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Schizotypal personality disorder

Medically reviewed by Drugs.com. Last updated on Dec 13, 2022.

Overview

People with schizotypal personality disorder are often described as odd or eccentric and usually have few, if any, close relationships. They generally don't understand how relationships form or the impact of their behavior on others. They may also misinterpret others' motivations and behaviors and develop significant distrust of others.

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

Schizotypal personality disorder typically is diagnosed in early adulthood and is likely to endure across the lifespan, though treatment, such as medications and therapy, can improve symptoms.

Symptoms

Schizotypal personality disorder typically includes five or more of these signs and symptoms:

Signs and symptoms of schizotypal personality disorder, such as increased interest in solitary activities or a high level of social anxiety, may be seen in the teen years. The child may be an underperformer in school or appear socially out of step with peers, which may result in teasing or bullying.

Schizotypal personality disorder vs. schizophrenia

Schizotypal personality disorder can easily be confused with schizophrenia, a severe mental illness in which people lose contact 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 key distinction is that people with schizotypal personality disorder usually can be made aware of the difference between their distorted ideas and reality. Those with schizophrenia generally can't be swayed away from their delusions.

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

When to see a doctor

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

If you need immediate help

If you're concerned that you might harm yourself or someone else, go to an emergency room or call 911 or your local emergency number immediately. Or contact a suicide hotline. In the U.S., call or text 988 to reach the 988 Suicide & Crisis Lifeline, available 24 hours a day, seven days a week. Or use the Lifeline Chat. Services are free and confidential.

Causes

Personality is the combination of thoughts, emotions and behaviors that makes you unique. It's the way you view, understand and relate to the outside world, as well as how you see yourself. Personality forms during childhood, shaped through an interaction of inherited tendencies and environmental factors.

In normal development, children learn over time to appropriately interact with others, to interpret social cues, and to respond to social situations appropriately and with flexibility. What exactly goes wrong for a person with schizotypal personality disorder isn't known for certain, but it's likely that changes in the way the brain functions, genetics, environmental influences and learned behaviors may play a role.

Risk factors

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

Complications

People with schizotypal personality disorder are at an increased risk of:

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:

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:

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:

Preparing for an 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:

Some basic questions to ask include:

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

What to expect from your doctor

Examples of questions your doctor may ask, include:

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.

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