Schizotypal personality disorder

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Schizotypal personality disorder:

Schizotypal personality disorder (ST PD) or  schizotypal disorder is a psychiatric condition marked by disturbed thoughts and behavior, unusual beliefs, fears and difficulty with forming and maintaining relationships.
  • It's a mental disorder characterized by severe social anxiety, thoughts disorder, paranoid ideation , derealization, transient psychosis and often  unconventional beliefs. Personality disorder with maintaining close relationships with people, mainly because they think that their peers harbor negative thoughts towards them, so they avoid forming them. Peculiar speech mannerisms and odd modes of dress are also symptoms of this disorder. Those with ST PD may react oddly in conversations, not respond or talk to themselves.
  • Symptoms:
  • People  with this disorder may be severely disturbed and might appear schizophrenic. More commonly, however, patients beliefs are stranger than their behavior and may often keep them isolated from normal relationships. Hallucinations, however, are not common symptoms. Other symptoms include:

  • discomfort in social relationship
  • odd beliefs, fantasies or preoccupations
  • odd behavior or appearance
  • odd speech
  • difficulty making/keeping friendships
  • inappropriate display of feelings
  • suspiciousness or paranoia
  • belief in special powers such as superstations
  • unusual perceptions such as having illusions

Causes:

Genetic causes:

Schizotypal personality disorder is widely understood to be a "schizophrenia spectrum" disorder. Rates of schizotypal personality disorder are much higher in relatives of individuals with schizophrenia than in the relatives of people with other mental illness or in people without mentally ill relatives. Technically speaking schizotypal personality disorder may also be considered an "extended phenotype " that helps geneticists track the familiar or genetic transmission of genes that are implicated in schizophrenia. But there is also a genetic connection of schizotypal personality disorder to mood disorder and depression in particular.

Social and environmental causes:

There is now evidence to suggest that parenting styles, early separation, trauma/ maltreatment history (specially early childhood neglect) can lead to the development of schizotypal trait. Neglect or abuse, trauma or family dysfunction during childhood may increase the risk of developing schizotypal personality disorder.

Developmental coarse:

Schizotypal personality disorder is diagnosed in early adulthood and is likely to endure, though treatment, such as medications and therapy can improve symptoms. It occurs in approximately 3% of the general population and is more common in males. 

Complications:

People with schizotypal personality disorder are at an increased risk of :
  • depression
  • anxiety
  • work, school, relationship and social problems
  • other personality disorders
  • problems with alcohol or drugs
  • suicide attempts
  • temporary psychotic episodes, usually in response to stress
  • schizophrenia

Schizotypal personality disorder and schizophrenia:

ST PD can easily be confused with schizophrenia, a severe mental illness in which people lose contact with reality. while people with ST PD may experience brief psychotic episodes with delusions or hallucinations, the episodes are not as frequent , prolonged or intense as in schizophrenia.
    Another key distinction is that people with ST PD usually can be made aware of the differences between their distorted ideas and reality.
    Despite the differences people with schizotypal personality disorder can benefit from treatments similar to those used for schizophrenia. ST PD is sometimes considered on a spectrum with schizophrenia with schizotypal personality disorder  viewed as less severe. 

Treatment:

Medication:

ST PD is rarely seen as the primary reason for treatment in clinical setting, but it often occurs as a co morbid finding with other mental disorders. When patients with ST PD are prescribed pharmaceuticals, they are most often prescribed the same drugs used to treat patients suffering from schizophrenia including traditional neuroleptics such as haloperidol and thiothixene. In order to decide which type of medication should be used, Paul Markovitz distinguishes two basic groups of schizotypal patients:
  • schizotypal patients who appear to be almost schizophrenic in their beliefs and behaviors are usually treated with low doses of antipsychotic medications, e.g thiothixene. However, it must be mentioned that long term efficacy of neuroleptics is doubtful.
  • for schizotypal patients who are more obsessive-compulsive in their beliefs and behaviors, SSRIs like sertraline appear to be more effevtive. 
Lamotrigine, anauti-convulsant, appears to be helpful in dealing with social isolation.

Therapy:

According to Theodore Millon, the ST PD is one of the easiest personality disorder  to identify but one of the most difficult to treat with psychotherapy. Persons with ST PD usually consider themselves to be simply eccentric, productive or nonconformist. As a rule they underestimate maladaptiveness of their social isolation and perceptual distortions. It's not so easy to gain rapport with people who suffer from ST PD due to the fact that increasing familiarity and intimacy usually increases their level of anxiety and discomfort. In most cases they don't respond to informality and humor.
     Group therapy is recommended for persons with ST PD only if the group is well constructed and supportive. otherwise, it could lead to loose and tangential ideation.

References:

  • psychology today.(n.d).Retrieved from: https://www.psychology    today.com/conditions/schizotypal-personality-disorder.Accessed on 5 march 2018
  • schizotypal personality disorder.(n.d).Retrieved from: https://wikipedia.org/wiki/schizotypal-personality-disorder. accessed on 5 march 2018
  • mayo clinic.(n.d). Retrieved from: https://www.mayoclinic.org/diseases-conditions/schizotypal-personality/symptoms-causes/syc-20353919 

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