An Overview of Schizotypal Personality Disorder

As humans, each and every one of us exhibits unique behaviours based upon individual thoughts and feelings. These facets are referred to as traits which are responsible for our personalities. Personality traits model the way in which we experience the world around us, and the manner in which we relate to those we come into contact with. By adulthood part of who we are has already been determined.

Within each individual person there lies a spectrum of traits. E.g. It is not unusual to experience jealousy, seek favour or feel emotional throughout our lifetime. However, being diagnosed with a personality disorder involves these traits causing problems, risk or damage. Research has revealed that personality disorders occur regularly. ‘Around one in 20 people live with some form of personality disorder.[1]’

Living with a personality disorder can affect an individuals coping mechanisms, emotions and interpersonal relationships. Often, those with a personality disorder find that their strategies for daily living and set of beliefs differ from peers and remain fixed.

The manner in which emotions are experienced may be intense, difficult to control, tiring and often confusing. The individual alongside friends and family members may find this distressing. Quite often, high levels of this type of discomfort may lead to the development or exacerbation of other mental health issues such as anxiety or depression. Amongst many other signs and symptoms associated with having a personality disorder is the prevalence of self-harm. There are various reasons to why people exhibit these behaviours. Some report self-harm to ease the way in which feelings triggered by negative or overwhelming emotions are managed. It can also be used as a means of coping with distress alongside communicating the levels and significance of stress being experienced at that time.

Quite often, a diagnosis of personality disorder can be further complicated by the use of substances and/or heavy alcohol consumption as a means of coping. It is frequently recognised that drug use and personality disorders are regularly associated with each other[2]. In 1990, Edgar P Nace et al presented the view that, ‘the pharmacological effects of alcohol and drugs induce personality regression with a weakening of ego function.[3]’ This conclusion is fundamental when considering the key aspects of personality disorders such as; necessity for instant gratification, poor interpersonal skills, impaired ability to recognise and process painful emotions and regulating behaviour, difficulties maintaining personal relationships and poor stress responses.

The two most widely used set of guidelines applied by medical professionals to diagnose mental health problems are: International Classification of Diseases (ICD-10) originating from the World Health Organisation (WHO), and Diagnostic and Statistical Manual (DSM-5) produced by the American Psychiatric Association (APA). Personality disorders diagnoses are grouped into three ‘clusters’, A, B, and C. In certain cases, Doctors encounter difficulties working towards the diagnosis of a personality disorder. These include; Complexity and symptoms not settling into any specific one of the 3 clusters, reluctance of Doctors to give a diagnosis due to fears it may cause future difficulties in accessing help, symptom overlap whereby there exist difficulties in pinpointing unique characteristics, drug/alcohol use. Those finally diagnosed with a personality disorder may feel that doctors making the decision are unclear regarding their diagnosis. Some may experience being stigmatised by a diagnosis whilst others have the opportunity to use the diagnosis to their advantage by accessing the correct support and treatment. 

Cluster A personality disorders present with those experiencing difficulties relating to others. Behaviour patterns may appear eccentric or out of the ordinary. Schizotypal Personality Disorder is a significantly debilitating personality disorder belonging to Cluster A which makes forming relationships and bonds with others extremely difficult. Some people may experience odd, intrusive thoughts and feel paranoid and/or experience auditory or visual hallucinations. This can also be identified as those diagnosed as appearing eccentric and lacking emotion. Other characteristics of this condition include; those diagnosed thinking alternatively and exhibiting odd behaviours. Upon times, some may become tense or anxious when people fail to share their beliefs. It has been noted that some people often use strange words or phrases. Those diagnosed with schizotypal personality disorder sometimes refer to themselves as having special abilities, e.g. sixth sense or telepathy and can feel very uncomfortable in social settings. There are no specifically recommended medications for the treatment of schizotypal personality disorder. However, Doctors may prescribe antidepressants, antipsychotics, benzodiazepines or mood stabilisers to help alleviate symptoms such as low mood and anxiety.

Schizotypal personality disorder exhibits many symptoms of psychosis. Each individual’s experience of psychosis is totally unique. Schizotypal personality disorder occurs in approximately 3% of the population and is more common in males. Many of these people do not come into contact with mental health services because they do not find their experiences distressing. Some people, however, are so distressed and have experienced significant life changing problems that they seek professional help, or others seek help on their behalf.

Many individuals who suffer from psychosis have survived traumatic or abusive experiences, therefore, it may be beneficial for therapy to focus not only on the present but also on the psychological effects of trauma. At Khiron, our psychologists are skilled in working therapeutically with trauma survivors, including working with flashbacks and dissociation (mentally distancing yourself from what is happening, a common way that people cope with trauma).  We use adapted trauma-focused approaches to therapy as a method to help those who experience psychosis.

If you have a client, or know of someone who is struggling with a diagnosis of Schizotypal Personality Disorder, or is experiencing symptoms described in this article – reach out to Khiron. We believe that we can stop the revolving door of treatment and misdiagnosis by providing effective residential and out-patient therapies for underlying psychological trauma. Allow us to help you find the path to effective, long lasting recovery. For information, call us today. UK: 020 3811 2575 (24 hours). USA: (866) 801 6184 (24 hours).


  1. accessed 9/11/2019
  2. Daley D.C. Moss H.B and Campbell M.S.N (1993) Dual Disorders: Counselling Clients with Chemical Dependency and Mental Illness. Hazelden. Minn

  3. Edgar P. Nace MD (1990) Substance Abuse and Personality Disorder, Journal of Chemical Dependency Treatment, 3:2, 183-198, DOI: 10.1300/J034v03n02_08