Symptoms and causes

Symptoms

Schizotypal personality disorder typically includes five or more of these signs and symptoms:

  • Being a loner and lacking close friends outside of the immediate family
  • Incorrect interpretation of events, such as a feeling that something which is actually harmless or inoffensive has a direct personal meaning
  • Peculiar, eccentric or unusual thinking, beliefs or mannerisms
  • Dressing in peculiar ways, such as appearing unkempt or wearing oddly matched clothes
  • Belief in special powers, such as mental telepathy or superstitions
  • Unusual perceptions, such as sensing an absent person's presence or having illusions
  • Persistent and excessive social anxiety
  • Peculiar style of speech, such as vague or unusual patterns of speaking, or rambling oddly during conversations
  • Suspicious or paranoid thoughts and constant doubts about the loyalty of others
  • Flat emotions or limited or inappropriate emotional responses

Signs of schizotypal personality disorder, such as increased interest in solitary activities or a high level of social anxiety, may be seen in the teen years. The child may be an underperformer in school or appear socially out of step with peers, and as a result is often bullied or teased.

Schizotypal personality disorder vs. schizophrenia

Schizotypal personality disorder can easily be confused with schizophrenia, a severe mental illness in which people lose contact with reality (psychosis). While people with schizotypal personality disorder may experience brief psychotic episodes with delusions or hallucinations, the episodes are not as frequent, prolonged or intense as in schizophrenia.

Another key distinction is that people with schizotypal personality disorder usually can be made aware of the difference between their distorted ideas and reality. Those with schizophrenia generally can't be swayed away from their delusions.

Despite the differences, people with schizotypal personality disorder can benefit from treatments similar to those used for schizophrenia. Schizotypal personality disorder is sometimes considered to be on a spectrum with schizophrenia, with schizotypal personality disorder viewed as less severe.

When to see a doctor

People with schizotypal personality disorder 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, you might gently suggest that the person seek medical attention, starting with a primary care physician or mental health provider.

If you need immediate help

If you're concerned that you might harm yourself or someone else, go to an emergency room or call 911 or your local emergency number immediately. Or call a suicide hotline number. In the U.S., call the National Suicide Prevention Lifeline at 1-800-273-TALK (1-800-273-8255).

Causes

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.

In normal development, children learn over time to accurately interpret social cues and respond appropriately. What exactly goes wrong for a person with schizotypal personality disorder isn't known for certain, but it's likely that changes in the way the brain functions and genetics may play a role.

Risk factors

Your risk of schizotypal personality disorder may be greater if you have a relative who has schizophrenia or another psychotic disorder.

Complications

People with schizotypal personality disorder are at an increased risk of:

  • Depression
  • Anxiety
  • Work, school, relationship and social problems
  • Other personality disorders
  • Problems with alcohol or drugs
  • Suicide attempts
  • Temporary psychotic episodes, usually in response to stress
  • Schizophrenia
April 01, 2016
References
  1. Schizotypal personality disorder. In: Diagnostic and Statistical Manual of Mental Disorders DSM-5. 5th ed. Arlington, Va.: American Psychiatric Association; 2013. http://www.psychiatryonline.org. Accessed March 14, 2016.
  2. Hur JW, et al. Biological motion perception, brain responses, and schizotypal personality disorder. JAMA Psychiatry. 2016;73:260.
  3. Stone MH. Paranoid, schizotypal, and schizoid personality disorders. In: Gabbard's Treatment of Psychiatric Disorders. 5th ed. Arlington, Va.: American Psychiatric Association; 2014. http://psychiatryonline.org/doi/full/10.5555/appi.books.9781585625048.gg00pre. Accessed March 14, 2016.
  4. Silk KR. Personality disorders. http://www.uptodate.com/home. Accessed March 14, 2016.
  5. Rosell DR, et al. Schizotypal personality disorder: A current review. Current Psychiatry Report. 2014;16:452.
  6. Get help. National Suicide Prevention Lifeline. http://www.suicidepreventionlifeline.org/gethelp.aspx. Accessed March 16, 2016.
  7. Palmer BA (expert opinion). Mayo Clinic, Rochester, Minn. March 21, 2016.