Schizotypal Personality Disorder: What is it?

Schizotypal personality disorder is affected by up to 3% of the general population. People who suffer from it have a marked deficit in interpersonal relationships. In addition, they can manifest particular or strange behaviors and thoughts.

In this article we will explain in more detail what this disorder consists of, who spoke about it for the first time, how it evolved in DSM and what are its 11 fundamental characteristics.

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Schizotypal Personality Disorder: What is it?

Schizotypal Personality Disorder is one of the 10 Personality Disorders (PD) DSM-5 (Diagnostic Manual of Mental Disorders) and ICD-10 (International Classification of Diseases).

It is characterized by a marked deficit in social and interpersonal relationships, associated with acute discomfort and a reduced capacity for personal relationships.

This personality disorder arose with the term "latent schizophrenia" proposed by Eugen Bleuler, a Swiss psychiatrist and eugenicist. In other words, it was this psychiatrist who spoke for the first time about this PD. However, it was another author, S. Rado, in 1956, who coined the term "schizotypal personality disorder."

Rado coined the term to refer to those patients who failed to decompensate in schizophrenic disorders (schizophrenia proper), and which could lead to a life "normal". That is, without delusions or hallucinations, and without psychotic symptoms.

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Historical review

Schizotypal personality disorder was first incorporated into the DSM, in its third edition (DSM-III), in 1980, when the borderline variant of psychosis was separated.

In the revision of this third edition of the DSM (DSM-III-TR), a new criterion is added in the disorder, which are eccentric behaviors. In addition, two other symptoms (dissociative symptoms) are suppressed: depersonalization and derealization.

In the fourth version of DSM-IV, the characterization and definition of this disorder does not undergo important changes, as it does not occur in its latest version (DSM-5).

A curious fact is that schizotypal personality disorder is not included in the ICD-10 as a personality disorder, but as a disorder that is part of the spectrum of disorders schizophrenics.

Some data

Schizotypal Personality Disorder affects 3% of the general population, a fairly high figure. On the other hand, it is a little more common in men than in women. People with this personality disorder are more likely to have first-degree relatives with schizophrenia or other psychotic disorders.

That is, it is considered a schizophrenic spectrum disorder (at least that is the case in ICD-10). In addition, biological markers related to those of schizophrenia have been found in people with this PD.

Characteristics

The characteristics that we are going to present about schizotypal personality disorder refer to the different diagnostic criteria for such PD, both from the DSM and the ICD.

Let's see its 11 most important characteristics then.

1. Reference ideas

One of the main characteristics of schizotypal personality disorder is the existence of reference ideas on the part of the subject who suffers from it. That is, the person constantly feels (or on a large number of occasions) that others are talking about them.

She always feels alluded to, and has "paranoid" tendencies. These ideas of reference, however, do not become delusional (they do not constitute a delusion itself).

2. Weird beliefs or magical thinking

People with schizotypal personality disorder also have strange beliefs or magical thoughts. These beliefs or thoughts are not typical of their culture, that is, they are considered "far away" from normality.

3. Unusual perceptual experiences

These unusual perceptual experiences do not become hallucinations; that is, they don't "see" anything that doesn't really exist, for example. However, these are "strange" experiences, unusual (for example having the feeling that someone is constantly following them, "noticing" strange things, etc.).

That is, they are, for example, bodily illusions, manifestations of depersonalization or derealization, etc.

4. Weird thinking and language

People with this personality disorder also have peculiar thinking and language. They use unusual expressions or constructions when interacting with others, and this is extrapolated to their thinking.

Thus, both his thought and his language are usually vague, metaphorical, circumstantial, stereotyped or extraordinarily elaborate. When you talk to these people, you may have the feeling that they are "talking funny" or that they are "not understood." These alterations that we mention, but, are often subtle, and do not constitute a clear incoherence in language and / or thought.

5. Suspicion and paranoid ideation

Another characteristic feature of schizotypal personality disorder is suspicion and paranoid ideation. They are "paranoid" people, with a tendency to think that others are constantly talking about them, criticizing them, hiding things from them, "conspiring" against them, acting maliciously, and so on. In addition, they are suspicious of others.

6. Inappropriate or restricted affectivity

In the emotional and affective field, there are also alterations. Thus, their affectivity is inappropriate or restricted; This means that both can behave in a way not according to the context, or express emotions "not adjusted ”or“ coherent ”with the situation”, such as expressing very few emotions (affectivity restricted).

This, logically, affects them in their social relationships, which are difficult.

7. Strange demeanor or appearance

People with schizotypal personality disorder may also exhibit behaviors that are considered “rare”, or deviant from normality.

Their appearance can also be strange (this includes the way they dress, for example not in line with the time of year or dress “codes”). Thus, they are people, that if we know them, we can think that they are "strange".

8. Lack of close or trusted friends

Generally, these subjects do not have close or trusted friends (beyond their first-degree relatives), due to their social deficits.

9. Social anxiety

Subjects with schizotypal personality disorder also present marked social anxiety (or simply anxiety), which also does not diminish with familiarization; This social anxiety is due, more than to a negative judgment of oneself, to paranoid fears.

That is, the paranoid ideations already mentioned can cause these people to avoid social contact and end up isolating themselves.

10. Obsessive rumination

These people can also manifest obsessive rumination (they do not resist them internally), especially about aggressive, sexual or dysmorphic content.

11. "Almost" psychotic episodes

Although schizotypal disorder, in what differs from schizophrenia, is that psychotic outbreaks do not appear, it is true that “almost” psychotic episodes can appear; these, however, are occasional and transitory.

They consist, for example, of visual or auditory hallucinations, pseudo-delusions (as we have already seen), etc., triggered without external provocation.

Bibliographic references

• Álvarez, E. (2000). Schizotypal personality and cognitive markers. Cognitive correlates in psychometric schizotypy. Doctoral Thesis, University of Barcelona.

• American Psychiatric Association. (2002). Diagnostic and statistical manual of mental disorders (4th edition, revised text). Barcelona: Masson.

• American Psychiatric Association -APA- (2014). DSM-5. Diagnostic and Statistical Manual of Mental Disorders. Madrid: Panamericana.

• WHO (2000). ICD-10. International Classification of Diseases, Tenth Edition. Madrid. Pan American.