What is Schizotypal Personality Disorder?

People with schizotypal personality disorder are loners who prefer to stay away from others and are uncomfortable being in relationships. They sometimes tend to speak or behave strangely. You can find more information below.

What is schizotypal personality disorder?

People with schizotypal personality disorder are often described as strange or eccentric and often have few close relationships. They often do not understand how relationships are formed or the impact their behavior has on others. They may also misinterpret the motivations and behavior of others and develop a significant distrust of others.

Similar article: Schizoid personality disorder

These problems can lead to severe anxiety and a tendency to avoid social situations, as the person with schizotypal personality disorder tends to hold idiosyncratic beliefs and may have difficulty responding appropriately to social cues.

This personality disorder is typically diagnosed in early adulthood and is likely to last a lifetime, but treatment such as medications and psychotherapy can improve symptoms.

Causes of schizotypal personality disorder

Personality is the combination of thoughts, feelings, and behaviors that make you unique. It is the way you know, understand and relate to the outside world and how you see yourself. Personality is shaped by the interaction of hereditary tendencies and environmental factors, forming the character.

In normal development, over time, children learn to interact appropriately with others, interpret social cues, and respond appropriately and flexibly to social situations. What exactly goes wrong for a person with schizotypal personality disorder is not known for certain, but it’s possible that changes in brain function, genetics, environmental influences, and learned behavior may play a role.

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Who is at risk?

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

Symptoms of schizotypal personality disorder

This personality disorder typically includes five or more of the following symptoms:

  • Being alone and lacking close friends other than immediate family
  • Flat emotions, limited or inappropriate emotional responses
  • Persistent and extreme social anxiety
  • Misinterpretation of events, such as the feeling that something that is not actually harmless or offensive has direct personal meaning
  • Weird, eccentric, or unusual thinking, beliefs, or attitudes
  • Suspicious or paranoid thoughts and persistent doubts about the loyalty of others
  • Belief in special powers such as mental telepathy or superstitions
  • Unusual perceptions, such as feeling the presence of a person or having illusions
  • Dressing in odd ways, such as looking messy or wearing oddly matching outfits
  • Uncertain, unusual speech patterns or odd way of speaking, such as awkwardly slurring during conversation

Symptoms of schizotypal personality disorder, such as increased interest in metaphysical activities or high levels of social anxiety, can be seen in the teenage years. The child may underperform in school or appear socially different from peers, resulting in teasing or bullying.

Schizotypal personality and schizophrenia

This personality disorder can easily be confused with schizophrenia, a serious mental illness in which people lose touch 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 important distinction is that people with schizotypal personality disorder often have distorted ideas and the ability to recognize the difference between reality. People with schizophrenia often cannot be distracted from their delusions.

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

When should you see a doctor?

People with this type of personality disorder are likely to seek help only at the call of their friends or family members, or people with schizotypal personality disorder may seek help for another problem, such as depression. If you suspect a friend or family member may have the condition, you may suggest that the person seek medical advice, starting with their primary care doctor or mental health professional.

Diagnosis of schizotypal personality disorder

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

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 this type of personality disorder is typically based on:

  • Talking extensively 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

Schizotypal personality disorder treatment

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


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

Psychotherapy may include:

  • Cognitive-behavioral therapy: Helpful in identifying and challenging negative thought patterns, learning certain social skills, and changing problem behaviors.
  • Supportive therapy: Helps to encourage and develop adaptive skills.
  • Family therapy: Therapy that includes family members that can help improve communication, trust, and the ability to work together at home can also be beneficial for the person concerned and other family members.
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There are no drugs approved by the Food and Drug Administration specifically for the treatment of schizotypal personality disorder. However, doctors may prescribe an antidepressant to relieve or reduce certain symptoms, such as depression or anxiety. Certain medications can help increase thinking flexibility.

coping and support

While schizotypal personality disorder is lifelong, some symptoms may improve over time through experiences that help develop self-confidence, belief in one’s ability to overcome difficulties, and a sense of social support.

Factors that seem likely to help reduce some of the symptoms of this disorder include:

  • Positive relationships with friends and family
  • Healthy daily rhythms, including consistency with having a schedule, a good sleep routine, exercise, and taking prescription medications
  • Achieving something at school, work, and extracurricular activities

Complications of schizotypal personality disorder

People with schizotypal personality disorder are at increased risk for:

  • Depression
  • Worry
  • Other personality disorders
  • Schizophrenia
  • Transient psychotic episodes, usually in response to stress
  • Problems with alcohol or drugs
  • Suicide attempts
  • Work, school, relationship and social problems


The long-term outlook for schizotypal personality disorder varies and depends on many factors, including the severity of symptoms, the availability of support, how impaired the person is, and whether the person has depression or anxiety. If a person is willing and able to participate in treatment, the prognosis improves.

It may be unrealistic to expect a person with schizotypal personality disorder to be very comfortable socially. However, some with this disorder respond very well to treatment with medication. In the best case, these people can lead fulfilling lives by finding suitable jobs, making use of relationships and leisure activities that match their personality style.

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