Schizotypal Personality Disorder: Understanding the Symptoms, Causes, and Treatment Options

Schizotypal personality disorder, also known as SPD, is a mental health condition characterized by odd, eccentric, and unusual behavior, as well as strange beliefs, social anxiety, and cognitive distortions. People who have this disorder often experience difficulties in social interactions, tend to isolate themselves, and have a hard time forming close relationships.

What Are the Symptoms of Schizotypal Personality Disorder?

The symptoms of SPD can vary from mild to severe, and include:

  • Beliefs that seem eccentric or odd, such as being superstitious, believing in telepathy, psychic abilities, or having magical powers.
  • Suspiciousness or paranoid thoughts, such as thinking that people are plotting or conspiring against them, or that people are secretly watching or following them.
  • Social anxiety and fear of rejection, leading them to avoid or limit social interactions, or to have a few, close but peculiar relationships.
  • Difficulty expressing emotions or understanding others’ emotions, leading to a restricted range of expression, and misinterpretation of emotional cues.
  • Unusual behavior, such as speaking in an peculiar language, having strange mannerisms, dressing or grooming in an unusual way, or having a preoccupation with odd or trivial details.
  • Perceptual disturbances, such as experiencing unusual sensations, illusions or hallucinations that are not severe enough to meet the criteria for a psychotic disorder.
  • Cognitive distortions or magical thinking, such as believing in fate, destiny, or holding unusual beliefs that are not supported by evidence.

What Causes Schizotypal Personality Disorder?

The exact causes of SPD are not well understood, but research suggests that it may be caused by a combination of genetic and environmental factors. Studies have found that first-degree relatives of people with SPD are more likely to develop the disorder, suggesting a genetic component.

Environmental factors that may contribute to SPD include childhood trauma or abuse, neglect, parental rejection, social isolation, and bullying. Children who grow up in emotionally cold or emotionally chaotic environments may have difficulties developing social and communication skills, which may contribute to the development of SPD symptoms later in life.

How Is Schizotypal Personality Disorder Diagnosed?

SPD is a diagnosis that is made by a mental health professional, such as a psychiatrist or psychologist, who can conduct a comprehensive evaluation of a person’s symptoms, medical history, and cognitive functioning. Diagnosing SPD can be difficult, as many of its symptoms can overlap with other mental health conditions, such as depression, anxiety, or other personality disorders.

The diagnosis of SPD is based on the criteria outlined in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5). To receive a diagnosis of SPD, an individual must exhibit at least five of the following symptoms:

  • Ideas of reference (excluding delusions of reference)
  • Odd beliefs or magical thinking that influences behavior and is inconsistent with subcultural norms, such as superstitions, fears, or beliefs in paranormal phenomena.
  • Unusual perceptual experiences, including bodily illusions.
  • Odd thinking and speech, such as vague, metaphorical, or stereotyped.
  • Suspiciousness or paranoid ideation.
  • Inappropriate or constricted affect.
  • Behavior or appearance that is odd, eccentric, or peculiar.
  • Lack of close friends or confidants other than first-degree relatives.
  • Excessive social anxiety that does not diminish with familiarity and tends to be associated with paranoid fears rather than negative judgments about self.

What Are the Treatment Options for Schizotypal Personality Disorder?

There is no cure for SPD, but there are several treatment options that can help alleviate symptoms, improve social functioning, and enhance the quality of life. The most effective treatment options for SPD include:


Psychotherapy, also known as talk therapy, is the most common treatment for SPD. There are several forms of psychotherapy that can be effective in treating SPD, including cognitive-behavioral therapy (CBT), dialectical behavior therapy (DBT), and interpersonal therapy. Psychotherapy aims to help individuals with SPD explore their thoughts, emotions and beliefs, as well as improve their social skills, communication, and self-esteem.


There are no medications that are specifically designed to treat SPD, but medications can be helpful in managing some of the symptoms associated with the disorder, such as depression, anxiety, or paranoia. Antipsychotic medications, mood stabilizers, and antidepressants are commonly used to treat SPD.

Social Support

Developing a support network of understanding friends or relatives is important for individuals with SPD, as it can help alleviate feelings of isolation, increase self-esteem, and improve overall functioning. Support groups, activities, and hobbies that involve social interaction can be helpful in building social skills and confidence.


Schizotypal personality disorder is a mental health condition that can be challenging and isolating, but with the right treatment, individuals with SPD can lead fulfilling lives. Psychotherapy, medications, and social support are effective treatment options that can help alleviate symptoms, improve social functioning, and enhance quality of life.


What is Schizotypal Personality Disorder?

Schizotypal Personality Disorder is a mental health condition that is characterized by a range of unusual behaviours, beliefs, and perceptions. People with this disorder may experience social anxiety, difficulty forming relationships, and a distorted sense of reality. It is a type of personality disorder that is closely related to schizophrenia.

What are the symptoms of Schizotypal Personality Disorder?

Symptoms of Schizotypal Personality Disorder can include unusual beliefs or experiences, such as magical thinking or delusions; social anxiety or discomfort in social situations; paranoid thoughts, unusual speech patterns or unusual perceptual experiences or behavior. It’s common for those with Schizotypal Personality Disorder to avoid close relationships, may not have any hobbies or interests, and may struggle to express emotion or may show excessive emotional responses.

Can Schizotypal Personality Disorder be treated?

Yes, there are various treatments for Schizotypal Personality Disorder, but it is important that an accurate diagnosis is made beforehand. Treatment options may include therapy, medication, or a combination of both. Cognitive Behavioural Therapy (CBT) can help people learn coping strategies for their symptoms and understanding the social and emotional cues. Clinical Psychologist might recommend therapy for families or partners of those affected. If medication is necessary, then an Antipsychotic or antidepressant medication may be prescribed to manage symptoms by regulating the thoughts and emotions. Because handling stigma might also play a big role in the person’s recovery, it is also important to acknowledge it and plan ways to cope with it which could aid in the person’s ability to seek help.


1. American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (DSM-5®). Arlington, VA: American Psychiatric Publishing.

2. Baron-Cohen, S., Wheelwright, S., Hill, J., Raste, Y., & Plumb, I. (2001). The “reading the mind in the eyes” test revised version: A study with normal adults, and adults with Asperger syndrome or high-functioning autism. Journal of Child Psychology and Psychiatry, 42(2), 241-251.

3. Fonseca-Pedrero, E. (2019). Schizotypal personality disorder: current state of knowledge. Current psychiatry reviews, 15(2), 100-108.