Everyone has their own eccentricities or awkward behaviors. Sometimes, however, a person will begin to experience strange patterns of thinking and behaving and struggle to form relationships with others. This condition is a chronic mental illness known as schizotypal personality disorder (SPD).

People with schizotypal personality disorder are often identified as having an eccentric personality. They might take magical thinking, superstitions, or paranoid thoughts very seriously, avoiding people whom they irrationally mistrust. They also might dress strangely or ramble in speech. These behaviors can make it difficult for them to form close relationships and succeed at work or school.

Causes of Schizotypal Personality Disorder

Researchers do not understand exactly what causes schizotypal personality disorder, but they believe it is a combination of genetics and environmental factors. People with a 1st-degree relative with schizophrenia are at increased risk of developing the condition. For people genetically pre-disposed to developing SPD, experiencing psychological trauma or chronic stress can also increase the risk of symptoms emerging.

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Researchers estimate the lifetime prevalence of SPD to be roughly 4%, with the condition affecting men slightly more than women. Roughly half of people with schizotypal personality disorder have experienced at least one episode of major depression. People with bipolar disorder, post-traumatic stress disorder, borderline personality disorder, and narcissistic personality disorder are also at higher risk of having schizotypal personality disorder.

Schizotypal Personality Disorder Symptoms

The signs of schizotypal personality disorder include three major components. The first is a decreased capacity to form close relationships, which can cause a person severe discomfort. The second is experiencing distortions in one’s thinking or perceiving of events. The third is exhibiting eccentric behavior.

In younger people, schizotypal personality disorder may first manifest as attention problems, social anxiety, or interest in playing or working alone. Kids may struggle with being teased or bullied, which can further heighten social anxiety. To receive a diagnosis, a person must have experienced these signs by the time they reach early adulthood.

A person also must have experienced five of the following symptoms:

  • Lack of close friends outside of  immediate family
  • Eccentric or unusual beliefs or mannerisms
  • Belief in superpowers (i.e. telepathy) or superstitions
  • Excessive social anxiety associated with paranoid fears
  • Paranoid thoughts or doubts about others’ loyalty
  • Interpreting harmless events as having a personal meaning
  • Dressing in an unkempt or odd manner
  • Sensing an absent person is present
  • Strange or rambling speech patterns
  • Flat or limited emotional responses

Receiving a Diagnosis

A person cannot receive a diagnosis of schizotypal personality disorder if they have a diagnosis of schizophrenia, any other psychotic disorder, autism spectrum disorder, or a diagnosis of bipolar disorder or depressive disorder with psychotic features.

When being evaluated for a personality disorder, many people find it useful to bring along a friend or family member who has observed their behaviors and can offer insight to a doctor. You also might want to gather information about your family’s medical history, in particular whether there is any history of mental illness or stories about peculiar behavior or beliefs.

Schizotypal Personality Disorder Vs. Schizophrenia

Schizotypal personality disorder and schizophrenia may appear similar, but there are differences between the two diagnoses. People with schizotypal personality disorder typically don’t experience hallucinations and delusions, and if they do, they are not as intense or frequent as those experienced by people with schizophrenia. People with schizotypal personality disorder are open to the idea that their ideas and perceptions are distorted, whereas people with schizophrenia typically are not. However, a person who exhibits symptoms of SPD earlier in life may go on to develop schizophrenia.

What is the Treatment for Schizotypal Personality Disorder?

Treatment for Schizotypal Personality Disorder usually involves a combination of psychotherapy and medication. There is very little research about the use of psychotherapy with SPD patients. Psychotherapy can include psycho-education about social skills as well as cognitive-behavioral techniques that help patients identify and challenge negative or distorted patterns of thinking. Family therapy may also help educate family members about the disorder, improve communication, and address patterns which increase anxiety for the individual.

No medications have currently been approved by the Food and Drug Administration for the treatment of schizotypal personality disorder. However, doctors may prescribe antipsychotic medications, antidepressants, mood stabilizers, or anti-anxiety medications to help with symptoms. Stimulants often used to treat attention problems can also sometimes be found useful in patients with SPD.

Treatment may also include addressing some of the complications of the disorder, which can include increased anxiety, substance abuse, and suicidal thoughts and behaviors. It may also address specific complications at work, school, or with relationships.

Overall, symptoms tend to improve when people with schizotypal personality disorder begin to build stronger relationships and a sense of self-efficacy at school, work, or in other interests.

Can a Person with Schizotypal Personality Disorder Find Employment? 

The eccentric behaviors and beliefs that accompany schizotypal personality disorder can make it difficult for a person to find or maintain employment. They might show up to work dressed inappropriately or experience paranoid fears when dealing with customers or other coworkers.

A diagnosis of a personality disorder, however, should qualify an individual in the US to receive vocational rehabilitation services from their state. These services can help a person learn social skills, find appropriate accommodations at work, and also pair them with a job coach who can work with them on site. Employment can provide positive connections and meaningful work that can aid treatment for people with schizotypal personality disorder.

Getting Help for Schizotypal Personality Disorder

If you think that you or a loved one might have schizotypal personality disorder, it’s important to receive a proper evaluation. A psychiatric evaluation can help a doctor or mental health professional rule out other diagnoses and determine whether there are co-occurring conditions that also need to be treated.

Because so many people with schizotypal personality disorder also experience depression, they are at increased risk of suicide. If you or a loved one are experiencing suicidal thoughts or behaviors, it’s important to seek help immediately. US residents can call the National Suicide Prevention Lifeline at 1-800-273-8255 (1-800-273-TALK).

Although personality disorders are chronic conditions, medication and therapy can do a lot to alleviate symptoms and help a person build stronger relationships and feel effective in life. Don’t hesitate to reach out to your doctor today to get more information about living with schizotypal personality disorder.

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Last Updated: Nov 13, 2018