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Schizotypal personality disorder

Definition

Schizotypal personality disorder is a mental health condition in which a person has trouble with relationships and disturbances in thought patterns, appearance, and behavior.

Causes, incidence, and risk factors

The exact cause is unknown. Genes are thought to be involved, because this condition is more common in relatives of schizophrenics.

Schizotypal personality disorder should not be confused with schizophrenia. People with schizotypal personality disorder can have odd beliefs and behaviors, but they are not disconnected from reality and usually do not hallucinate.

Hallucinations, delusions (fixed, false beliefs), and loss of touch with reality are hallmarks of psychosis. People with schizotypal personality disorder do not usually have psychotic symptoms.

Between 30% and 50% of people with schizotypal personality disorder also have a major depressive disorder. A second personality disorder, such as paranoid personality disorder, is also common with this condition.

Symptoms

People with schizotypal personality disorder may be very disturbed. Their odd behavior may look like that of people with schizophrenia. For example, they may also have unusual preoccupations and fears, such as fears of being monitored by government agencies.

More commonly, however, people with schizotypal personality disorder behave oddly and have unusual beliefs (such as aliens). They cling to these beliefs so strongly that it prevents them from having relationships.

People with schizotypal personality disorder feel upset by their difficulty in forming and keeping close relationships. This is different from people with schizoid personality disorder, who do not want to form relationships.

Signs and tests

Some of the common signs of schizotypal personality disorder include the following:

• Discomfort in social situations
• Inappropriate displays of feelings
• No close friends
• Odd behavior or appearance
• Odd beliefs, fantasies, or preoccupations
• Odd speech

Treatment

Some people may be helped by antipsychotic medications. Talk therapy (psychotherapy) is a big part of treatment. Social skills training can help some people cope with social situations.

Support Groups

Expectations (prognosis)

Schizotypal personality disorder is usually a long-term (chronic) illness. The outcome of treatment varies based on the severity of the disorder.

Complications

• Poor social skills
• Lack of interpersonal relationships

Calling your health care provider

Talk to your health care provider or mental health professional if:

• You have trouble forming and keeping relationships due to unusual beliefs
• You suspect that your child may have this problem

Prevention

There is no known prevention. Awareness of risk, such as a family history of schizophrenia, may allow early diagnosis.

References

Blais MA, Smallwood P, Groves JE, Rivas-Vazquez RA. Personality and personality disorders. In: Stern TA, Rosenbaum JF, Fava M, Biederman J, Rauch SL, eds. Massachusetts General Hospital Comprehensive Clinical Psychiatry. 1st ed. Philadelphia, Pa: Mosby Elsevier; 2008:chap 39.