Schizotypal personality disorder is characterised by distortions in the way individuals perceive reality and their patterns of thought. In this article I will briefly outline the symptoms of schizotypal personality disorder, how it differentiates from schizophrenia, and how schizotypal personality disorder can be managed.

Symptoms of schizotypal personality disorder

The combination of symptoms is likely to vary across individuals as everyone is unique, however the DSM 5 states that 5 out of a total 9 criteria must be met for a diagnosis of schizotypal personality disorder to be made. Some of these symptoms include:

> Magical thinking, often accompanied by unusual beliefs (for example, excessive superstition)
> Lack of interest in forming or maintaining relationships (including friendships)
> Paranoia or suspicion
> Odd or eccentric speech and/or appearance

These symptoms must be relatively inflexible and ongoing, and identifying with one or two of the above symptoms does not necessarily mean an individual has schizotypal personality disorder. A useful way to remember what constitutes a ‘personality disorder’ is to use the ‘3 P’s’1 paradigm; that is, the individual’s experiences must be:

  1. Problematic (i.e. cause significant difficulties for the individual themselves or in inter-personal relationships, or deviate significantly from ‘normality’)
  2. Persistent (i.e. be ongoing), and
  3. Pervasive (i.e. remain across different contexts, such as work and personal life).

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Is schizotypal personality disorder the same as schizophrenia?

While the two share somewhat similar symptoms, schizotypal personality disorder and schizophrenia are not the same. Schizophrenia is what many clinicians would coin an ‘Axis I’ mental disorder, and is a significant impairment in individuals’ ability to differentiate between subjective perception and external reality.

On the other hand, a schizotypal personality disorder is an ‘Axis II’ diagnosis which often appears in late teenage or early adulthood years and is, as the name suggests, part of an individual’s ‘personality’. Another important distinction is that – generally speaking – individuals with a schizotypal personality disorder do not experience symptoms of psychosis (e.g. hallucinations or delusions); rather, they experience somewhat ‘milder’ versions of these symptoms (e.g. odd beliefs). On the other hand, symptoms such as hallucinations and delusions are key features and indicators of schizophrenia.

It is important to bear in mind that the validity and reliability of personality disorders as a diagnostic category is still argued amongst clinicians and individuals, however, some individuals find diagnostic criteria useful as a way of making sense of their experiences.

What causes schizotypal personality disorder?

Research suggests that schizotypal personality disorder is likely caused by a combination of both genetic and environmental factors. Some clinicians and researchers suggest that schizotypal personality disorder can be placed along the spectrum of schizophrenia and related disorders.
In brief, there is no single cause of schizotypal personality disorder, as is the case with many psychological disorders, however, professionals can work with clients to identify potential underlying factors that may have caused or triggered the development of schizotypal personality disorder.

Can schizotypal personality disorder be treated?

There are different forms of psychotherapy available for individuals with schizotypal personality disorder based on their individual needs and symptoms. For example, online cognitive behavioural therapy (CBT) is shown to be effective in targeting thought processes and beliefs to make them more adaptive and also uses a number of behavioural strategies and techniques which can help in relationship formation and maintenance.

For more information call 0753 718 1090 or email To book a Virtual Therapy appointment with the Online Therapy Company, please fill in the online booking form.

Author – Dr Aisha Ali – DPsych Couns Psych, ADOS 2 Certified B.Psych (Hons)

Dr Aisha Ali is a highly experienced BPS Chartered Counselling Psychologist and Expert witness with over 15 years experience of working within the NHS in complex care and private practice. She has extensive experience of working with individuals, couples and families presenting with complex psychological and emotional issues. Aisha provides life and performance coaching.

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