Schizotypal Personality Disorder

What Is Schizotypal Personality Disorder?

Schizotypal personality disorder is one of a group of conditions informally called "eccentric" personality disorders. People who have these disorders often seem odd or peculiar to others. They also may show unusual thinking patterns and behaviors.

What are personality disorders?

People with personality disorders have long-standing patterns of thinking and acting that differ from what society considers usual or normal. Their rigid personality traits can cause problems and interfere with many areas of life, including social and work. People with significant personality disorders generally also have poor coping skills and trouble forming healthy relationships.

Unlike people with anxiety disorders, who know that they have a problem but can’t control it, people with personality disorders generally are not aware that they have a problem and do not believe that they have anything to control.

 

Schizotypal Personality Disorder Symptoms

People with schizotypal personality disorder have odd behavior, speech patterns, thoughts, and perceptions. Other people often describe them as strange or eccentric. People who have this disorder may also:

  • Dress, speak, or act in an odd or unusual way
  • Be suspicious and paranoid
  • Be uncomfortable or anxious in social situations due to their distrust of others
  • Have few friends
  • Be very uncomfortable with intimacy
  • Tend to misinterpret reality or to have distorted perceptions (for example, mistaking noises for voices)
  • Have odd beliefs or magical thinking (for example, being overly superstitious or thinking of themselves as psychic)
  • Be preoccupied with fantasy and daydreaming
  • Tend to be stiff and awkward when relating to others
  • Come across as emotionally distant, aloof, or cold
  • Have limited emotional responses or seem “flat”

Schizotypal Personality Disorder vs. Schizophrenia

People with schizotypal personality disorder may have odd beliefs or superstitions. They have trouble forming close relationships and tend to distort reality. In this way, schizotypal personality disorder can seem like a mild form of schizophrenia, a serious brain disorder that distorts the way a person thinks, acts, expresses emotions, perceives reality, and relates to others.

People who have schizophrenia are disconnected from reality. They may have delusions and see or hear things that aren’t there (hallucinations). But people who have schizotypal personality disorder don’t.

In rare cases, people with schizotypal personality disorder may go on to develop schizophrenia.

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Schizotypal Personality Disorder Causes

Your genes may play a role in schizotypal personality disorder. It’s more common in relatives of people with schizophrenia and usually starts in early adulthood. A person’s temperament, reactions to life events, relationships, and coping strategies probably all have something to do with how their personality develops during childhood and adolescence.

Schizotypal Personality Disorder Diagnosis

If you have symptoms, your doctor will ask about your medical history and may do a physical exam. There are no lab tests to diagnose personality disorders, but your doctor might use other tests to rule out physical illness as the cause of the symptoms.

They might recommend that you see a psychiatrist or a psychologisthealth care professionals who are trained to diagnose and treat mental illnesses. Psychiatrists and psychologists use special interview and assessment tools to diagnose personality disorders.

Schizotypal Personality Disorder Treatment

People with schizotypal personality disorder rarely get treatment for the disorder itself. When they do go to the doctor, it’s often for a related disorder, such as depression or anxiety. Your treatment may include:

Psychotherapy

Psychotherapy -- a form of counseling -- is the most common treatment. The symptoms of schizotypal personality disorder could make it hard to begin a relationship with a therapist. But over time, you and your doctor can set common goals and work toward them.

The aim of therapy is to help you change your relationship styles, expectations, coping patterns, and habits of thinking and behavior. People with this disorder can often learn to realize when they are distorting reality.

Psychotherapy may include:

  • Cognitive behavioral therapy (CBT), which shows you how other people may see your behavior and helps you manage anxiety and improve your social skills.
  • Supportive therapy. This teaches you how to handle negative emotions or thoughts, how to trust people, and how to build relationships.
  • Supportive-expressive therapy. This helps you get rid of negative biases about relationships. You’ll open up about your thoughts, feelings, and concerns.
  • Family therapy. Treatment works best when family members are involved and supportive.

Medication

People with schizotypal personality disorder who also have another disorder, such as anxiety or depression, might take medication. But it usually isn’t the main treatment for personality disorders. 

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Your doctor could prescribe:

  • Antipsychotics such as aripiprazole (Abilify, Aristada), olanzapine (Zyprexa), quetiapine (Seroquel), or risperidone (Risperdal)
  • Stimulants like methylphenidate (Concerta, Ritalin)
  • The ADHD drug guanfacine (Intuniv, Tenex)
  • Benzodiazepines such as clonazepam (Klonopin)
  • Gabapentin (Gralise, Neurontin), which treats seizures

In some cases, especially during a period of crisis or severe stress, you might have severe symptoms and need to stay in the hospital briefly.

Lifestyle management

Things in your daily life that may help you manage schizotypal personality disorder symptoms include:

  • Healthy relationships with friends and family
  • A regular schedule with plenty of sleep and exercise
  • Taking your medications as directed
  • Opportunities to meet goals or make achievements at school, at work, or in recreational activities

 

Schizotypal Personality Disorder Complications

People with this disorder might be more likely to have anxiety or depression. They also tend to have poor social skills and lack fulfilling relationships. Without treatment, people with this disorder can become even more uncomfortable in social situations, which can lead to further isolation.

Schizotypal Personality Disorder Outlook

Your outlook depends on how severe the symptoms are. People who are motivated to change, get treatment, and stick with it have better results.

WebMD Medical Reference Reviewed by Brunilda Nazario, MD on July 23, 2020

Sources

SOURCES:

Mayo Clinic.

Sheppard Pratt: “Schizotypal Personality Disorder.”

Mount Sinai: “Schizotypal personality disorder.”

UpToDate: “Psychotherapy for schizotypal personality disorder,” “Approach to treating schizotypal personality disorder.”

Merck Manual Consumer Version: “Schizotypal Personality Disorder.”

Mayo Clinic: “Schizotypal personality disorder.”

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