Schizotypal personality disorder

Not to be confused with Semantic pragmatic disorder, Schizotypy, Schizoid personality disorder, or Schizoaffective disorder.

Schizotypal personality disorder
Other namesSchizotypal disorder
SpecialtyPsychiatry, clinical psychology
SymptomsIdeas of reference, unusual beliefs, perceptual illusions, odd thinking and speech, paranoia, inappropriate affect, strange behavior, social anxiety, dissociation
ComplicationsSchizophrenia, substance use disorder, major depressive disorder, schizoid personality disorder
Usual onset10–20 years old
DurationChronic
CausesGenetics; childhood neglect; childhood abuse
Risk factorsFamily history
Diagnostic methodBased on symptoms
Differential diagnosisOther cluster A personality disorders, borderline personality disorder, avoidant personality disorder, autism spectrum disorder (ASD), social anxiety disorder, attention deficit hyperactivity disorder, dissociative identity disorder
TreatmentCognitive behavioral therapy, metacognitive therapy, cognitive remediation therapy
MedicationAntipsychotics, antidepressants
PrognosisTypically poor, although significant improvements can be made
FrequencyEstimated 3% of general population

Schizotypal personality disorder (StPD or SPD), also known as schizotypal disorder, is a mental disorder characterized by thought disorder, paranoia, a characteristic form of social anxiety, derealization, transient psychosis, and unconventional beliefs. People with this disorder often feel pronounced discomfort in forming and maintaining social connections with other people, primarily due to the belief that other people harbor negative thoughts and views about them. People with StPD may react oddly in conversations, such as not responding as expected, or talking to themselves. They frequently interpret situations as being strange or having unusual meanings for them; paranormal and superstitious beliefs are common. Those with the disorder often score high on measures for self-disorder.

The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) classifies StPD as a personality disorder belonging to cluster A, which is a grouping of personality disorders exhibiting traits such as odd and eccentric behavior. In the International Classification of Diseases, the latest edition of which is the ICD-11, schizotypal disorder is not classified as a personality disorder, but among psychotic disorders.

People with StPD usually disagree with the suggestion that their thoughts and behaviors are a 'disorder' and seek medical attention for depression or anxiety instead. Schizotypal personality disorder occurs in approximately 3% of the general population and is more commonly diagnosed in males.

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