Those with schizotypal personality disorder experience long-standing patterns of eccentric behavior that may appear strange to others. Individuals suffering from this disorder are generally loners who prefer to keep their distance from other people and are extremely uncomfortable being in close relationships. They often have cognitive or perceptual distortions, may display odd characteristics in their everyday behavior, and generally do not understand how their behavior impacts, or is perceived by, others.

What Are Personality Disorders?

Individuals with personality disorders like schizotypal experience thought patterns and actions outside of the “norm,” according to the American Psychiatric Association. For instance, they will likely have poor coping skills and difficulty forming and maintaining healthy relationships with others. These troubling personality traits can get in the way of a person’s relationships, work life, and overall happiness. Those with a personality disorder are generally not aware they have a problem and likely do not believe the atypical characteristics of their personality are causing issues in their life and behavior.

Signs and Symptoms of Schizotypal Personality Disorder

Schizotypal personality disorder is characterized by a pattern of social and interpersonal deficits and a severe discomfort with close relationships. These patterns often begin by early adulthood and present in a variety of ways, but it will typically include five or more of the signs and symptoms below:

  • Their social anxiety is persistent and excessive
  • They are loners usually lacking close friends outside of their immediate family
  • They have flat affect, having limited or inappropriate emotional responses
  • They frequently have suspicious or paranoid thoughts and doubt the loyalty of others
  • They make unusual perceptions, for example sensing an absent person’s presence or experiencing illusions
  • Their can appear unkempt, as they tend to dress in peculiar ways
  • They generally have eccentric or unusual thinking, beliefs, or mannerisms
  • They tend to belief in special powers like mental telepathy or superstitions
  • They tend to incorrectly interpret events, and can sometimes feel that something that is actually harmless or inoffensive has a direct personal negative meaning
  • Their style of speech is peculiar, as they tend to have vague or unusual patterns of speaking, or rambling oddly during conversations

Signs and symptoms of schizotypal personality disorder may start to be seen in teenage years, including high levels of social anxiety and interest in solitary activities. In those instances, the child may be an underperformer in school, may be a social outsider, or experience bullying.

Causes of Schizotypal Personality Disorder

A personality is the combination of thoughts, emotions, and behaviors that make a person who they are. Personality generally forms and becomes fixed during childhood and influences how a person views themself and the world around them. While the precise cause of schizotypal personality disorder isn’t yet known or understood, it is believed that genetics, environmental influences, and learned behaviors may play a role. A person’s risk of having schizotypal personality disorder may be greater if they have a relative who has schizophrenia or another psychotic disorder.

Those who have schizotypal personality disorder are also at an increased risk of the following complications:

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

Diagnosing Schizotypal Personality Disorder

If you are experiencing five or more schizotypal personality disorder symptoms, it is important to meet with your doctor. In your initial consultation, your doctor will ask about your medical history and may do a physical exam. While there are no lab tests to diagnose a personality disorder, a doctor can use other tests and assessments to rule out physical illnesses as the cause of your symptoms. You might also be asked to see a licensed psychiatrist, psychologist, or other health care professional who is trained to diagnose and treat mental illness.

Diagnosis is typically based on a thorough review of your symptoms, your personal and medical history, and symptoms listed in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), published by the American Psychiatric Association. Your doctor will likely ask a number of questions, including how your symptoms manifest, impact your life, your satisfaction with relationships, and your family history with mental illness.

Treating Schizotypal Personality Disorder

Individuals with schizotypal personality disorder rarely initiate treatment. When treatment is pursued, however, some individuals can benefit from antipsychotic medications, and therapy is also a viable option. Psychotherapy may help people who have schizotypal personality disorder begin to trust others and learn coping skills by building a trusting relationship with a therapist. Therapy treatment types may include:

  • Cognitive-behavioral therapy. CBT can help a person cope with negative thought patterns. In cognitive behavioral therapy, an individual works with a licensed professional therapist in a highly structured way to help them develop coping techniques. The focus is placed on treating a person’s problems by managing dysfunctional emotions, behaviors, and thinking.
  • Supportive therapy. Support therapy serves as a first bridge out of social isolation and addresses personality issues, such as deficits in character and defense mechanisms. It can provide encouragement, foster adaptive skills, and improve self-esteem while taking a patient’s limitations into account.
  • Family therapy. Family therapy helps family members improve communication, resolve conflicts, or navigate difficult times. Unlike individual counseling, family therapy focuses on addressing problems as a familial unit.

If a doctor determines medication is needed, they may prescribe the following:

  • Antipsychotics — such as aripiprazole (Abilify, Aristada), olanzapine (Zyprexa), quetiapine (Seroquel), or risperidone (Risperdal)
  • Stimulants — like methylphenidate (Concerta, Ritalin)
  • Cognition-enhancing medication — such as the ADHD drug guanfacine (Intuniv, Tenex)
  • Benzodiazepines — such as clonazepam (Klonopin)
  • Anticonvulsant and nerve pain medication — like gabapentin (Gralise, Neurontin), which treats seizures

Schizotypal personality disorder is a chronic condition characterized by a pattern of social and interpersonal deficits, and as such, requires lifelong treatment. While a person’s specific outlook will depend on the severity of their symptoms, those who have access to therapy and medication treatments may be more successful in managing the disorder. Continue to monitor the development of other mental health disorders and communicate with your doctor if you start to notice signs of depression or other health issues.