Schizotypal personality disorder is suffered by up to 3% of the general population. People with schizotypal personality disorder show marked deficits in interpersonal relationships.. In addition, they may manifest particular or bizarre behaviors and thoughts.
In this article we will explain in more detail what this disorder is, who talked about it for the first time, how it evolved in the DSM and what are its 11 key features.
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Schizotypal personality disorder: what is it?
Schizotypal personality disorder is one of the 10 personality disorders (PD) of the DSM-5 (Diagnostic Manual of Mental Disorders) and ICD-10 (International Classification of Diseases). of the 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 distress and reduced capacity for personal relationships.
This personality disorder emerged with the term “latent schizophrenia” proposed by Eugen Bleuler, a Swiss psychiatrist and eugenicist. That is to say, it was this psychiatrist who first spoke of 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 did not decompensate into schizophrenic disorders (schizophrenia proper), and who were able to lead a “normal” life. That is to say, without delusions or hallucinations, and without psychotic symptoms.
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The schizotypal personality disorder was incorporated for the first time in the DSM, in its third edition (DSM-III), in 1980, when the borderline variant was separated from psychosis.
In the revision of this third edition of the DSM (DSM-III-TR), a new criterion is added to the disorder, which are eccentric behaviors. In addition, two other symptoms (dissociative symptoms) are deleted: depersonalization and derealization.
In the fourth version of the DSM-IV, the characterization and definition of this disorder does not undergo significant changes, nor does it 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 schizophrenic disorders.
Schizotypal personality disorder affects 3% of the general population, a rather high figure.a rather high figure. On the other hand, it is slightly more common in men than in women. People suffering from this personality disorder are more likely to have first-degree relatives with schizophrenia or other psychotic disorders.
That is, it is considered a schizophrenia spectrum disorder (at least so it is in the ICD-10). In addition, biological markers akin to those of schizophrenia have been found in people with this PT.
The characteristics that we are going to expose about schizotypal personality disorder refer to the different diagnostic criteria for schizotypal personality disorder, both DSM and ICD.
We are going to see its 11 most important characteristics below.
1. Ideas of reference
One of the main characteristics of schizotypal personality disorder is the existence of reference ideas on the part of the sufferer. That is, the person feels constantly (or on a large number of occasions) that others talk about him/her.
He/she always feels alluded to, and has “paranoid” tendencies. These ideas of reference, however, do not become delusional (they do not constitute a delirium as such).
2. Strange beliefs or magical thinking
People with schizotypal personality disorder also manifest bizarre beliefs or magical thinking. These beliefs or thoughts are not typical of their culture, i.e., they are considered “far from” normal.
3. Unusual perceptual experiences
These unusual perceptual experiences do not amount to hallucinations; that is, they do not “see” anything that does not really exist, for example. However, they are “strange”, unusual experiences (for example, having the sensation that someone is constantly following them, “noticing” strange things, etc.).
In other words, these are for example bodily illusions, manifestations of depersonalization or derealization, etc.
4. Strange thinking and language
People with this personality disorder also present peculiar thinking and language. They use unusual expressions or constructions when interacting with others, and this extrapolates to their thinking.
Thus, both their thinking and their language is often vague, metaphorical, circumstantial, stereotyped or extraordinarily elaborate. When you talk to these people, you may have the feeling that they “talk funny” or that “they are not understood”. These alterations we mentioned, however, are often subtle, and do not amount to a clear incoherence in language and/or thought.
5. Suspiciousness and paranoid ideation
Another characteristic feature of schizotypal personality disorder is suspiciousness 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 with malice aforethought, etc. In addition, they are distrustful 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 they may behave in a way that is not in accordance with the context, or express emotions that are “not adjusted” or “coherent” with the situation, or express very few emotions (restricted affectivity).
This, logically, affects their social relationships, which are difficult.
7. Bizarre behavior or appearance
People with schizotypal personality disorder may also exhibit behaviors that are considered “odd”, or deviant from normality.
Their appearance may also be bizarre (this includes their manner of dress, for example, not in keeping with the season or dress “codes”). Thus, they are people, who if we know them, we may think of as “strange”.
8. Lack of close or trusted friends
These subjects generally 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, moreover, does not diminish with familiarization; this social anxiety is due, rather than to negative self-judgment, to paranoid fears.
That is to say, the paranoid ideations already mentioned can cause these people to avoid social contact and end up isolating themselves.
10. Obsessive ruminations
These people can also manifest obsessive ruminations (they do not resist them internally), especially about aggressive, sexual or dysmorphic contents.
11. Episodes “almost” psychotic
Although schizotypal disorder differs from schizophrenia in that there are no psychotic outbreaks, it is true that “almost” psychotic episodes may occur, but these are occasional and transitory.
They consist, for example, of visual or auditory hallucinations, pseudodelusional ideas (as we have already seen), etc., triggered without external provocation.