Diagnosis

People with schizotypal personality disorder may seek help from their primary care doctor because of other symptoms, such as anxiety, depression or problems coping with frustration, or for treatment of substance misuse.

After a physical exam to help rule out other medical conditions, your primary care doctor may refer you to a mental health professional for further evaluation.

Diagnosis of schizotypal personality disorder typically is based on:

  • Thorough interview about your symptoms
  • Your personal and medical history
  • Symptoms listed in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), published by the American Psychiatric Association

Treatment

Treatment for schizotypal personality disorder often includes a combination of psychotherapy and medication. Many people can be helped by work and social activities that are a fit for their personality styles.

Psychotherapy

Psychotherapy may help people with schizotypal personality disorder begin to trust others and learn coping skills by building a trusting relationship with a therapist.

Psychotherapy may include:

  • Cognitive-behavioral therapy — Identifying and challenging negative thought patterns, learning specific social skills, and modifying problem behaviors
  • Supportive therapy — Offering encouragement and fostering adaptive skills
  • Family therapy — Involving family members, which may help improve communication, trust and the ability to work together in the home

Medications

There are no medications approved by the Food and Drug Administration specifically for the treatment of schizotypal personality disorder. However, doctors may prescribe an antidepressant to help relieve or reduce certain symptoms, such as depression or anxiety. Some medications may help improve flexibility in thinking.

Coping and support

Though schizotypal personality disorder is lifelong, some symptoms may improve over time through experiences that help foster — among other positive traits — self-confidence, a belief in one's ability to overcome difficulty and a sense of social support.

Factors that appear most likely to help reduce some symptoms of this disorder include:

  • Positive relationships with friends and family
  • Healthy daily rhythms, including having a schedule, a good sleep routine, exercise and consistency with taking prescribed medications
  • A sense of achievement at school, at work and in extracurricular activities

Preparing for your appointment

You're likely to start by seeing your primary care doctor. However, when you call to set up an appointment, you may be referred to a mental health professional such as a psychiatrist or psychologist.

Take a family member or friend along, if possible. With your permission, someone who has known you for a long time may be able to answer questions or share information with the mental health professional that you don't think to bring up.

Here's some information to help you prepare for your appointment.

What you can do

Before your appointment, make a list of:

  • Any symptoms you or your family noticed, and for how long. Ask friends or family members if they've felt concerned about your behavior and what they've noticed.
  • Key personal information, including traumatic events in your past and any current, major stressors. Find out about your family's medical history, including any history of mental illness.
  • Your medical information, including other physical or mental health conditions with which you've been diagnosed.
  • All medications you take, including the names and dosages of any medications, herbs, vitamins or other supplements you're taking.
  • Questions you want to ask your doctor to make the most of your appointment.

Some basic questions to ask include:

  • What is likely causing my symptoms?
  • What are other possible causes for my symptoms?
  • What treatments are most likely to be effective for me?
  • How much can I expect my symptoms to improve with treatment?
  • How often will I need psychotherapy, and for how long?
  • Are there medications that can help?
  • Is there a generic alternative to the medicine you're prescribing?
  • If you're recommending medications, what are the possible side effects?
  • I have other health conditions. How can I best manage them together?
  • Are there any brochures or other printed material I can take? What websites do you recommend?

Don't hesitate to ask other questions during your appointment.

What to expect from your doctor

Your doctor is likely to ask you a number of questions, such as:

  • What are your symptoms?
  • When did you or your family first notice these symptoms?
  • How are your symptoms affecting your life?
  • Have your family members or friends expressed concern about your behavior?
  • Do you feel comfortable in social situations? Why or why not?
  • Do you have any close relationships?
  • If you're not satisfied with work, school or relationships, what do you think is causing your problems?
  • Have you ever thought about harming yourself or others? Have you ever actually done so?
  • Have you ever felt that other people can control your thoughts or that you could influence other people and events through your thoughts?
  • Have any of your close relatives been diagnosed with or treated for mental illness?

Your doctor or mental health professional will ask additional questions based on your responses, symptoms and needs. Preparing and anticipating questions will help you make the most of your appointment time.

Oct. 08, 2019
  1. Schizotypal personality disorder. In: Diagnostic and Statistical Manual of Mental Disorders DSM-5. 5th ed. American Psychiatric Association; 2013. https://dsm.psychiatryonline.org. Accessed March 10, 2019.
  2. Schizotypal personality disorder (STPD). Merck Manual Professional Version. https://www.merckmanuals.com/professional/psychiatric-disorders/personality-disorders/schizotypal-personality-disorder-stpd#. Accessed March 10, 2019.
  3. Damgaard Jakobsen K, et al. Antipsychotic treatment of schizotypy and schizotypal personality disorder: A systematic review. Journal of Psychopharmacology. 2017; doi:10.1177/0269881117695879.
  4. Kirchner SK, et al. Diagnosis and treatment of schizotypal personality disorder: Evidence from a systematic review. NPJ Schizophrenia. 2018; doi:10.1038/s41537-018-0062-8.
  5. Gabbard GO, ed. Paranoid, schizotypal, and schizoid personality disorders. In: Gabbard's Treatment of Psychiatric Disorders. 5th ed. American Psychiatric Association; 2014. https://psychiatryonline.org. Accessed March 10, 2019.
  6. Hur J-W, et al. Biological motion perception, brain responses, and schizotypal personality disorder. JAMA Psychiatry. 2016; doi:10.1001/jamapsychiatry.2015.2985.
  7. Rosell DR, et al. Schizotypal personality disorder: A current review. Current Psychiatry Report. 2014; doi:10.1007/s11920-014-0452-1.
  8. Talk to someone now. National Suicide Prevention Lifeline. https://suicidepreventionlifeline.org/talk-to-someone-now/. Accessed March 10, 2019.
  9. Balaratnasingam S, et al. Normal personality, personality disorder and psychosis: Current views and future perspectives. Current Opinion in Psychiatry. 2015; doi:10.1097/YCO.0000000000000124.
  10. Rosell DR. Approach to treating schizotypal personality disorder. https://www.uptodate.com/contents/search. Accessed March 11, 2019.
  11. Sawchuk CN (expert opinion). Mayo Clinic. Sept. 26, 2019.

Schizotypal personality disorder