Schizotypal Personality Disorder

Schizotypal personality disorder (SPD) was first conceptualized based on observations of otherwise healthy relatives of patients with schizophrenia. Genetic and familial studies, along with molecular studies that have identified several candidate genes, provide evidence of a phenotypic association between SPD and schizophrenia. Persons with SPD are noted to have odd, stereotyped behaviors; suspiciousness; difficulty relating to others; lack of empathy; and magical thinking. Cognitive impairments and neural abnormalities are evident in these individuals as well; neuropsychological, psychophysiological, and neuroimaging findings suggest a pattern of functioning that is intermediate between those of persons with schizophrenia and healthy controls. Although SPD is a chronic disorder that affects social and occupational functioning, psychiatric hospitalizations are rare, and antipsychotic treatments are seldom needed. A focus of treatment is to address cognitive deficits in SPD using dopamine agonists. Further work is needed to understand the genetic, biological, and clinical lines between SPD and other schizophrenia spectrum disorders.