People with schizotypal disorder of personality exhibited a consistent long – term pattern of severe social constraints and relationship, seem to have little joy in life, regardless of the circumstances and usually choose to engage in solitary activities rather than those that involve other people, this can make treatment very challenging.
What is schizotypal personality disorder?
It is a mental disorder characterized by severe social anxiety , paranoid ideation, derealization, transient psychosis, and unconventional beliefs. People with this disorder feel extreme discomfort to maintain close relationships with people, mainly because they think that their peers harbor negative thoughts towards them, so they avoid forming them. Those who suffer from it can react strangely in conversations, not respond or speak alone.
They often interpret situations as strange or having an unusual meaning for them; paranormal and superstitious beliefs are common. Such people often seek medical attention for their anxiety or depression rather than their personality disorder , which occurs in about 3% of the general population and is more common in men.
The term “schizotypal” was first coined by Sandor Rado in 1956 as an abbreviation for “schizophrenic phenotype.” It is classified as a group A (“strange or eccentric”) personality disorder. It is believed to be part of a continuum of schizophrenia-related illnesses.
Symptoms of Schizotypal Personality Disorder
People with this disorder can be severely disturbed and appear schizophrenic, and commonly the patient’s beliefs (aliens, witchcraft, possessing a “sixth sense”) are stranger than their behavior, and often keep them isolated from normal relationships. The hallucinations are not a common symptom. These begin in early adulthood and occur in a variety of contexts, as indicated by five (or more) of the following:
- Ideas of reference (excluding delusions of reference).
- Discomfort in social situations.
- Weird beliefs, fantasies, or worries.
- Strange behavior or appearance.
- Strange speech.
- Difficulty making / maintaining friendships.
- Inappropriate display of feelings.
People tend to lead lonely lives, if you have intense social anxiety you may find it difficult to establish relationships and you may blame others for your discomfort in social situations.
People with this disorder generally do not have psychotic symptoms. Delusions are fixed and false beliefs but they often have reference ideas, what he means is that it is an incorrect interpretation of accidental incidents and external events that the person believes have a particular and unusual meaning. This meaning can be in general or for the person experiencing the reference idea.
Like most personality disorders, this type of disorder will generally decrease in intensity with age, and many people will experience some of the most extreme symptoms by the time they are in their 40s and 50s.
Causes of schizotypal personality disorder
Experts do not have a clear understanding of the causes, it has been theorized that genetics play a fundamental role in its development because the disorder is more common in families with schizophrenia . Most experts believe that causation stems from a triple and complex combination of genetic, biological, and social factors.
People with a family history of schizophrenia and other psychopathologies are at a higher risk of developing it, in fact, research indicates that those with a first-degree relative who has schizotypal symptoms may be up to 50 percent more likely to develop the disorder compared to others.
Environmental factors, especially childhood experiences, may play a role in the development of this disorder. These factors include:
How is schizotypal personality disorder diagnosed?
Most people with this disorder are diagnosed in early adulthood, if your doctor suspects you have it, they will start by doing a physical exam to check for physical conditions that could cause your symptoms, they will also ask about your symptoms and if other family members have personality disorders.
Your doctor may refer you to a psychiatrist or psychologist for a psychiatric evaluation, they will likely ask you about:
- When the symptoms started.
- How your symptoms affect your daily life.
- How you feel in social situations.
- Your experiences at school and work.
- Your childhood.
The psychiatrist or psychologist may ask if you have ever thought about harming yourself or others and if your family members have commented on your behavior. Your answers will help them develop a diagnosis.
What tests diagnose this type of disorder?
There is no specific definitive test, such as a blood test, that can accurately assess whether a person has schizotypal personality disorder, and those concerned that they may have this diagnosis could explore the possibility by taking a self-test, either online. such as a questionnaire, a structured interview, an inventory of feelings and experiences, the Oxide Inventory of Schizotypal Cognitions, the Community Assessment of Psychic Experiences or the Schizotypal Personality Scale.
To determine the presence of the disorder, health professionals conduct a mental health interview that looks for the history and presence of symptoms, also called diagnostic criteria, previously described.
As with any evaluation, the professional will generally work to rule out other mental disorders, including detecting mood problems such as depression and anxiety, including generalized anxiety , obsessive-compulsive symptoms, types of other personality disorders such as narcissism , antisocial , schizoid or histrionic , drug abuse problems , as well as problems of being out of touch with reality, such as schizophrenia or delusional disorder.
In addition to determining whether the person has schizotypal personality disorder, the mental health professional may determine that although there are some symptoms (traits) of the disorder, the person does not fully qualify for the diagnosis. Because often it has been found that the disorder occurs (called comorbid) with borderline personality disorder , disorder avoidant personality disorder and paranoid personality, the presence of these will also specifically explored.
The healthcare professional will also try to make sure that the person does not have a medical problem that can cause emotional symptoms that resemble those of schizotypal personality disorder, so they will ask when the person has recently had a physical exam. , complete blood tests and any other tests that you consider necessary to ensure that the individual does not have a medical condition.
Due to the use of an interview and the fact that this condition, like any personality disorder, can be quite resistant to treatment, it is of great importance that the professional knows how to perform a thorough evaluation, to ensure that it is not incorrectly evaluated that the person suffers from a disorder when in fact they are not.
When determining the presence of schizotypal personality disorder, the evaluator will likely explore whether the symptoms indicate the presence of a generalized pattern of social and interpersonal deficits marked by acute discomfort and reduced capacity for close relationships, as well as cognitive or perceptual distortions. and behavioral eccentricities, beginning in early adulthood and presenting in a variety of contexts as indicated by five or more of the aforementioned symptoms and signs.
The diagnosis should not be assigned if it only occurs during the course of having schizophrenia, bipolar disorder, or a depressive disorder with psychotic features, psychotic disorder , or an autism spectrum disorder.
Treatments for schizotypal personality disorder
Schizotypal patients rarely initiate treatment for their disorder, and instead tend to seek relief from depressive problems. Some people may be helped with antipsychotic medications, but therapy is preferable in many situations, severely affected patients may require hospitalization to provide therapy and improve socialization, although sometimes they do not show significant progress. Therefore, treatment should help patients to establish a satisfactory lonely existence.
The social consequences of severe mental disorders, that is, those that affect a person’s ability to function in social and occupational settings, can be dire. Comprehensive treatment is crucial to alleviating symptoms and finding a path to recovery.
Consumer self-help programs, family self-help, housing advocacy and services, and vocational assistance complement the formal treatment system.
Behavior modification, a cognitive-behavioral treatment approach, can allow patients with schizotypal personality disorder to remedy some of their strange thoughts and behaviors, recognize abnormalities by watching videotapes, and meet with a therapist to improve habits. speech are two effective methods of treatment. Read more information about Psychotherapy .
It is rarely considered as the main reason for treatment in a clinical setting, but occurs as a finding comorbid with other mental disorders. When patients are prescribed pharmaceuticals, they are more often prescribed the same medications that are used to treat patients with schizophrenia, including traditional neuroleptics such as haloperidol and thiothixene. In deciding what type of drug to use, two basic groups of schizotypal patients are distinguished:
- Schizotypal patients who appear to be almost schizophrenic in their beliefs and behaviors (aberrant perceptions and cognitions) are generally treated with low doses of antipsychotic medications. However, it should be mentioned that the long-term efficacy of neuroleptics is doubtful.
- For schizotypal patients who are more obsessive-compulsive in their beliefs and behaviors, SSRIs like Sertraline appear to be more effective.
Lamotrigine, an anticonvulsant, appears to be useful in treating social isolation.
Hello, how are you? My name is Georgia Tarrant, and I am a clinical psychologist. In everyday life, professional obligations seem to predominate over our personal life. It's as if work takes up more and more of the time we'd love to devote to our love life, our family, or even a moment of leisure.