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Schizotypal Personality Disorder

Schizotypal personality disorder is an ingrained pattern of thinking and behavior marked by unusual beliefs and fears, and difficulty with forming and maintaining relationships.

People with schizotypal personality disorder are uncomfortable with close relationships and may exhibit eccentric behavior. Speech may include digressions, odd use of words or display "magical thinking," such as a belief in clairvoyance and bizarre fantasies. Patients usually experience distorted thinking and avoid intimacy. They typically have few, if any, close friends, and feel nervous around strangers although they may marry and maintain jobs. The disorder, which may appear more frequently in males, surfaces by early adulthood and can exacerbate anxiety and depression.


People with this disorder avoid socializing and derive little pleasure from interacting with others, a hallmark of the schizoid personality as well. Those with schizotypal personality, however, manifest strange beliefs (aliens, witchcraft, possessing a "sixth sense"). According to the DSM-5, the symptoms include:

  • Discomfort in social situations
  • Odd beliefs, fantasies or preoccupations
  • Odd behavior or appearance
  • Odd speech
  • Difficulty making/keeping friendships
  • Inappropriate display of feelings
  • Suspiciousness or paranoia
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As with most personality disorders, the cause of schizotypal personality disorder is unknown, but there is an increased incidence among relatives of those with the condition, as well as those whose relatives are on the schizophrenia spectrum. The prenatal risk factors that apply to schizophrenia are also relevant to schizotypal personality disorder, including maternal exposure to certain viruses.

Drug use may be a contributing factor for people already at risk of developing this disorder due to an underlying genetic predisposition.


Schizotypal patients rarely initiate treatment for their disorder, tending to seek relief from depressive problems instead. Some people may be helped by antipsychotic medications, but therapy is preferable for most. Because the characteristics of this disorder cannot be fundamentally altered for those with moderate to extreme cases, therapy is often aimed at helping people with this disorder establish a satisfying solitary existence.

Behavioral modification, a cognitive-behavioral treatment approach, can allow schizotypal personality disorder patients to remedy some of their bizarre thoughts and behaviors. Recognizing abnormalities by watching videotapes and meeting with a therapist to improve speech habits are two effective methods of treatment.

American Psychiatric Association, Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition
National Institutes of Health: National Library of Medicine  
National Mental Health Association
Last updated: 02/07/2019