schizotypal personality disorder

 Schizotypal personality disorder: causes, symptoms, diagnosis and treatment.

Definition

Schizotypal personality disorder is a mental disorder characterized by symptoms similar to those of schizophrenia, but with subtle manifestations.

Causes of schizotypal personality disorder

Schizotypal personality disorder is one of the most severe forms of borderline mental pathology, which adversely affects a person's adaptation to life in a social environment and leads to hospitalizations in a psychiatric hospital.

It is believed that schizotypal personality disorder develops in individuals with a genetic predisposition. The disease most often occurs in biological relatives of patients diagnosed with schizophrenia. Schizotypal disorder is characterized by inconspicuous manifestation and slow development.

The onset of the disease is not tied to a specific age, but most often manifests itself during puberty.

Some of the symptoms of schizotypal personality disorder may begin in childhood, affecting learning and peer relationships. Over the years, violations may weaken and not interfere with social adaptation, but they may also increase.

Classification of the disease

According to the periods of the disease:

• latent (hidden) period,
• the stage of pronounced development of the disease with typical signs,
• stabilization period.

Variants of the course of the disease:

• positive symptom complexes (neurosis-like disorders),
• negative symptoms:
• pseudopsychopathic,
• simple and symptom-poor disorder.

Symptoms of schizotypal personality disorder

The symptom complex of schizotypal personality disorder does not lead to such significant personality changes in the end of the disease as in schizophrenia.

The line between schizotypal personality disorder and extravagant behavior is not easy to draw. Schizotypal personality disorder is diagnosed when a person has a negative form of stress or impairment in personal, family, social, academic, professional, and other important areas of life.

In a patient with schizotypal disorders, the following traits and behavioral features can be noted:

• eccentricity, eccentricity, pomposity;
• neglect of the rules of personal hygiene, slovenliness of clothes;
• mannerism, inconsistency of facial expressions with emotions or an experienced situation with a characteristic look that avoids an interlocutor;
• angularity, "articulateness" of movements;
• withdrawal from social contacts;
• incredulity, suspicion of strangers and loved ones;
• intrusive thoughts;
• vague, stereotypical thinking;
• episodes of illusions, auditory or other hallucinations with delusional content that occur without an external cause.

Schizotypal personality disorder differs from schizoid psychopathy by a greater severity of oddities in behavior and thinking, and from schizophrenia by the absence of the main psychotic manifestations characteristic of it.

For all schizotypal disorders, episodes of affective disorders are quite characteristic:

• panic attacks that occur suddenly against a background of anxiety and are of a protracted nature (up to several hours), proceed with a predominance of perverted sensory sensitivity (heat is perceived as pain or cold); the patient is afraid of losing control over himself, going crazy, harming himself and others;
• depression (oppressed, depressed, sad, anxious state), dysphoria (a deep state of anxiety or dissatisfaction), emotions that do not correspond to the irritant that causes them (for example, a patient with a sad look talks about a joyful event);
• gloomy discontent, irritability, grouchiness, a feeling of impending misfortune, trouble;
• apathy, adynamia;
• persistent high spirits, accompanied by a high threshold of sensitivity to negative events.

Realizing their mental ill-being, patients see its cause outside, blame relatives, colleagues, fate. Patients lack deep attachment to loved ones.

Over time, there is a gradual shortening of light intervals, the course of the disease approaches a continuous one with some fluctuations in the strength of symptoms.

There is a tendency to exaltation (an emotional state in which a person is inspired for no good reason) and rash acts.

Dual suicidal tendencies are observed: the patient hesitates for a long time whether to make a suicide attempt, stops halfway. The reason for the suicidal act is often not able to explain. However, there may be completed suicides.

Patients with schizotypal disorder are characterized by phobias (obsessive fears): social phobia (fear of being in society, fear of performing any public actions), nosophobia (fear of getting a serious illness), agoraphobia (fear of open space, open doors), bacillophobia (fear of a person pollution or contamination), which are exacerbated in some situations.
With schizotypal personality disorder, general symptoms can be observed: loss of appetite, physical weakness, various unpleasant sensations in various parts of the body, cyanosis and coldness of the extremities, pressure in the back of the head, dizziness, tinnitus, nausea, eating disorders.

Diagnosis of schizotypal personality disorder

Schizotypal personality disorder is not easy to diagnose because it is accompanied by multiple symptoms that resemble other mental disorders. Therefore, often the disease is detected when the patient goes to the doctor for other reasons: due to prolonged depression, anxiety, or disorders associated with fears.

The psychiatrist conducts a conversation with the patient, examines him, conducts tests, pathopsychological and neurophysiological studies. This helps the specialist to understand what violations exist in a person's perception of the world and other people, his reaction to ongoing events, and peculiarities of thinking.

The following information is taken into account during the state analysis process:

• family cases of the disease;
• features of development in childhood and adolescence;
• the presence of unusual hobbies;
• decrease in intellectual activity;
• decrease in working capacity, violation of social adaptation.

The diagnostic criteria for schizotypal personality disorder is to determine whether a patient has, for at least two years, four or more of the following traits:

• emotional coldness, detachment from what is happening around;
• eccentric appearance or manner of dressing;
• violation of communication with other people, social phobia;
• paranoid ideas, suspicion;
• intrusive thoughts;
• illusory perception of reality.

To make a diagnosis of schizotypal personality disorder, it is important to take into account that the patient's symptoms and behavioral characteristics are not a manifestation of another disease (for example, brain tumors), did not result from exposure to the central nervous system of psychoactive substances (alcohol withdrawal) or drugs (for example, corticosteroids) are not manifestations of other mental or behavioral disorders.

Which doctors to contact

In case of occurrence or suspicion of the presence of behavioral features, it is necessary to contact a psychiatrist to clarify the diagnosis.

Treatment of schizotypal personality disorder

An integrated approach, including the use of psychotropic drugs and psychotherapy, is important for the treatment of schizotypal personality disorder.

There are three stages in drug therapy.

• Cupping therapy - from the moment of diagnosis to clinical remission. Its goals are the elimination of psychotic disorders, the correction of behavioral disorders and their accompanying symptoms.
• Aftertreatment or stabilization is the continuation of effective antipsychotic therapy.
• Anti-relapse therapy to maintain stable remission, prevent new psychotic attacks and slow the rate of disease progression.

To achieve the goals, the following drugs can be used:

• typical neuroleptics,
• atypical antipsychotics,
• tranquilizers,
• antidepressants.

Psychotherapy is provided by a psychotherapist. Treatment is aimed at teaching skills to control outbursts of anger, manage aggression and adequately interact with society.

Complications

Schizotypal personality disorder rarely develops into autism and schizophrenia.

Prevention of schizotypal personality disorder

Timely initiation of therapy in combination with social rehabilitation measures can achieve remission and preserve the patient's social functioning and activity.