Schizotypal Personality Disorder
Schizotypal personality disorder is among the three “eccentric” type personality disorders known as Cluster A. Schizotypal personality disorder features odd behaviors and mannerisms, but without the psychosis that accompanies schizophrenia. However, schizotypal personality disorder is sometimes considered a schizophrenia spectrum disorder. Similar to schizophrenia, individuals with schizotypal personality disorder have been found to have abnormalities of the dopamine production in the brain.
Individuals with schizotypal personality disorder do, however, sometimes display unusual beliefs, such as superstitions. These individuals prefer to live a solitary life because interpersonal interactions make them feel extremely uncomfortable, and in fact may fear being around people.
While similar to schizoid personality disorder because of the similar propensity towards live a loner-type lifestyle and avoiding intimacy, the schizotypal personality disorder includes a unique feature. These individuals may exhibit odd beliefs, such as in magic, witchcraft, clairvoyance, aliens, and having a “sixth sense,” further enhancing the eccentric features of this disorder.
As far as a cause for schizotypal personality disorder, it seems to have a strong genetic component. If there is a family member with schizophrenia then there is a higher chance of another family member developing schizotypal personality disorder. Other possible factors include childhood neglect, trauma, or abuse. Symptoms usually appear in early adulthood and affect more males than females.
Symptoms of Schizotypal Personality Disorder
According to the DSM-5, individuals with schizotypal personality disorder will have five of the following symptoms present:
- Odd thinking and speech patterns
- Suspiciousness and paranoid ideation
- Odd, eccentric, or peculiar behavior or appearance
- Ideas of reference
- Strange beliefs or magical thinking
- Inappropriate and constricted affect
- Odd perceptual experiences
- Few friends other than family members
- Intense social anxiety that does not resolve over time
Although rare, in some cases schizotypal personality disorder may emerge in childhood or adolescence. The symptoms might include:
- Bizarre fantasies
- Underachieving in school
- Difficulty in peer relationships
- Social anxiety, isolating behaviors
- Odd thoughts and language
The level of impairment caused by the symptoms of schizotypal personality disorder will help determine the diagnosis.
Diagnosis and Treatment of Schizotypal Personality Disorder
Diagnosing schizotypal personality disorder relies on an interview and assessment of symptoms. Prior to arriving at a diagnosis the individual will first undergo a physical exam to rule out any health conditions. If there are none, then a psychiatrist will begin the process of narrowing down the symptoms and to the possible disorders that align with the symptoms, including schizophrenia, psychotic disorders, bipolar disorders, and neurodevelopmental disorders such as autism. These may share some of the same features, so the psychiatrist or psychotherapist must be careful to arrive at an accurate diagnosis. There are some self-tests that can help in the diagnosing process, such as the Schizotypal Personality Questionnaire, the Structured Interview or Schizotypy, or the Oxford-Liverpool Inventory of Feelings and Experiences.
Treatment for schizotypal personality disorder will involve getting psychological support through cognitive behavioral therapy. CBT can help the individual identify thought distortions and help them learn new coping skills and better speech habits. Psychodynamic therapy is also useful for treating individuals with schizotypal personality disorder.
Because there is a high comorbidity with other mental health disorders, especially depression, dysthymia, and social phobia, medications may help. For those individuals with a more pronounced schizophrenic-like form of the disorder, antipsychotics may be prescribed.
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