What Is Schizotypal Personality Disorder?

Written by WebMD Editorial Contributors
Medically Reviewed by Jabeen Begum, MD on December 18, 2024
7 min read

Schizotypal personality disorder (STPD) is a mental health condition that causes extreme distress involving close relationships and social contact. Schizotypal personality disorder is part of a group of conditions called “Cluster A” personality disorders. People who have these disorders often seem odd or peculiar to others. They also may show unusual thinking patterns and behaviors.

What are personality disorders?

People with personality disorders have long-standing patterns of thinking and acting that differ from what society considers usual or normal. Their rigid personality traits can cause problems and interfere with many areas of life, including social and work. People with significant personality disorders generally also have poor coping skills and trouble forming healthy relationships.

People with personality disorders sometimes aren’t aware they have a condition and don’t believe they have anything to control.

People with schizotypal personality disorder have odd behavior, speech patterns, thoughts, and perceptions. Other people often describe them as strange or eccentric. People who have this disorder may also:

  • Dress in an odd or unusual way (unkempt, messy, or an unusual style)
  • Be suspicious and paranoid
  • Be uncomfortable or anxious in social situations due to their distrust of others
  • Have few friends except for first-degree relatives
  • Be very uncomfortable with intimacy
  • Tend to misinterpret reality or to have distorted perceptions (for example, mistaking noises for voices)
  • Have odd beliefs or magical thinking (for example, being overly superstitious or thinking of themselves as psychic)
  • Be preoccupied with fantasy and daydreaming
  • Tend to be stiff and awkward when relating to others
  • Come across as emotionally distant, aloof, or cold
  • Have limited or overly intense emotional responses or seem “flat”
  • Have unusual thoughts or ways of speaking (being vague, using odd metaphors, repeating phrases, speaking slowly or with long pauses, showing little variation in tone)
  • Lack drive and underachieve in school and at work
  • Have thinking that ranges from clear and organized to vague and rambling

People with schizotypal personality disorder may have odd beliefs or superstitions. They have trouble forming close relationships and tend to distort reality. In this way, schizotypal personality disorder can seem like a mild form of schizophrenia, a serious brain disorder that distorts the way a person thinks, acts, expresses emotions, perceives reality, and relates to others.

People who have schizophrenia are disconnected from reality and have trouble functioning day to day. They may have delusions and see or hear things that aren’t there (hallucinations). But people who have schizotypal personality disorder don’t.

In rare cases, people with schizotypal personality disorder may go on to develop schizophrenia.

Your genes may play a role in schizotypal personality disorder. It’s more common in relatives of people with schizophrenia and usually starts in early adulthood. A person’s temperament, reactions to life events, relationships, and coping strategies probably all have something to do with how their personality develops during childhood and adolescence.

How common is STPD?

Around 3% to 5% of people in the United States live with schizotypal personality disorder, making it a somewhat rare condition.

STPD risk factors

Men and people assigned male at birth are more likely to have STPD than women and those assigned female at birth. You may start noticing symptoms as a teenager when your personality evolves.

If you have symptoms, your doctor will ask about your medical history and may do a physical exam. 

They might recommend that you see a psychiatrist, psychologist, or other healthcare professionals trained to diagnose and treat mental illnesses. They use special interview and assessment tools to diagnose personality disorders and may ask about your childhood, relationships, and work history. Since someone with STPD may not view their behavior as a problem, mental health professionals also talk to the person's family and friends to gain more insight.

Schizotypal personality disorder test

There are no lab tests to diagnose personality disorders, but your doctor might use other tests to rule out physical illness as the cause of the symptoms.

Schizotypal personality disorder criteria

To be diagnosed with STPD, a mental health professional should find that you have five or more symptoms of the condition.

 

People with schizotypal personality disorder rarely get treatment for the disorder itself. When they do go to the doctor, it’s often for a related disorder, such as depression or anxiety. Your treatment may include:

Psychotherapy

Psychotherapy -- a form of counseling -- is the most common treatment. The symptoms of schizotypal personality disorder could make it hard to begin a relationship with a therapist. But over time, you and your doctor can set common goals and work toward them.

Therapy aims to help you change your relationship styles, expectations, coping patterns, and habits of thinking and behavior. People with this disorder can often learn to realize when they are distorting reality.

Psychotherapy may include:

  • Cognitive behavioral therapy (CBT), which shows you how other people may see your behavior and helps you manage anxiety and improve your social skills.
  • Group therapy involves discussing problems in a group with a therapist or psychologist. It may also help people with schizotypal personality disorder improve their social skills.
  • Supportive therapy. This teaches you how to handle negative emotions or thoughts, trust people, and build relationships.
  • Supportive-expressive therapy. This helps you get rid of negative biases about relationships. You’ll open up about your thoughts, feelings, and concerns.
  • Family therapy. Treatment works best when family members are involved and supportive.

Medication

People with schizotypal personality disorder who also have another disorder, such as anxiety or depression, might take medication. But it usually isn’t the main treatment for personality disorders. 

Your doctor could prescribe:

In some cases, especially during a period of crisis or severe stress, you might have severe symptoms and need to stay in the hospital briefly.

Lifestyle management

Things in your daily life that may help you manage schizotypal personality disorder symptoms include:

  • Healthy relationships with friends and family
  • A regular schedule with plenty of sleep and exercise
  • Taking your medications as directed
  • Opportunities to meet goals or make achievements at school, at work, or in recreational activities

If you have a personality disorder, managing your emotions and experiences can sometimes feel overwhelming. In the moment, try focusing on small actions to help: breathing exercises, creative activities, listening to music, or journaling can ease frustration. Watching a favorite show, reaching out to friends, or cuddling a pet might help if you're feeling sad or lonely. For anxiety or dissociation, grounding techniques like sipping a warm drink, walking barefoot, or focusing on your surroundings can be calming. If you feel like self-harming, try expressing yourself through writing, art, or music, or consider taking a cold shower as a distraction.

For longer-term support, talking to trusted friends, peer groups, or helplines can make you feel less alone. Techniques like keeping a mood diary can help you track triggers and patterns, while self-help tools for dialectical behavior therapy (DBT) may teach you skills to manage emotions. Planning for difficult times — like creating a crisis plan with contacts, safe spaces, and coping strategies — can also help.

It can be challenging when someone you care about is diagnosed with a personality disorder. You may not always understand their feelings or behaviors, but there are ways to support them while also taking care of yourself.

Be there for them by validating their feelings, even if you don’t fully understand their experience. Acknowledge their emotions by saying things like, “That sounds really tough right now.” Staying calm when they’re overwhelmed and sitting with them quietly can also help them feel supported. Learn more about personality disorders to challenge misconceptions and better understand what they’re going through.

Offer practical support by helping them plan for appointments or simply encouraging them to seek help. Remind them of the qualities you value in them, like their kindness or creativity, as they may struggle to see these in themselves. Setting clear boundaries about what you can offer and expect in the relationship can help both of you navigate tough situations.

Plan for difficult times by discussing what might help if they feel overwhelmed or have thoughts of self-harm. Finally, remember to care for your own mental health. Supporting someone can be emotionally demanding, so it’s important to prioritize your own well-being, too.

Living with schizotypal personality disorder means you have a higher chance of other health problems, including:

  • Depression
  • Anxiety
  • Other personality disorders
  • Schizophrenia
  • Stress-related psychotic periods
  • Alcohol and drug misuse
  • Suicide attempts
  • Issues at work and school and with social relationships

Schizotypal personality disorder is a mental health condition that affects how you think, behave, and relate to others. People with STPD may appear odd, have unusual speech patterns, dress eccentrically, or believe in things like magic or supernatural ideas. They often feel anxious in social situations, have trouble forming close relationships, and may misinterpret reality, like mistaking sounds for voices. 

Treatment often includes psychotherapy, like cognitive behavioral therapy (CBT), to improve social skills and coping strategies. Medications, such as antipsychotics or antidepressants, may be used to address related issues like anxiety or depression. Although many people with STPD avoid seeking help, therapy can help them manage symptoms and improve their relationships over time. Your outlook depends on how severe your symptoms are. People motivated to change, get treatment, and stick with it have better results.

What is the difference between schizoid and schizotypal personality disorder?

While people with schizotypal personality disorder are uncomfortable with personal relationships, those with schizoid personality disorder (ScPD) have no interest in them. People with ScPD also lack the peculiar thoughts and behaviors associated with STPD.

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