Schizotypal personality disorder
Schizotypal personality disorder
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, leading to severe anxiety and a tendency to turn inward in social situations.
In schizotypal personality disorder, people also exhibit odd behaviors, respond inappropriately to social cues and hold peculiar beliefs.
Schizotypal personality disorder typically begins in early adulthood and is likely to endure, though symptoms may improve with age. Medications and therapy also may help.
People with classic schizotypal personalities are apt to be loners. They feel extremely anxious in social situations, but they're likely to blame their social failings on others. They view themselves as alien or outcast, and this isolation causes pain as they avoid relationships and the outside world.
People with schizotypal personalities may ramble oddly and endlessly during a conversation. They may dress in peculiar ways and have very strange ways of viewing the world around them. Often they believe in unusual ideas, such as the powers of ESP or a sixth sense. At times, they believe they can magically influence people's thoughts, actions and emotions.
In adolescence, signs of a schizotypal personality may begin as an increased interest in solitary activities or a high level of social anxiety. The child may be an underperformer in school or appear socially out-of-step with peers, and as a result often becomes the subject of bullying or teasing.
Schizotypal personality disorder symptoms include:
Schizotypal personality disorder can easily be confused with schizophrenia, a severe mental illness in which affected people lose all contact with reality (psychosis). While people with schizotypal personalities may experience brief psychotic episodes with delusions or hallucinations, they are not as frequent or intense as in schizophrenia.
Another key distinction between schizotypal personality disorder and schizophrenia is that people with the personality disorder usually can be made aware of the difference between their distorted ideas and reality. Those with schizophrenia generally can't be swayed from their delusions.
Both disorders, along with schizoid personality disorder, belong to what's generally referred to as the schizophrenic spectrum. Schizotypal personality falls in the middle of the spectrum, with schizoid personality disorder on the milder end and schizophrenia on the more severe end.
When to see a doctor
People with schizotypal personality are likely to seek help only at the urging of friends or relatives. If you suspect a friend or family member may have the disorder, be on the lookout for certain signs. You might gently suggest that the person seek medical attention, starting with a primary care physician or mental health provider.
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.
When someone chronically feels or behaves in an inappropriate way, that person has a personality disorder.
In normal development, children learn over time to accurately interpret social cues and respond appropriately. For people with schizotypal personalities, something goes wrong during this process, leading to illogical beliefs, magical thinking and paranoia. What exactly goes wrong isn't known, but it's likely that one or more factors — such as childhood abuse, neglect or stress — cause problems with the way the brain functions.
Factors that appear to increase the risk of schizotypal personality disorder include:
People with schizotypal personality disorder are at an increased risk of:
Preparing for your appointment
You're likely to start by seeing your family doctor or a general practitioner. However, in some cases when you call to set up an appointment, you may be referred immediately to a psychiatrist.
Here's some information to help you prepare for your appointment, and what to expect from your doctor.
What you can do
For schizotypal personality disorder, some basic questions to ask your doctor include:
In addition to the questions that you've prepared to ask your doctor, don't hesitate to ask questions during your appointment at any time that you don't understand something.
What to expect from your doctor
What you can do in the meantime
If you have fantasies about hurting yourself or someone else, go to an emergency room or call 911 or your local emergency number immediately.
Tests and diagnosis
Doctors diagnose personality disorders based on a thorough interview about your symptoms as well as your personal and medical history. A physical examination will help rule out other conditions, and a mental health provider will likely be consulted for further evaluation.
For a diagnosis of schizotypal personality disorder, at least five of the following criteria must be met, according to criteria spelled out in the Diagnostic and Statistical Manual of Mental Disorders (DSM), published by the American Psychiatric Association:
In addition, to be diagnosed with schizotypal personality disorder, a person must never have met the criteria for any other schizophrenic disorder.
To distinguish schizotypal personality disorder from schizophrenia, doctors look for the presence of psychosis and experiences with hallucinations or delusions.
Treatments and drugs
Treatment for schizotypal personality disorder often includes a combination of medication and one or more types of therapy:
Until recently, doctors generally believed that once a personality disorder has developed, it will last throughout life. However, it's thought that symptoms of conditions such as schizotypal personality disorder may improve over time. Factors that appear most likely to reduce the symptoms of this disorder include positive relationships with friends and family as well as a sense of achievement at school, work and in extracurricular activities.
These experiences may create a protective effect by fostering — among other positive traits — self-confidence, a belief in one's ability to overcome difficulty and a sense of social support. In addition, early interventions such as youth programs that foster personal achievement and strong community relationships may help prevent personality disorders in at-risk children. The earlier these kinds of interventions reach a child in any challenging situation, the better are his or her chances of doing well.
Last Updated: 2010-10-08
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