiatric condition marked by disturbed thoughts and behavior, unusual beliefs and fears, and difficulty with forming and maintaining relationships.

Definition

The word personality describes deeply ingrained patterns of behavior and the manner in which individuals think about themselves and their world. Personality traits are conspicuous features of behavior and are not necessarily pathological, although certain ones may encourage social problems. Personality disorders are enduring, persistent behavior patterns severe enough to cause significant impairment in functioning as well as internal distress.

Schizotypal personality disorder is a pattern of social and interpersonal difficulties that includes a sense of discomfort with close relationships, eccentric behavior, and unusual thoughts and perceptions of reality. Speech may include digressions, odd use of words or display "magical thinking," such as a belief in clairvoyance and bizarre fantasies. Patients usually experience distorted thinking, behave strangely, and avoid intimacy. They typically have few, if any, close friends, and feel nervous around strangers although they may marry and maintain jobs. The disorder, which may appear more frequently in males, surfaces by early adulthood and can exacerbate anxiety and depression.

Symptoms

People with this disorder may be severely disturbed and might appear schizophrenic. More commonly, however, patient beliefs (aliens, witchcraft, possessing a "sixth sense") are stranger than their behavior, and may often keep them isolated from normal relationships. Hallucinations, however, are not a common symptom. Other symptoms include:

  • Discomfort in social situations
  • Odd beliefs, fantasies or preoccupations
  • Odd behavior or appearance
  • Odd speech
  • Difficulty making/keeping friendships
  • Inappropriate display of feelings
  • Suspiciousness or paranoia

Causes

The cause of schizotypal personality disorder is unknown, but there is an increased incidence among relatives of those with the condition.

Awareness of risk, such as a family history of schizophrenia, may allow early diagnosis.

Treatments

Schizotypal patients rarely initiate treatment for their disorder, tending to seek relief from depressive problems instead. Some people may be helped by antipsychotic medications, but therapy is preferable in many situations. Patients severely afflicted with the disorder may require hospitalization to provide therapy and improve socialization. Schizotypal personality disorder patients do not often demonstrate significant progress. Treatment should therefore help patients establish a satisfying solitary existence.

The social consequences of serious mental disorders—those that affect a person's ability to function in social and occupational settings—can be calamitous. Comprehensive treatment is crucial to the alleviation of symptoms and finding a path toward recovery. Consumer self-help programs, family self-help, advocacy, and services for housing and vocational assistance complement and supplement the formal treatment system. Many of these services are operated by people who use mental health services themselves. The logic behind their leadership in delivery of these services is that those using the system might be especially effective in reaching out to those in need.

Psychotherapy

Behavioral modification, a cognitive-behavioral treatment approach, can allow schizotypal personality disorder patients to remedy some of their bizarre thoughts and behaviors. Recognizing abnormalities by watching videotapes and meeting with a therapist to improve speech habits are two effective methods of treatment.

Prognosis

The outcome varies with the severity of this typically chronic disorder.

References

  • American Psychiatric Association, Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition
  • National Institutes of Health: National Library of Medicine
  • National Mental Health Association

Last reviewed 04/18/2017