Schizotypal Personality Disorder: What Are the Symptoms?

We all know people who are a bit odd in their behavior, appearance, or way of thinking. And not just at Mardi Gras.

Society often attaches the word eccentric to such individuals. It’s a mostly benign characterization. Many eccentrics are considered whimsical, quirky and interesting because of their non-conforming nature.

Sometimes, an overly peculiar demeanor, when coupled with excessive social anxiety and other psychological markers, can be diagnosed as a mental health condition called schizotypal personality disorder.

It’s relatively rare, affecting 3% to 5% of people in the United States. People with it can have trouble forming and maintaining close relationships. It is typically diagnosed in early adulthood.

Description and symptoms

According to the American Psychiatric Association, a person with schizotypal personality disorder exhibits “a pattern of being very uncomfortable in close relationships, having distorted thinking and eccentric behavior.” The person may have “odd beliefs or odd or peculiar behavior or speech or may have excessive social anxiety.”

People with this disorder typically have trouble relating to people and do not have close friends.

Other characteristics among people diagnosed with the disorder include:

• Unusual mannerisms and patterns of speech.

• Misinterpreting or being overly suspicious of the intentions of others.

• Inability to maintain eye contact during face-to-face conversations.

• Being overly superstitious or believing that they can read the minds of others.

• A lack of awareness about how their thoughts and behaviors impact others.

• Wearing oddly matched or ill-fitting clothes or appearing unkept in public places.

• Difficulty in responding appropriately to social cues.

The symptoms can vary among individuals and vary in intensity as well.

The peculiarities of those with schizotypal personality disorder are not so severe that they can be diagnosed as schizophrenia, a mental illness that involves losing contact with reality. But the two are often confused.

People with schizotypal personality disorder might experience brief psychotic episodes with delusions or hallucinations, whereas those with schizophrenia have more frequent, intense and prolonged incidences of being out of touch with reality.

Diagnosis and treatment

Because a person’s personality continues to evolve throughout childhood and adolescence, mental health experts usually don’t diagnose someone with schizotypal personality disorder until after 18 years of age.

Any personality disorder can be difficult to diagnose because in many cases people don’t realize there’s a problem with their behavior or way of thinking and don’t see a need to change anything.

When people do seek help, it’s usually for a related condition such as anxiety or depression.

Healthcare providers can use special interviews and other assessment tools to diagnose schizotypal personality disorder. A psychiatrist or psychologist may ask the patient about their childhood, medical and work history and ask to for a detailed explanation of symptoms and how those symptoms impact relationships.

A combination of psychotherapy and medication is often prescribed together to combat schizotypal personality disorder.

Cognitive behavioral therapy, which has been effective for a range of mental health problems including depression, anxiety and personality disorder, is often the go-to treatment. With this therapy, mental health providers can identify and challenge negative thought patterns, introduce specific social skills, and reshape certain behavior patterns.

Doctors may also prescribe an antidepressant to help address depression, anxiety or other issues that may be association with the personality disorder.