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Schizotypal Personality Disorder

Reviewed by Psychology Today Staff

Schizotypal personality disorder is an ingrained pattern of thinking and behavior marked by unusual beliefs and fears, and difficulty with forming and maintaining relationships. This disorder is within the schizophrenia spectrum.

People with schizotypal personality disorder are uncomfortable with close relationships and may exhibit eccentric behavior. Speech may include digressions, odd use of words, or evidence of magical thinking, such as a belief in clairvoyance and bizarre fantasies. Patients usually experience distorted thinking 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.

Schizotypal personality disorder is classified under the Diagnostic and Statistical Manual of Mental Disorders-5. Cluster A is described as odd, eccentric. The other two cluster A personality disorders are schizoid personality disorder and paranoid personality disorder. Social awkwardness and withdrawal are hallmarks of this cluster.


People with this disorder are solitary in nature; they avoid socializing and derive little pleasure from interacting with others, a hallmark of the schizoid personality as well. They have the tendency to warp and misinterpret social interactions, leading them to feel distrust and paranoia. Those with schizotypal personality, however, demonstrate strange beliefs in addition to avoidance of others and potential for paranoia. Beliefs might include the existence of aliens or that they possess a sixth sense or telepathy. According to the DSM-5 and the NIH, the symptoms include:

  • Discomfort in social situations, social anxiety
  • Odd beliefs, fantasies, or preoccupations
  • Odd behavior or appearance
  • Odd speech
  • Difficulty making and keeping friendships, lack of close friends
  • Inappropriate display of feelings or lack of emotion
  • Suspiciousness or paranoia
How is schizotypal personality disorder diagnosed?

The health professional, psychiatrist or psychologist will want to know when symptoms appeared, early childhood experiences, daily functioning at home, work, or school, as well as what emotions come up in social settings. An individual might also be asked whether they have any first-degree relatives with schizophrenia spectrum disorders. 

What is the difference between schizoid and schizotypal personality disorders?

Both are Cluster A disorders and are described as odd and eccentric. A big difference is that people with schizoid personality disorder are in touch with reality, while those with schizotypal personalities are paranoid and suspicious of others.

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As with most personality disorders, the cause of schizotypal personality disorder is unknown, but there is an increased incidence among relatives of those with the condition, as well as those whose relatives are on the schizophrenia spectrum. The prenatal risk factors that apply to schizophrenia are also relevant to schizotypal personality disorder, including maternal exposure to certain viruses.

Drug use may be a contributing factor for people already at risk of developing this disorder due to an underlying genetic predisposition. The environment can play a role in risk as well. The risk is higher for a child who experiences trauma, abuse, neglect, and high stress.

How common is schizotypal personality disorder?

About 4 percent of the American population suffers from schizotypal personality disorder. It is also somewhat more prevalent in men than women. Schizotypal persoanlity disorder represents approximately 1 to 2 percent of all personality disorders diagnosed, according to a large Norwegian study.  As in other personality disorders, more people display some, but not all criteria of the disorder, meaning that their behavior may be notably "different," but they do not qualify for a clinical diagnosis. 


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 for most individuals. Because the characteristics of this disorder cannot be fundamentally altered for those with moderate to extreme cases, therapy is often aimed at helping people with this disorder establish a satisfying solitary existence. Talk therapy and family therapy are two types of treatment that may help the patient manage this sometimes life-long disorder.

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.

As with any condition, early diagnosis and intervention will greatly help the outcome. Therapy can also address co-occurring conditions, including depression and anxiety

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 updated: 07/23/2021