Schizotypal personality disorder is characterized by someone who has great difficulty in establishing and maintaining close relationships with others. A person with schizotypal personality disorder may have extreme discomfort with such relationships, and therefore have less of a capacity for them. Someone with this disorder usually has cognitive or perceptual distortions as well as eccentricities in their everyday behavior.

Individuals with schizotypal personality disorder often have ideas of reference (e.g., they have incorrect interpretations of casual incidents and external events as having a particular and unusual meaning specifically for the person). People with this disorder may be unusually superstitious or preoccupied with paranormal phenomena that are outside the norms of their subculture.

Individuals with schizotypal personality disorder often seek treatment for the associated symptoms of anxiety, depression, or other dysphoric effects rather than for the personality disorder features per se.

A personality disorder is an enduring pattern of inner experience and behavior that deviates from the norm of the individual’s culture. The pattern is seen in two or more of the following areas: cognition; affect; interpersonal functioning; or impulse control. The enduring pattern is inflexible and pervasive across a broad range of personal and social situations. It typically leads to significant distress or impairment in social, work, or other areas of functioning. The pattern is stable and of long duration, and its onset can be traced back to early adulthood or adolescence.

Symptoms of Schizotypal Personality Disorder

Schizotypal personality disorder is characterized by a pattern of social and interpersonal deficits marked by acute discomfort with, and reduced capacity for, close relationships. The disorder is also characterized by cognitive or perceptual distortions and eccentricities of behavior. These begin by early adulthood and present in a variety of contexts, as indicated by five (or more) of the following:

  • Ideas of reference (excluding delusions of reference)
  • Odd beliefs or magical thinking that influences behavior and is inconsistent with subcultural norms (e.g., superstitiousness, belief in clairvoyance, telepathy, or “sixth sense”; in children and adolescents, bizarre fantasies or preoccupations)
  • Unusual perceptual experiences, including bodily illusions
  • Odd thinking and speech (e.g., vague, circumstantial, metaphorical, overelaborate, or stereotyped)
  • Suspiciousness or paranoid ideation
  • Inappropriate or constricted affect
  • Behavior or appearance that is odd, eccentric, or peculiar
  • Lack of close friends or confidants other than first-degree relatives
  • Excessive social anxiety that does not diminish with familiarity and tends to be associated with paranoid fears rather than negative judgments about self

Because personality disorders describe long-standing and enduring patterns of behavior, they are most often diagnosed in adulthood. It is uncommon for them to be diagnosed in childhood or adolescence, because a child or teen is under constant development, personality changes, and maturation. However, if it is diagnosed in a child or teen, the features must have been present for at least 1 year.

Schizotypal personality disorder appears in about 3.9 percent of the general population according to NESARC research.

Like most personality disorders, schizotypal personality disorder typically will decrease in intensity with age, with many people experiencing few of the most extreme symptoms by the time they are in the 40s or 50s.

How is Schizotypal Personality Disorder Diagnosed?

Personality disorders such as  schizotypal personality disorder are typically diagnosed by a trained mental health professional, such as a psychologist or psychiatrist. Family physicians and general practitioners are generally not trained or well-equipped to make this type of psychological diagnosis. So while you can initially consult a family physician about this problem, they should refer you to a mental health professional for diagnosis and treatment. There are no laboratory, blood, or genetic tests that are used to diagnose schizotypal personality disorder.

Many people with schizotypal personality disorder don’t seek out treatment. People with personality disorders, in general, do not often seek out treatment until the disorder starts to significantly interfere or otherwise impact a person’s life. This most often happens when a person’s coping resources are stretched too thin to deal with stress or other life events.

A diagnosis for schizotypal personality disorder is made by a mental health professional comparing your symptoms and life history with those listed here. They will make a determination as to whether your symptoms meet the criteria necessary for a personality disorder diagnosis.

Causes of Schizotypal Personality Disorder

Researchers today don’t know what causes schizotypal personality disorder. There are many theories, however, about the possible causes of schizotypal personality disorder. Most professionals subscribe to a biopsychosocial model of causation — that is, the causes are likely due to biological and genetic factors, social factors (such as how a person interacts in their early development with their family and friends and other children), and psychological factors (the individual’s personality and temperament, shaped by their environment and learned coping skills to deal with stress). This suggests that no single factor is responsible — rather, it is the complex and likely intertwined nature of all three factors that are important. If a person has this personality disorder, research suggests that there is a slightly increased risk for this disorder to be “passed down” to their children.

Treatment of Schizotypal Personality Disorder

Treatment of schizotypal personality disorder typically involves long-term psychotherapy with a therapist that has experience in treating this kind of personality disorder. Medications may also be prescribed to help with specific troubling and debilitating symptoms.

For more on treatment, please see schizotypal personality disorder treatment.