In this series, I dig a little deeper into the meaning of psychology-related terms. This week we’re doing a 2-for-1 looking at schizoid and schizotypal personality disorder.
Both schizoid and schizotypal personality disorder fall within the DSM-5‘s cluster A, which is the odd/eccentric cluster. Despite the similarities in names (it took me a long time to get straight in my head which was which), there are considerable differences.
Schizoid personality disorder
While the name sounds like schizophrenia, schizoid PD is more along the lines of an asocial personality disorder (not that such a thing exists), with asociality taken to extremes. Still, a family history of schizophrenia is a risk factor for schizoid PD, so there is some link there. Emotionally cold, neglectful, or detached parents can also increase risk.
Symptoms can include:
- feeling detached from and completely disinterested in social relationships
- lack of emotional expression during interpersonal interactions
- no interest in or pleasure from social relationships, including family or romantic relationships
- strong preference for solitary activities
- lack of enjoyment in activities
- lack of close social relationships
- appear indifferent to what others think of them (not in the sense of feeling confident without others’ validation; rather, it’s a matter of total disinterest in other people)
- emotional coldness or detachment
Like any personality disorder, symptoms begin early and are well established by adulthood, and cause significant functional impairment and/or distress. The disorder is consistent over time, even more so than other personality disorders. It occurs in 3-5% of the population.
About half of people with schizoid PD also experience major depressive disorder. It’s common to have other co-occurring personality disorders. Lack of interest in having anything to do with other people and translate to lack of motivation to participate in treatment.
Schizotypal personality disorder
Schizotypal PD is sort of like schizophrenia lite. It’s thought to be quite biologically based, and is more common when there is a family history of some form of psychotic disorder.
Symptoms can include:
- decreased ability to function in social relationships, with intense discomfort and lack of understanding of social cues
- distorted thoughts /perceptions and behavioural eccentricities
- belief that things in the environment around them are specifically directed at them, known as ideas of reference, but not to the intensity level of delusions
- odd beliefs (e.g. in the paranormal) or magical thinking (the belief that thinking something can make it happen)
- odd perceptual experiences, such as hearing whispering
- suspicious/paranoid (but not to the intensity of delusions)
- odd/eccentric behaviours or appearance
- don’t have close social relationships
- social anxiety (related to paranoia)
As a personality disorder, this begins when younger and is well established by adulthood. It occurs in about 4% of the population, and is slightly more common in males. Co-occurring depression is very common, as is substance use disorder.
While medications don’t play a huge role in most personality disorders, antipsychotics and antidepressants are commonly used to treat schizotypal PD. Cognitive behavioural therapy (CBT) is also used.
In my mental health nursing career, I didn’t tend to come across either of these disorders, which probably has a lot to do with the types of settings I worked in. I’m pretty darn asocial, but schizoid PD is an entirely different thing from my strong introvert leanings. Schizotypal sounds like a very difficult disorder to live with. The symptoms might not be as severe as schizophrenia, but they’re very persistent, and I would imagine that quality of life is probably rather low.
Were you familiar with either of these disorders, or do you know people that experience them?