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Symptoms
By Mayo Clinic staffPeople with classic schizotypal personalities are apt to be loners. They feel extremely anxious in social situations, but they're likely to blame their social failings on others. They view themselves as alien or outcast, and this isolation causes pain as they avoid relationships and the outside world.
People with schizotypal personalities may ramble oddly and endlessly during a conversation. They may dress in peculiar ways and have very strange ways of viewing the world around them. Often they believe in unusual ideas, such as the powers of ESP or a sixth sense. At times, they believe they can magically influence people's thoughts, actions and emotions.
In adolescence, signs of a schizotypal personality may begin as an increased interest in solitary activities or a high level of social anxiety. The child may be an underperformer in school or appear socially out-of-step with peers, and as a result often becomes the subject of bullying or teasing.
Schizotypal personality disorder symptoms include:
- Incorrect interpretation of events, including feeling that external events have personal meaning
- Peculiar thinking, beliefs or behavior
- Belief in special powers, such as telepathy
- Perceptual alterations, in some cases bodily illusions, including phantom pains or other distortions in the sense of touch
- Idiosyncratic speech, such as loose or vague patterns of speaking or tendency to go off on tangents
- Suspicious or paranoid ideas
- Flat emotions or inappropriate emotional responses
- Lack of close friends outside of the immediate family
- Persistent and excessive social anxiety that doesn't abate with time
Schizotypal personality disorder can easily be confused with schizophrenia, a severe mental illness in which affected people lose all contact with reality (psychosis). While people with schizotypal personalities may experience brief psychotic episodes with delusions or hallucinations, they are not as frequent or intense as in schizophrenia.
Another key distinction between schizotypal personality disorder and schizophrenia is that people with the personality disorder usually can be made aware of the difference between their distorted ideas and reality. Those with schizophrenia generally can't be swayed from their delusions.
Both disorders, along with schizoid personality disorder, belong to what's generally referred to as the schizophrenic spectrum. Schizotypal personality falls in the middle of the spectrum, with schizoid personality disorder on the milder end and schizophrenia on the more severe end.
When to see a doctor
Because personality tends to become entrenched as people age, it's best to seek treatment for a personality disorder as early as possible.
People with schizotypal personality are likely to seek help only at the urging of friends or relatives. If you suspect a friend or family member may have the disorder, be on the lookout for certain signs. You might gently suggest that the person seek medical attention, starting with a primary care physician or mental health provider.
- In: Diagnostic and Statistical Manual of Mental Disorders DSM-IV-TR. 4th ed. Arlington, Va.: American Psychiatric Association; 2000. http://www.psychiatryonline.com. Accessed July 13, 2010.
- Skodol AE, et al. Specific personality disorders. In: Hales RE, et al., eds. The American Psychiatric Publishing Textbook of Psychiatry. 5th ed. Arlington, Va.: American Psychiatric Association; 2008. http://www.psychiatryonline.com. Accessed July 13, 2010.
- Blais MA, et al. Personality and personality disorders. In: Stern TA, et al. Massachusetts General Hospital Comprehensive Clinical Psychiatry. Philadelphia, PA: Mosby; 2008. http://www.mdconsult.com/das/book/body/208922830-3/1022719999/1657/387.html#4-u1.0-B978-0-323-04743-2..50041-X--cesec11_990. Accessed July 13, 2010.
- Silk KR. Personality disorders. http://www.uptodate.com/home/index.html. Accessed July 13, 2010.
- Cohen P. Child development and personality disorder. Psychiatric Clinics of North America. 2008;31:477.
- Skodol AE, et al. Positive childhood experiences: Resilience and recovery from personality disorder in early adulthood. Journal of Clinical Psychiatry. 2007;68:1102.
- Hall-Flavin DK (expert opinion). Mayo Clinic, Rochester, Minn.
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