Schizotypal personality disorder (SPD) is a mental disorder that is reasonably well understood despite the fact that it is actually moderately difficult to diagnose. What makes it difficult to diagnose is the fact that the symptoms of SPD make it difficult to observe. People suffering from SPD tend to be reclusive, often hiding the symptoms from friends or family who might notice the problem.
Symptoms – Schizotypal Personality Disorder
According to the DSM-5, there are many traits associated with schizotypal personality disorder. Almost every trait associated with the disorder is also associated with at least one other mental disorder, though. Because of this, when diagnosing the disorder, medical professionals usually looks for the presence of at least five or more of the following traits:
- Being reclusive and lacking personal attachments beyond family
- A likelihood to interpret neutral events as having personal meaning
- Eccentricity in beliefs and mannerisms
- Dressing in particularly unusual ways
- Odd superstitions or belief in the supernatural
- Flashes of perception that are out of touch with reality
- Persistent, sometimes paralyzing, social anxiety
- Illogical patterns of speech
- Regular distrust of other people
- Inappropriate emotional responses, with flat emotional responses being the most common identifier
Some of these traits are present in almost everybody and the presence of multiple of these traits may not necessarily indicate SPD. Other mental disorders, particularly schizophrenia, can also cause these traits to be present in a person.
Schizophrenia vs. Schizotypal Personality Disorder
Most people see the word “schizotypal” and simply assume that it is synonymous with schizophrenia. And while there are some similarities between the two disorders, they are anything but identical.
Schizophrenia is a severe mental disorder that causes the person suffering from it to perceive reality in a different way than the average person. Usually this altered perception includes hallucinations that are not caused by pharmaceutical substances. In addition to having altered perceptions of the world, schizophrenics are likely to experience delusions that are completely irrational.
People with schizotypal personality disorder, conversely, are not subject to full on hallucinations that overwhelm their perception of the world. They do experience flashes of altered perceptions, but not in such a way that overwhelms them. SPD also tends to be characterized by discomfort with personal relationships and a belief system that is unusual or eccentric. It is not uncommon for someone suffering from this disorder to have metaphysical or supernatural beliefs that otherwise are completely logical.
The most important difference between the two disorders is that the former is always severe while the latter can range from mild to severe, though it is important to note that even the most severe cases of SPD are still less debilitating than schizophrenia. Additionally, while many schizophrenics avoid personal interactions in reaction to their hallucinations or as a result of their delusions, schizophrenia, unlike SPD, does not automatically result in discomfort with social interactions.
In short, the two disorders share similarities, but the differences are actually quite sharp, especially when being diagnosed by a trained psychiatrist.
Alcohol & Personality Disorders
According to clinical studies, the prevalence of personality disorders with alcoholism ranges from as low as 22-40% to as high as 58-78%. The studies have focused primarily on antisocial and borderline personality disorders, however, almost the whole spectrum of personality disorders can be encountered in alcohol dependence, such as the dependent, avoidant, paranoid and others.
Personality Disorders and Substance Abuse
In a study done in 2012 (In-depth study of personality disorders in first-admission patients with substance use disorders) they discovered 46% of the substance abuse (SUD) patients had at least one Personality Disorder (16% antisocial [males only]; 13% borderline; and 8% paranoid, avoidant, and obsessive-compulsive, respectively).
Cluster C disorders were as prevalent as Cluster B disorders. SUD patients with PDs were younger at the onset of their first SUD and at admission; used more illicit drugs; had more anxiety disorders, particularly social phobia; had more severe depressive symptoms; were more distressed; and less often attended work or school.
Treatment – Schizotypal Personality Disorder
Building a framework of trust is the key to treatment for SPD. Such trust is often built through psychotherapy, where the therapist first builds one-on-one trust with the patient and then works to expand that trust to others. There is no specific form of psychotherapy that is a magic bullet for this disorder. However, cognitive-behavioral therapy, supportive therapy, and family therapy have all resulted in successful treatment in specific cases.
Drugs may also play a part in treatment, but not directly. There is no medication currently approved for treatment of SPD, but some medications can provide supplementary assistance by relieving symptoms of depression, anxiety, or helping to improve cognitive abilities.
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