Schizotypal Personality Disorder

What is schizotypal personality disorder?

Schizotypal personality disorder is a severe personality disorder related to paranoid personality disorder and schizophrenia.

It is a disorder which typically lasts for an individual’s entire life, and it requires lifelong treatment. Although the disorder is a challenge to live with, regular treatment for the disorder can help an individual have a happy, healthy, and functional life.

Schizotypal personality disorder overview

Schizotypal personality disorder is one of a cluster of three eccentric personality disorders – a group known as Cluster A. These disorders are characterized by social awkwardness and isolation, and are considered to be quite serious personality disorders. Individuals diagnosed with these disorders consider themselves to be out of sync or at odds with the rest of the world.

The group includes two other disorders: schizophrenic personality disorder and paranoid personality disorder. Individuals with eccentric personality disorders think and interact in ways that are often deemed bizarre and peculiar. Schizotypal personality disorder is often confused with schizophrenia, and although both disorders are categorized as Cluster A personality disorders, they are not the same disorder. Schizophrenia is a severe illness which is defined by a proclivity to intense delusions and hallucinations.

Schizophrenia is known for causing psychotic episodes, while schizotypal personality disorder does not usually cause psychosis. Schizophrenic individuals often experience difficulty in social interactions as a result of eccentric behavior – it is the outlandish thoughts and beliefs of those with STPD that impairs their social abilities. People with schizotypal personality disorder come across as peculiar, eccentric, and socially awkward. Their cognitive and mental distortions tend to be superstitious and magical – many of them believing in a sixth sense, telekinesis, and other paranormal phenomena.

Throughout their lives, individuals with schizotypal personality disorder experience great difficulty in even the most casual social encounters. Intimate relationships and close friendships are usually quite challenging for those with STPD. Maintaining or even finding an occupation which suits their personality may also be difficult for someone with the disorder. They will not understand or correctly interpret others’ mannerisms and behaviors in social interactions. As a result, schizotypal individuals may feel suspicious or wary of others, which usually gives way to extreme social anxiety and depression.

Although psychotic episodes are not common among those with STPD, they are possible. Additionally, because of its relation to schizophrenia, in certain individuals, schizotypal personality disorder may later become schizophrenia. While such occurrences are not frequent, patients should be aware of the possibility.

With regular treatment, symptoms and byproducts of the disorder can be reduced and minimized. This will typically require various forms of treatment – most notably psychotherapy. However, the disorder will continue throughout a person’s lifetime, with symptoms diminishing in intensity during mid-to-late adulthood.

Schizotypal personality disorder symptoms

An individual exhibiting signs of schizotypal personality disorder should seek the diagnosis and evaluation of a mental health professional as soon as possible. Often times, an individual with STPD will seek treatment for a problem which is tangential to the disorder – such as depression or anxiety.

A mental health professional will diagnose the patient through a series of evaluations in order to look for diagnostic criteria in the patient. Because STPD is a serious diagnosis, the mental health professional may also explore other potential causes of the patient’s symptoms. At current, there are no tests or X-rays which can diagnose or determine whether someone has schizotypal personality disorder. Additionally, certain other disorders have been found to frequently occur alongside schizotypy – for example, borderline personality disorder, paranoid personality disorder, and avoidant personality disorders.

Schizotypal personality disorder is most often diagnosed in a person’s early adulthood. Although indications of STPD may be present before an adult – during an individual’s adolescence, for example – a diagnosis of STPD is not typically made. This is because a person’s personality is still developing during adolescence. In rare cases, a diagnosis may be made, but requires that the patient display symptoms indicative of STPD for a period of about a year.

One or two symptoms is not a sufficient indication that a person has schizotypal personality disorder. Numerous signs of STPD should be present in order to suggest that someone has the disorder. Hallmark symptoms are: extreme social anxiety, inability to forge or maintain intimate relationships, and strange belief systems which often incorporate magical thinking. In most cases of STPD, it is the individual’s bizarre beliefs – rather than behavior – that causes them social awkwardness.

The following are signs and symptoms of schizotypal personality disorder:

  • Severe social anxiety: a persistent aversion to social interactions, even the most casual social encounters; schizotypal individuals lack close friends and confidantes outside of immediate family members.
  • Extreme discomfort with intimacy; those with STPD will experience a general inability to develop intimate or romantic relationships .
  • A bizarre and often grossly inaccurate interpretation of events and interactions with other people; a person with schizotypal personality disorder will often misread benign conversations in a way that provokes suspicion and paranoia in the schizotypal individual.
  • Outlandish, often fantastical beliefs, a preoccupation with fantasy and the paranormal – magical thinking is a common occurrence in individuals with STPD – that is generally inconsistent with their cultural upbringing.
  • Peculiar, idiosyncratic mannerisms and behaviors are also typical of such individuals – for example, choosing to dress in an unkempt, disorderly, or unconventional way.
  • A stiff, awkward, and generally aloof manner when relating to or socializing with others is a signature sign of schizotypal personality disorder; people with schizotypal personality disorder will generally exhibit emotional distance even when speaking with close family members and loved ones.
  • A schizotypal person will typically believe that they possess some form of special or magical powers, such as mind-reading, telepathy, or a sixth sense.
  • An individual with STPD will often speak in unusual speech patterns. They may communicate in a vague way or a way which is logically inconsistent and difficult for others to follow.
  • Individuals may display suspiciousness, hypervigilance, and/or paranoia even when paranoia is completely unfounded.
  • Flat or inappropriate emotional responses are common with schizotypal people in situations which would typically generate an emotional response.

Schizotypal personality disorder causes

The exact cause of schizotypal personality disorder is not definitively known. It is believed that schizotypal personality disorder is a result of both nurture and nature. In other words, it is a combination of various factors: the character with which a person is born, the way that they are raised, events and interactions which occurred to them as a child, and genetics.

Additionally, people with relatives that have a psychotic disorder, such as schizophrenia, are more likely to develop schizotypal personality disorder. In fact, studies have shown that someone is 50% more likely to develop STPD if a relative has schizophrenia.

Issues during a mother’s pregnancy may also increase a child’s likelihood to develop schizotypal personality disorder. If she smoked while pregnant, or if the child had any physical abnormalities when born, the chance of the child developing STPD in adulthood is higher.

Other factors which increase a person’s likelihood of developing the disorder include an unstable or low socioeconomic background, sexual abuse, physical abuse, and emotional abuse. Childhood drug use can also be a contributing factor.

There are thought to be two different types of schizotypal personality disorder. One is closely related to schizophrenia and is seen in individuals with a genetic vulnerability to schizophrenia. It is usually caused by neuro-developmental problems. The other type of schizotypal personality disorder is less predictable and more closely related to poor psycho-social capabilities.

Schizotypal personality disorder treatment

Treatment for schizotypal personality disorder tends to rely on a combination of methods, including psychotherapy and medication. Often times, if a patient is able to find a job, social activity, or hobby which they enjoy and find satisfying, symptoms of the disorder will subside.

While such activities cannot fix or cure the disorder, they can mitigate its negative effects, improve the individual’s quality of life, and increase an individual’s socialization. It is unusual for someone with schizotypal personality disorder to seek out treatment for the disorder. More often, they will seek treatment for a problem that may be a byproduct related to / of the condition, such as anxiety or depression.

Psychotherapy can help a schizotypal person learn how to confide and engage with others. Many different forms of therapy can help, including cognitive behavioral therapy (CBT), supportive therapy, and family therapy. Many types of psychotherapy have been found to be helpful to schizotypal individuals, so it is important that they try multiple types of therapy in order to find the best fit. It is not common for people with the disorder to greatly change their ways of socializing; therefore, the goal of therapy tends to be one which allows them to cope with and accept the disorder.

A significant purpose of therapy is to help the individual develop better social skills, since this is generally the aspect of a patient’s life that causes the greatest anxiety and depression. Therapy should be an ongoing process throughout a patient’s life and a part of their regular treatment.

Although there are no medications specifically formulated for schizotypal personality disorder, doctors will often prescribe other medications for the patient’s symptoms. Medications commonly prescribed to patients are: antipsychotics, mood stabilizers, antidepressants, and anti-anxiety pills.

However, medication is not often the primary way of treating schizotypal personality disorder. Usually, it is a way of keeping the other symptoms or conditions resulting from the disorder in check. It should be noted that medication can also bring about negative side effects for those with schizotypal personality disorder, so it is important to be aware of the potential risks that may accompany a medication.

Patients may need to experiment with various combinations of medicine before finding what works for them. Because many schizotypal patients suffer from depression, the most common medication prescribed to them is an antidepressant.

As with most other disorders, the inclusion and support of family members and loved ones in a patient’s treatment program tend to go hand-in-hand with better results. Although it is extremely rare that the disorder resolves itself, it is possible for a patient to live a satisfying life with STPD.

It is important that their treatment program focuses on how to live with the diagnosis, rather than trying to eliminate the disorder. It is also important that patients establish a support system and a wide network of resources, as it is the tendency of those with STPD to become recluses.

Schizotypal personality disorder prevention

Although schizotypal personality disorder is not currently preventable, the earlier that is caught and treated, the better the outcome for the patient. Remaining aware of signs and symptoms, as well as a family history which may make someone susceptible to the disorder, is important.

Societal and communal efforts to prevent substance abuse and child abuse in families can reduce the occurrences of mental health disorders, such as schizotypal personality disorder.

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Last Reviewed:
September 12, 2017
Last Updated:
September 12, 2017
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