Schizotypal personality disorder is a mental pathology that shares a number of symptoms with schizophrenia, but they are not the same. Let’s review its clinical bases.
Therefore, before any behavior, sensation or persistent problem, the safest option will always be to go to a medical professional. This will be able to detect relatively common and “harmless” disorders (such as generalized anxiety disorder or GAD, easily treatable) to conditions that can be life-threatening, such as anorexia nervosa. Of all psychological disorders, anorexia is the most lethal, killing almost 20% of people who do not seek treatment.
On the other hand, the most common clinical entities in the field of psychiatry are personality disorders (PTs), experienced by up to 60% of patients who come to ask for help. Today we focus on schizotypal personality disorder (PET), which has a low prevalence, but not inconsiderable risks.
- We recommend you read: “The 6 types of schizophrenia (causes and symptoms)”
What is schizotypal personality disorder?
As we have said, schizotypal personality disorder (SPD) is included within personality disorders (PD), specifically in cluster A. It shares a category with paranoid personality disorder and schizoid personality disorder , and the 3 together they represent those psychological problems with symptomatic similarities to schizophrenia.
According to epidemiological studies, the percentage of the population affected by PTSD in high-income regions such as the United States ranges from 4% (4.2% in men, 3.7% in women), with a low but quantifiable social impact. This entity presents certain comorbidity with bipolar disorders type I and II and narcissistic personality disorder (NPD), in addition to a marked loss of quality of life, due to the symptoms presented and the relationships with the environment.
People with PTSD have a clear difficulty in dealing with interpersonal relationships and present alterations in thought patterns, appearance and behaviortag. Beyond this, they also have symptoms in the form of transient psychosis, episodes of derealization, paranoia, and highly unconventional beliefs. As you can see, it has certain similarities with schizophrenia in use, although we remember that they are not the same pathology in any case.
- We recommend you read: “Borderline Personality Disorder: causes, symptoms and treatment”
Diagnosis of schizotypal personality disorder
The American Psychological Association (APA) edits and publishes from time to time its Diagnostic and Statistical Manual of Mental Disorders (DMS-V), in which it collects all psychiatric pathologies and their diagnostic criteria. For a patient with schizotypal personality disorder to be considered as such, they must meet at least 5 of the following symptoms :
- Ideas of reference: belief that daily events have a special meaning or directed to the patient. It cannot be confused with delusions of reference, since the latter are more intense.
- Bizarre or fictional beliefs: for example, being preoccupied with paranormal phenomena, belief in superpowers, telepathy, etc.
- Atypical perceptual experiences: for example, hearing voices whispering in the patient’s ear.
- Atypical speech and train of thought: The patient uses language that is metaphorical, vague, overly elaborate, or stereotyped.
- Paranoid ideas and suspicions of the environment.
- Incongruous or limited effect.
- Strange appearance and/or behavior.
- Lack of close friends.
- Excessive social anxiety: this does not decrease in the presence of relatives and is directly related to paranoid fears.
Within all these signs, the most striking are those that involve strange beliefs and paranoid ideastag. It is common for a person with schizotypal personality disorder to feel that the government is persecuting them, to think that there are cameras inside their house or that they are being monitored by aliens. She may also believe that someone in her close circle is setting her up or that a certain group wants to end her life.
Beyond these differential signs, it should be noted that the condition must have started in early adulthood and the patient must clearly show cognitive/perceptual distortions, eccentricity in behavior and a persistent pattern of intense discomfort with close relationships. Lastly, the symptoms must occur more than 2 years apart and schizophrenia must be ruled out as a possible underlying cause.
Causes of schizotypal personality disorder
Studies have revealed over the years that PTSD has a clear genetic component, since people with relatives who suffer from a cluster A personality disorder are more likely to manifest ittag. An increased chance has also been shown if a person has a twin with PTSD, although this does not explain the entirety of the condition. Based on this premise, abnormalities in genes such as CACNA1C have been associated with schizophrenia and schizoid disorders.
In any case, it can never be forgotten that almost all sources place the environment as the main trigger of this disorder. As with schizophrenia, prenatal fetal damage (such as influenza virus infection in the sixth week of gestation or other events) is thought to be associated with a higher probability of developing schizotypal behavior in the adult population. . As shocking as it may seem, some of the conditions play their role before the patient is born.
It has also been found that stress, psychiatric trauma and especially harsh life events can promote PTSD. Still, the way each person responds to trauma is different, and is believed to be largely determined by individual genetic background. In other words, for now the scientific community finds itself in a cyclical conflict:is genetics the trigger and cause, or is the environment conducive to its manifestation? Science continues to search for answers.
Treatment of schizotypal personality disorder
Unfortunately, the literature that reflects the success or failure of psychotherapy in patients with PTSD is scarce or non-existenttag. Normally, cognitive-behavioral therapy is used, based on a series of techniques and instructions that teach the patient to “unlearn” their maladaptive behaviors. If we operate on the fact that every action process is learned, then it can be reversed and replaced by options that report a greater psychosocial benefit.
In any case, it should be noted that pharmacological therapy is not ruled out in any case for this type of patient. For example, risperidone (0.25-2 milligrams), a second-generation atypical antipsychotic, has been approved by the Food and Drug Administration (FDA) to treat the symptoms of schizoid personality disorder.
According to certain sources, selective serotonin reuptake inhibitors (SSRIs) do not seem to have positive effectson the clinical signs of the patient, but benzodiazepines could help in the greatest moments of stress, anxiety and paranoia, even if only partially. . Although there is still no perfect drug for all patients with PTSD, little by little progress is being made until the most suitable combination is found for each case.
Summary
As you may have seen, PTSD is a clinical entity with a relatively low incidence (4% of the population), but it presents with disabling and quite notorious symptoms, characterized by conspiracies, atypical thoughts, paranoia, a feeling of being persecuted and many other things. We remember that, as much as it resembles schizophrenia, it is a different pathology.
If you have been reflected in any of the diagnostic criteria in recent times, it is best that you go to a psychiatric professionaltag. Although it seems like a very ethereal and difficult condition to deal with, schizotypal personality disorder can be kept under control with appropriate psychological care and pharmacological treatment.
To the classic question “what do you do?” I always answer “basically I am a psychologist”. In fact, my academic training has revolved around the psychology of development, education and community, a field of study influenced my volunteer activities, as well as my first work experiences in personal services.