People with schizotypal personality disorder
Schizotypal personality disorder - Symptoms and causes
Overview
People with schizotypal personality disorder are often described as odd or eccentric and usually have few, if any, close relationships. They generally don't understand how relationships form or the impact of their behavior on others. They may also misinterpret others' motivations and behaviors and develop significant distrust of others.
These problems may lead to severe anxiety and a tendency to avoid social situations, as the person with schizotypal personality disorder tends to hold peculiar beliefs and may have difficulty with responding appropriately to social cues.
Schizotypal personality disorder typically is diagnosed in early adulthood and is likely to endure across the lifespan, though treatment, such as medications and therapy, can improve symptoms.
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Symptoms
Schizotypal personality disorder typically includes five or more of these signs and symptoms:
- Being a loner and lacking close friends outside of the immediate family
- Flat emotions or limited or inappropriate emotional responses
- Persistent and excessive social anxiety
- Incorrect interpretation of events, such as a feeling that something that is actually harmless or inoffensive has a direct personal meaning
- Peculiar, eccentric or unusual thinking, beliefs or mannerisms
- Suspicious or paranoid thoughts and constant doubts about the loyalty of others
- Belief in special powers, such as mental telepathy or superstitions
- Unusual perceptions, such as sensing an absent person's presence or having illusions
- Dressing in peculiar ways, such as appearing unkempt or wearing oddly matched clothes
- Peculiar style of speech, such as vague or unusual patterns of speaking, or rambling oddly during conversations
Signs and symptoms of schizotypal personality disorder, such as increased interest in solitary activities or a high level of social anxiety, may be seen in the teen years. The child may be an underperformer in school or appear socially out of step with peers, which may result in teasing or bullying.
Schizotypal personality disorder vs. schizophrenia
Schizotypal personality disorder can easily be confused with schizophrenia, a severe mental illness in which people lose contact with reality (psychosis). While people with schizotypal personality disorder may experience brief psychotic episodes with delusions or hallucinations, the episodes are not as frequent, prolonged or intense as in schizophrenia.
Another key distinction is that people with schizotypal personality disorder usually can be made aware of the difference between their distorted ideas and reality. Those with schizophrenia generally can't be swayed away from their delusions.
Despite the differences, people with schizotypal personality disorder can benefit from treatments similar to those used for schizophrenia. Schizotypal personality disorder is sometimes considered to be on a spectrum with schizophrenia, with schizotypal personality disorder viewed as less severe.
When to see a doctor
People with schizotypal personality disorder are likely to seek help only at the urging of friends or family members. Or people with schizotypal personality disorder may seek help for another problem such as depression. If you suspect that a friend or family member may have the disorder, you might gently suggest that the person seek medical attention, starting with a primary care doctor or mental health professional.
If you need immediate help
If you're concerned that you might harm yourself or someone else, go to an emergency room or call 911 or your local emergency number immediately. Or contact a suicide hotline. In the U.S., call or text 988 to reach the 988 Suicide & Crisis Lifeline, available 24 hours a day, seven days a week. Or use the Lifeline Chat. Services are free and confidential.
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Causes
Personality is the combination of thoughts, emotions and behaviors that makes you unique. It's the way you view, understand and relate to the outside world, as well as how you see yourself.
Personality forms during childhood, shaped through an interaction of inherited tendencies and environmental factors.
In normal development, children learn over time to appropriately interact with others, to interpret social cues, and to respond to social situations appropriately and with flexibility. What exactly goes wrong for a person with schizotypal personality disorder isn't known for certain, but it's likely that changes in the way the brain functions, genetics, environmental influences and learned behaviors may play a role.
Risk factors
Your risk of schizotypal personality disorder may be greater if you have a relative who has schizophrenia or another psychotic disorder.
Complications
People with schizotypal personality disorder are at an increased risk of:
- Depression
- Anxiety
- Other personality disorders
- Schizophrenia
- Temporary psychotic episodes, usually in response to stress
- Problems with alcohol or drugs
- Suicide attempts
- Work, school, relationship and social problems
By Mayo Clinic Staff
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Schizotypal Personality Disorder: Symptoms & Treatment
Overview
What is schizotypal personality disorder?
Schizotypal personality disorder (STPD) is a mental health condition marked by a consistent pattern of intense discomfort with close relationships and social interactions.
People with STPD have distorted views of reality, superstitions and unusual behaviors. Their relationships are usually hindered by their symptoms.
Schizotypal personality disorder is one of a group of conditions called “Cluster A” personality disorders, which involve unusual and eccentric thinking or behaviors. Personality disorders are chronic (long-term) dysfunctional behavior patterns that are inflexible, prevalent and lead to social issues and distress.
People with schizotypal personality disorder typically display unusual behavior, odd speech and magical beliefs. They often don’t realize their behavior is unusual or problematic.
Some people with schizotypal personality disorder later develop schizophrenia.
What is the difference among schizoid and schizotypal personality disorders and schizophrenia?
Schizoid personality disorder (ScPD) is a mental health condition marked by a consistent pattern of detachment from and general disinterest in social relationships.
This is distinct from schizotypal personality disorder (STPD) because people with STPD have an intense discomfort with personal relationships, not a lack of interest in them.
People with STPD also have peculiar thoughts and behaviors, such as magical thinking, whereas people with ScPD generally don’t.
Many researchers consider schizotypal personality disorder to be one of the schizophrenia spectrum disorders, which also includes brief psychotic disorder, schizophreniform disorder, schizoaffective disorder and delusional disorder.
However, schizotypal personality disorder is distinct from schizophrenia because people with STPD don’t have psychotic symptoms, such as hallucinations and delusions, which are hallmarks of schizophrenia.
Schizophrenia negatively impacts someone’s day-to-day function much more than schizotypal personality disorder.
Who does schizotypal personality disorder affect?
Most personality disorders, including schizotypal personality disorder (STPD), begin in the teen years when personality further develops and matures.
STPD affects people assigned male at birth (AMAB) slightly more than people assigned female at birth (AFAB).
How common is schizotypal personality disorder?
Schizotypal personality disorder is relatively rare. It affects approximately 3% to 5% of people in the United States.
Symptoms and Causes
What are the signs and symptoms of schizotypal personality disorder?
People with schizotypal personality disorder experience intense discomfort and distress in social situations. They have a lot of difficulties forming close relationships and maintaining them, partially due to a distorted interpretation of social interactions, as well as odd social behavior.
A person with schizotypal personality disorder may:
- Have intense social anxiety and poor social relationships.
- Not have close friends or confidants, except for first-degree relatives.
- Have peculiar behaviors and mannerisms.
- Have odd thoughts and speech, such as using excessively abstract or concrete phrases or using phrases or words in unusual ways.
- Have unusual perceptive experiences and magical beliefs, such as thinking they have special paranormal powers.
- Incorrectly interpret ordinary situations or happenings as having special meaning for them (idea of reference).
- Be paranoid and suspicious of others’ intentions.
- Have difficulty with responding appropriately to social cues, such as maintaining eye contact.
- Have a lack of motivation and underachieve in educational and work settings.
A person with STPD generally lacks awareness about how their thoughts and behaviors impact others.
What causes schizotypal personality disorder?
Personality disorders, including schizotypal personality disorder, are among the least understood mental health conditions. Researchers are still trying to figure out the exact cause of them, but believe they develop due to several factors.
Researchers think the cause of schizotypal personality disorder (STPD) is mainly biological and genetic because it shares many of the brain changes characteristic of schizophrenia.
STPD is also more common among biological relatives of people with schizophrenia or Cluster A personality disorders, which suggests a genetic link.
Diagnosis and Tests
How is schizotypal personality disorder diagnosed?
Personality continues to evolve throughout childhood, adolescence and early adulthood. Because of this, healthcare providers don’t typically diagnose someone with schizotypal personality disorder until after the age of 18.
Personality disorders, including schizotypal personality disorder, can be difficult to diagnose since most people with a personality disorder don’t think there’s a problem with their behavior or way of thinking and don’t think they need to change their behavior.
When they do seek help, it’s often due to co-existing conditions, such as anxiety or depression, not the disorder itself. Rates of these two mental health conditions are particularly high among people with schizotypal personality disorder.
When a mental health professional, such as a psychologist or psychiatrist, suspects someone might have schizotypal personality disorder, they often ask questions that’ll shed light on:
- Childhood history.
- Relationships.
- Work history.
- Reality testing.
Because a person suspected of having schizotypal personality disorder may lack insight into their behaviors, mental health professionals often work with the person’s family and friends to collect more details about their behaviors and history.
Mental health providers base a diagnosis of schizotypal personality disorder on the criteria for the condition in the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders.
Management and Treatment
How is schizotypal personality disorder treated?
Psychotherapy (talk therapy) and low-dose antipsychotic (neuroleptic) medication are the main treatment options for schizotypal personality disorder.
Antipsychotic medication for schizotypal personality disorder
Healthcare providers sometimes prescribe low-dose antipsychotic (neuroleptic) medications for people with schizotypal personality disorder to treat the following symptoms:
- Cognitive peculiarities.
- Odd speech.
- Depression.
- Anxiety.
- Impulsivity.
Antipsychotic medications are particularly useful for people with moderately severe schizotypal symptoms and those experiencing mild, transient psychotic symptoms.
Psychotherapy for schizotypal personality disorder
Psychotherapy (talk therapy) is a term for a variety of treatment techniques that aim to help people identify and change troubling emotions, thoughts and behaviors. Working with a mental health professional, such as a psychologist or psychiatrist, can provide support, education and guidance to the person and their loved ones.
Types of psychotherapy that may benefit people with schizotypal personality disorder include:
- Group therapy: This is a type of psychotherapy in which a group of people meets to describe and discuss their problems together under the supervision of a therapist or psychologist. Group therapy may help someone with schizotypal personality disorder develop social skills because it addresses social anxiety and awkwardness.
However, people with more severe symptoms may be disruptive in group therapy, especially if they have prominent paranoid thinking and behaviors. - Cognitive behavioral therapy (CBT): This is a structured, goal-oriented type of therapy. A therapist or psychologist helps someone take a closer look at their thoughts and emotions to understand how their thoughts affect their actions. For someone with schizotypal personality disorder, a therapist may focus on reality testing and attention to interpersonal boundaries. They may also help the person recognize distorted thinking patterns, such as referential, paranoid or magical thinking.
Prevention
Can schizotypal personality disorder be prevented?
While schizotypal personality disorder generally can’t be prevented, treatment can allow a person who’s prone to this condition to learn more productive ways of altering unhelpful behaviors and thoughts.
Outlook / Prognosis
What is the prognosis (outlook) for schizotypal personality disorder?
Schizotypal personality disorder is a chronic condition that requires lifelong treatment.
If left untreated, the prognosis (outlook) for schizotypal personality disorder (STPD) is generally poor. It’s very common for people with STPD to have other mental health conditions, including:
- Social anxiety disorder.
- Depression.
- Obsessive-compulsive disorder.
- Substance use disorder.
About 30% to 50% of people have major depressive disorder when they’re diagnosed with STPD.
It’s essential that people with STPD receive treatment for these conditions.
A note from Cleveland Clinic
It’s important to remember that schizotypal personality disorder (STPD) is a mental health condition. As with all mental health conditions, seeking help as soon as symptoms appear can help decrease the disruptions in a person’s life. Mental health professionals can offer treatment plans that can help manage thoughts and behaviors.
The family members of people with STPD often experience stress, depression and isolation.
It’s important to take care of your mental health and seek help if you’re experiencing these symptoms.
What is schizotypal personality disorder?
Schizotypal personality disorder is a disorder characterized by abnormalities in interpersonal relationships, an emotional inner world, and extravagant behavior. People suffering from this disorder are usually prone to social isolation and inappropriate emotional reactions. Previously, in some classifications of mental disorders, schizotypal disorder was called "simple schizophrenia", but the manifestations of this disease differ from the symptoms of schizophrenia. Later, schizotypal personality disorder came to be defined as a completely separate and distinct disorder.
Symptoms of schizotypal personality disorder
A person suffering from schizotypal personality disorder usually behaves strangely, but he does not suffer from psychosis, his behavior is not inappropriate. For example, such people can behave shockingly, and this is not because it is important for them to show themselves in this way to others, but simply because they want to behave this way, they feel an inner need for it.
People with schizotypal personality disorder may dress unusually or untidy and wear clothes that do not fit. Most often they are lonely and do not seek the company of other people, they are quite comfortable in their rich inner world. Such people work, study and some of them start a family. But because they do suffer from a personality disorder, their socialization can be severely disrupted.
People suffering from this disease adequately perceive reality, and this greatly distinguishes them from people with schizophrenia.
People with schizotypal disorder are not interested in communicating with the outside world, and they can maintain some kind of contact only officially and superficially. If a patient with a schizotypal disorder has friendships, then they are very rare, and such a person does not need them on an ongoing basis. If he has to communicate with other people, he does this without much desire, because he considers himself different and does not feel part of the group.
However, sometimes such people say that the lack of relationships makes them unhappy. They also feel anxious in social situations, especially in unfamiliar ones.
People suffering from this disease adequately perceive reality, and this greatly distinguishes them from people with schizophrenia. Such people often work in areas related to abstract creativity, for example, in the field of computer graphics, painting, and so on. Also, such people can often be found among mathematicians, physicists, astronomers, paleontologists and archaeologists.
See also
Myths about schizophrenia
People with schizotypal personality disorder have odd ways of thinking, perceiving, and communicating. For example, such people may have magical thinking and believe that they somehow control the people around them by performing certain actions. They are sometimes paranoid, suspicious, distrustful, and mistakenly believe that other people are stalking or intent on harming them.
Sometimes people with schizotypal personality disorder believe that they have paranormal abilities, thanks to which they know about events before they happen, or read other people's minds. With all this, they are not psychotic and adequate.
Causes of schizotypal personality disorder
Any personality disorder begins to manifest from childhood. Already at 12-13 years old, a child may develop symptoms, and with an exacerbation of obvious symptoms at this age, an appropriate diagnosis can already be made. It is usually possible to determine the presence of symptoms of schizotypal disorder in a child based on his social activity. Such children are often unsociable and have social alienation. They are interested in spending time only with themselves, in their hobbies. If parents see that such a child is not socialized, they need to contact a psychologist.
A person suffering from schizotypal disorder does not believe that he is ill with anything, and does not experience problems because of his symptoms.
Schizotypal personality disorder develops mainly due to genetic factors, like other personality disorders, such as borderline personality disorder. As a rule, if a child develops schizotypal personality disorder, then personality disorder or personality accentuation can also be found in one of his family members. Parenting can only aggravate the symptoms or influence the child in such a way that he grows up as a person with a schizotypal personality structure. However, it is the disorder that develops in a person without connection with education. The transition from a personality structure to a personality disorder is manifested not in education, but in a deterioration in the quality of socialization. The less socialization, the more pathology manifests in a person.
Diagnosis and treatment of schizotypal personality disorder
Schizotypal personality disorder detected only by clinical interview. Unfortunately, not all professionals are qualified to recognize this disorder and separate its symptoms from those of other personality disorders.
As a rule, the symptoms of such disorders cause discomfort not in the patients themselves, but in the people who surround them. A person suffering from schizotypal disorder does not believe that he is ill with anything, and does not experience problems because of his symptoms. Patients with other personality disorders may worry about the reactions of others and seek help on their own.
See also
Myths about diagnosing mental illness
With schizotypal disorder, a person does not interfere with anyone, so it is unlikely that anyone will bring him for treatment. Very rarely, such people feel uncomfortable that they are alone and no one communicates with them. A person with schizotypal personality disorder may see that people around him are starting families, but he can't seem to find a partner. In this case, he may come to therapy with a very specific request to build a romantic relationship with someone.
However, such a person will never seek help with a request to save him from a personality disorder. People with this disease have empathy, so they may also come to treatment for a relative who cares deeply for them.
Treatment for schizotypal personality disorder can take many years. The most effective method of treatment is psychotherapy, however, it is difficult to say which one. In some cases, cognitive-behavioral therapy is used, and in others, psychodynamic therapy. Provided that the patient wants to achieve results and stay in psychotherapy, treatment for schizotypal personality disorder can last up to 5 years. Unfortunately, not all patients wait for the result and complete the treatment. In the process of psychotherapy, a specialist helps the patient to adjust the structure of his personality, change his worldview, and learn to adapt to the surrounding reality.
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Peculiarities of the course of schizotypal personality disorder – Central Medical Health Center “Alliance”
Schizotypal personality disorder is a mental condition characterized by abnormalities of thought and perception in the context of eccentric behavior that begin in early childhood.
Such people are characterized by problems in communication, suspicion, a tendency to strange beliefs and superstitions. All this prevents a person from living a normal life and, without timely psychiatric assistance, leads to social isolation, various addictions, or joining sects and cults.
Factors contributing to the development of a schizotypal personality:
- Hereditary predisposition - mental disorders in close relatives (especially the presence of schizophrenia).
- Psychological trauma, stress, unhealthy family environment.
- Biochemical features - characterized by high activity of the neurotransmitter dopamine.
ICD-10 considers schizotypal personality disorder as a disease that is difficult to distinguish from some other mental disorders. The disease resembles schizophrenia, but does not meet its diagnostic criteria. This condition does not have the typical symptoms of schizophrenia and is not characterized by deep personality defects.
Help for patients with schizotypal personality disorder is provided by a psychiatrist and psychotherapist.
Schizoid and schizotypal personality disorder also have similar features, but with the former, eccentric behavior and strange thinking are not so pronounced. In this regard, the diagnosis of schizotypal disorder is a difficult task, which requires an experienced specialist with high qualifications.
How to recognize schizotypal personality disorder?
Patients with schizotypal personality disorder tend to be socially withdrawn, which is also characteristic of people with schizoid personality disorder. But unlike schizoids, schizotypal individuals have pronounced cognitive (associated with thinking) and perceptual (associated with perception) impairments.
From the outside, the behavior of such people looks eccentric and inadequate. Strange beliefs and mystical thinking are observed: patients find clairvoyance or telepathy abilities in themselves or in someone from the environment, superstitions, symbols, omens become very important for them.
At the same time, emotions in relation to relatives become flattened, limited. There is coldness in communication, avoidance of contact with other people.
Important
It is often difficult for the patient and those around him to distinguish the characteristics of a person’s character, symptoms of fatigue or overstrain from the manifestations of the disease. To avoid exacerbations, you need to regularly visit the attending psychiatrist.
A person ceases to follow social norms: neglects personal hygiene, dresses eccentrically, a tendency to vagrancy may appear. Speech becomes incoherent, blurry, with many unnecessary details, it becomes difficult to perceive. All this can be the cause of ridicule, which leads to further aggravation of anxiety, isolation and suspicion.
However, unlike schizophrenic personality disorder, the condition in question is not characterized by full-fledged delusions and hallucinations. Patients may have features that are found in schizophrenia, have bizarre beliefs, and behave in defiance of social norms.
But at the same time, they are not characterized by isolation from reality. There are distortions of perception and thinking, when it seems to a person that he sees a shadow hiding in the corner or hears someone pronounce his name. However, he soon realizes that this is not true. Learn more about diagnosing schizotypal personality disorder.
A person who suffers from schizotypal personality disorder is recommended to start treatment with a specialist as soon as possible: without the necessary help, the disease will progress, worsen, and prevent a normal life and professional activity.
Treatment and course of schizotypal disorder
The treatment uses modern antipsychotics, tranquilizers and antidepressants. These drugs control symptoms and improve mood. Learn more about the treatment of schizotypal personality disorder.
The best result can be achieved with a combination of drug treatment with psychotherapy, which helps to understand one's condition, find motivation for recovery, teaches one to defend oneself from negative emotions and manage the situation.
