What is schizotypal personality disorder

By Cristiano Antonino Last updated Jun 18, 2023

Although the essential characteristic of Schizotypal Personality Disorder is a picture characterised by social isolation and unusual and bizarre behaviour, the most relevant aspects are the oddities of thought

They revolve around four themes

1) suspiciousness and paranoid ideation (e.g. believing that others are plotting against them)

2) reference ideas (i.e. incorrect interpretations of unrelated events as if they were meaningfully connected);

3) bizarre beliefs and magical thinking (e.g. they may feel they have a special power to sense events before they happen or to read the thoughts of others);

4) unusual perceptual experiences (e.g. they may feel the presence of another person).

The patient with Schizotypal Personality Disorder

Because patients with schizotypal personality disorder are usually unable to utilise the full range of affect and interpersonal behaviours necessary to succeed in interpersonal relationships, they appear to interact with others in an inappropriate, rigid, or limited manner.

They are often considered odd or eccentric, dress shabbily and show a disregard for social conventions.

Such socially inappropriate behaviour contributes to social isolation.

Individuals with schizotypal disorder experience dealing with others as problematic.

They interact with other people when they have to, but prefer to be on their own, as they feel they are different.

Although there may be a lack of desire for relationships (as in patients with schizoid personality disorder), isolation is more likely to be a consequence of social anxiety and suspiciousness about the intentions of others.

Schizotypal personality disorder owes its name to the slight borderline that separates it from full-blown schizophrenia

These people do not present actual delusions or hallucinations, but their contact with reality is moderately impaired and the logic of their thinking is at least ‘strange’ and non-linear.

Therapy of schizotypal disorder is very difficult. It can rely, albeit partially, on the neuroleptic drugs used for schizophrenia and other psychotic syndromes and on medium- to long-term (1 to 2 years) cognitive-behavioural psychotherapeutic support.

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