Overview

People with schizotypal personality disorder are often described as odd or eccentric, and they usually have few, if any, close relationships. They generally don't know how relationships form or how their behavior affects others. They also tend to misinterpret others' motivations and behaviors and greatly distrust others.

These problems may lead to severe anxiety and a tendency to stay away from social situations. That's because people with schizotypal personality disorder tend to hold odd beliefs and may find it hard to respond correctly to social cues.

Schizotypal personality disorder usually is diagnosed in early adulthood, although some features of this condition may show up during childhood and the teen years. It's likely to be a lifelong condition. Treatments, such as medicines and therapy, can make symptoms better.

Symptoms

Schizotypal personality disorder usually includes five or more of these symptoms. The person may:

  • Be a loner and lack close friends and other relationships outside of the immediate family.
  • Have flat emotions or have emotional responses that are limited or not proper socially.
  • Have too much social anxiety, which is ongoing.
  • Incorrectly interpret events, such as feeling that something harmless or not offensive has a direct personal meaning.
  • Have strange or unusual thinking, beliefs or mannerisms.
  • Have suspicious or paranoid thoughts and constant doubts about the loyalty of others.
  • Believe in special powers, such as mental telepathy or superstitions.
  • Have unusual thoughts, such as sensing an absent person's presence, or having illusions.
  • Dress in odd ways, such as appearing messy or wearing oddly matched clothes.
  • Speak in an odd way, such as vague or unusual patterns of speaking, or ramble oddly while speaking.

Symptoms of schizotypal personality disorder, such as more interest in activities done alone or a high level of social anxiety, may be seen in the teen years. The child may not do well in school or appear socially out of step with peers. This may lead to teasing or bullying.

Schizotypal personality disorder vs. schizophrenia

It's easy to confuse schizotypal personality disorder with schizophrenia, which is a severe mental health condition where people struggle with interpreting and managing reality. This is known as psychosis. People with schizotypal personality disorder may have brief psychotic bouts with delusions or hallucinations. But the bouts aren't as often, as long or as intense as with schizophrenia.

Another key difference is that people with schizotypal personality disorder usually can be made aware of how their distorted ideas differ from reality. Those with schizophrenia generally can't be swayed away from their delusions.

Despite the differences, people with schizotypal personality disorder can benefit from treatments like those used for schizophrenia. Sometimes schizotypal personality disorder is thought to be on a spectrum with schizophrenia, with schizotypal personality disorder viewed as less severe.

When to see a doctor

People with schizotypal personality disorder are likely to seek help only at the urging of friends or family members. Or people with schizotypal personality disorder may seek help for another problem such as depression, anxiety or substance misuse. If you think that a friend or family member may have the condition, consider gently suggesting that the person seek the help of a healthcare professional or mental health professional.

If you need immediate help

If you're concerned that you might harm yourself or someone else, go to an emergency department or call 911 in the U.S. or your local emergency number right away. Or contact a suicide hotline. In the U.S., call or text 988 to reach the 988 Suicide & Crisis Lifeline, available 24 hours a day, seven days a week. Or use the Lifeline Chat. Services are free and confidential. The Suicide & Crisis Lifeline in the U.S. has a Spanish language phone line at 1-888-628-9454 (toll-free).

Causes

It's not known what causes schizotypal personality disorder. But it's likely that changes in the way the brain functions, genetics, environmental influences and learned behaviors play a role.

Risk factors

You may be more at risk of schizotypal personality disorder if a relative has schizophrenia or another psychotic disorder.

Complications

People with schizotypal personality disorder are more at risk of:

  • Depression.
  • Anxiety.
  • Other personality disorders.
  • Schizophrenia.
  • Temporary psychotic bouts, usually in response to stress.
  • Misuse of alcohol or drugs.
  • Suicide attempts.
  • Problems with work, school and other social relationships.
By Mayo Clinic Staff