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What is the Difference Between Schizophrenia and Schizotypal Personality Disorder?

Updated on March 20, 2016
Bridget F profile image

Bridget is a Licensed Master Social Worker with experience in mental health, crisis intervention and aging.

The Main Differences Between Schizophrenia and Schizotypal PD

  • Individuals with schizophrenia experience hallucinations and delusions, and are unaware that they are experiencing psychosis.
  • On the other hand, people with schizotypal PD experience social isolation, strange preoccupations, beliefs, behavior and ways of dressing, and may interpret situations differently than others.
  • People with schizophrenia experience delusions and cannot always tell the difference between those delusions and reality - people with schizotypal personality disorder know the difference between their beliefs and what is real.

Let's Begin With Schizotypal Personality Disorder

  • Individuals with schizotypal personality disorder have difficulty with relationships, a strange or unusual appearance, and odd behavior and thought patterns.
  • The cause of this disorder has not yet been identified.
  • Schizotypal personality disorder is not the same thing as schizophrenia or schizoid personality disorder.


The American Psychiatric Association has defined Schizotypal Personality Disorder as a "pervasive pattern of social and interpersonal deficits marked by acute discomfort with, and reduced capacity for, close relationships as well as by cognitive or perceptual distortions and eccentricities of behavior, beginning by early adulthood and present in a variety of contexts".

People with this disorder, as well as with other personality disorders, are generally not aware that they have a problem. People with schizotypal personality disorder may :

  • dress in an odd way
  • may be suspicious or paranoid
  • may be uncomfortable in social situations due to pervasive mistrust of others
  • come off as aloof or emotionally distant or cold
  • may have odd beliefs or magical thinking or may seem to "'live in a fantasy world"


Do you know anyone with schizotypal personality disorder?

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Prevalence and Co-Morbidity with other disorders

  • Schizotypal personality disorder occurs in 0.6%-4.6% of the general population. This disorder occurs slightly more commonly in males.
  • Other disorders that frequently occur with schizotypal personality disorder include borderline personality disorder, avoidant personality disorder and depressive disorders.

A Test for Schizotypal Personality Disorder

One tool that is used to assess for schizotypal personality disorder is the Schizotypal Personality Questionnaire or SPQ (See below).

Remember: Psychiatric conditions can only be diagnosed by mental health professionals!!

In this video, Dr Rhoda Hahn discusses schizotypal personality disorder.

Now, Onto Schizophrenia

Positive Symptoms (Psychotic symptoms not seen in healthy people)

  • Hallucinations (seeing or hearing things that are not really there)
  • Delusions (false beliefs such as the belief that someone is communicating with you through the TV)
  • Lack of emotion
  • Thought disorders or disorganized thinking (unusual ways of thinking or making up words)
  • Movement disorders (repetitive movements) or catatonia (not moving, speaking, or responding to others)

Negative Symptoms (symptoms that involve disruption to normal symptoms and behavior)

  • Lack of pleasure in everyday life
  • Speaking very little
  • Lack of ability to plan or to sustain planned activities
  • Difficulty maintaining personal hygiene

Cognitive Symptoms

  • Problems with decision-making
  • Problems focusing
  • Poor short-term memory


For a diagnosis of schizophrenia, two diagnostic criteria have to be met over much of the time of a period of at least one month, with a significant impact on social or occupational functioning for at least six months. The person has to be suffering from delusions, hallucinations or disorganized speech. A second symptom could be negative symptoms or severely disorganized or catatonic behavior or another positive symptom. (American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders (5th ed.). Arlington: American Psychiatric Publishing. ISBN 978-0890425558.)


What Causes Schizophrenia?

Studies have shown that schizophrenia runs in families. The risk is highest for the identical twin of someone with schizophrenia.

Scientists also think that a brain imbalance leads to schizophrenia. Studies of individuals after death have indicated that there are brain differences in people who have schizophrenia. Scientists found small changes in the distribution or characteristics of brain cells that they think occurred before birth. Some experts think problems during brain development before birth may lead to faulty connections which may not be evident until puberty begins. The brain undergoes major changes during puberty, and these changes could trigger psychotic symptoms.

About 1% of Americans have schizophrenia.

What Causes Schizophrenia?

Studies have shown that schizophrenia runs in families. The risk is highest for the identical twin of someone with schizophrenia.

Scientists also think that a brain imbalance leads to schizophrenia. Studies of individuals after death have indicated that there are brain differences in people who have schizophrenia. Scientists found small changes in the distribution or characteristics of brain cells that they think occurred before birth. Some experts think problems during brain development before birth may lead to faulty connections which may not be evident until puberty begins. The brain undergoes major changes during puberty, and these changes could trigger psychotic symptoms.

About 1% of Americans have schizophrenia.

Schizophrenia Treatment

Schizophrenia cannot be cured but the symptoms can be treated. One major treatment involves anti-psychotic drugs such as:

  • Chlorpromazine (Thorazine)
  • Haloperidol (Haldol)
  • Perphenazine (Etrafon, Trilafon)
  • Fluphenazine (Prolixin).

Atypical anti-psychotics are also utilized and include:

  • Risperidone (Risperdal)
  • Olanzapine (Zyprexa)
  • Quetiapine (Seroquel)
  • Ziprasidone (Geodon)
  • Aripiprazole (Abilify)
  • Paliperidone (Invega).

One problem with the long-term use of anti-psychotics is that it can lead to a disorder called Tardive Dyskinesia or TD which involves involuntary muscle movements.

Job training, family education, cognitive behavioral therapy and support groups are other treatments for schizophrenia.


More Facts About Schizophrenia


Positive Symptoms (Psychotic symptoms not seen in healthy people)

  • Hallucinations (seeing or hearing things that are not really there)
  • Delusions (false beliefs such as the belief that someone is communicating with you through the TV)
  • Lack of emotion
  • Thought disorders or disorganized thinking (unusual ways of thinking or making up words)
  • Movement disorders (repetitive movements) or catatonia (not moving, speaking, or responding to others)

Negative Symptoms (symptoms that involve disruption to normal symptoms and behavior)

  • Lack of pleasure in everyday life
  • Speaking very little
  • Lack of ability to plan or to sustain planned activities
  • Difficulty maintaining personal hygiene

Cognitive Symptoms

  • Problems with decision-making
  • Problems focusing
  • Poor short-term memory


For a diagnosis of schizophrenia, two diagnostic criteria have to be met over much of the time of a period of at least one month, with a significant impact on social or occupational functioning for at least six months. The person has to be suffering from delusions, hallucinations or disorganized speech. A second symptom could be negative symptoms or severely disorganized or catatonic behavior or another positive symptom. (American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders (5th ed.). Arlington: American Psychiatric Publishing. ISBN 978-0890425558.)




Summary


  • As you can see, the names may be similar but the disorders are very different!
  • Schizotypal personality disorder differs from schizophrenia, as individuals with schizophrenia experience hallucinations and delusions, and are unaware that they are experiencing psychosis.
  • People with schizotypal PD experience social isolation, strange preoccupations, beliefs, behavior and ways of dressing, and may interpret situations differently than others.
  • People with schizophrenia experience delusions and cannot always tell the difference between those delusions and reality - people with schizotypal personality disorder know the difference between their beliefs and what is real (or at least that others do not believe the same things that they do!)





Question

Have you ever experienced Schizophrenia or Schizotypal Personality Disorder?

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