While most people may think of schizophrenia when they hear the word schizotypal, there are many differences between schizophrenia and schizotypal personality disorder

Most people are at least somewhat familiar with schizophrenia and its symptoms of hallucinations and delusions. Far fewer are familiar with schizotypal personality disorder. Schizotypal personality disorder is characterized by disorganized thinking, severe anxiety, unfounded paranoia, odd beliefs, feelings of derealization and, in some cases, psychosis. 

By reviewing schizotypal personality disorder vs. schizophrenia, it becomes easier to see how the two disorders are very different. Both disorders are related to distorted thinking patterns, but beyond this fact (and the similarities of their names), many differences distinguish schizotypal vs. schizophrenia

Schizotypal Personality Disorder Symptoms

A primary feature of schizotypal personality disorder is a social skill deficit. However, this deficit and the presence of distorted thinking alone do not fully encompass what schizotypal personality disorder is

Other schizotypal personality disorder symptoms include:

  • Inability to form personal relationships
  • Social isolation
  • Improper interpretation of events
  • Unusual thoughts, beliefs or mannerisms
  • Dressing in strange ways
  • Unusual patterns of speech
  • Paranoid thinking
  • Distorted perceptions
  • Superstitious beliefs
  • Flat affect

Many people with schizotypal personality disorder also struggle with depression and memory. Schizotypal personality disorder causes are not known, but the consensus is that the disorder results from a combination of genetic and environmental factors. Some evidence of a relationship between schizotypal personality disorder and schizophrenia exists. Individuals who have a close relative diagnosed with schizophrenia may be more likely to develop schizotypal personality disorder. 

Schizophrenia Symptoms and Characteristics

The primary characteristics of schizophrenia are hallucinations and delusions. Hallucinations refer to distortions of perception, including:

  • Auditory hallucinations: such as hearing voices that are not there
  • Visual hallucinations: such as seeing things that are not real

Delusions refer to false beliefs. For example, someone who believes they have been possessed or that the government has implanted a monitoring device in their brain is exhibiting delusions. 

Other signs and symptoms of schizophrenia include:

  • Disorganized speech
  • Odd or atypical behavior
  • Flat affect
  • Lack of motivation
  • Difficulties processing information

Like schizotypal personality disorder, schizophrenia causes are often not concretely known. It appears that there is a genetic component to schizophrenia as it often runs in families. However, there are other causes of schizophrenia which may exist independent of a genetic predisposition or in addition to a genetic origin. 

Other causes of schizophrenia include:

  • Growing up in a stressful environment, including growing up in poverty
  • Disruptions to brain function and chemistry before or after birth
  • Exposure to viruses or nutritional deficits before birth

Differentiating Schizophrenia and Schizotypal Personality Disorder

While potentially related, these disorders should not be confused. There are several key differences to keep in mind when differentiating between these disorders, including:

  • The primary difference between schizotypal personality disorder and schizophrenia revolves around the primary symptoms of schizophrenia–hallucinations and delusions. Both schizotypal personality disorder and schizophrenia may include odd social behaviors and strange beliefs, but a person with schizotypal personality disorder does not experience hallucinations and delusions. 
  • Distorted thinking is a central feature of schizotypal personality disorder, which is far different from the full psychotic break from reality that occurs with schizophrenia. Though in some rare cases, a person with schizotypal may experience lower intensity psychosis. 
  • Schizotypal personality disorder and schizophrenia differential diagnosis also looks at the presence of co-occurring disorders. A secondary mood disorder often accompanies schizotypal personality disorder, whereas schizophrenia rarely co-occurs with mood disorders. 

Personality Disorders vs. Psychotic Disorders

Schizotypal personality disorder and schizophrenia at their essence are also two very different types of disorders. Understanding the differences and similarities of personality disorder vs. psychotic disorder may benefit deeper understanding. 

Unlike other mental health conditions, personality disorders are believed to be:

  • Pervasive: affecting all areas of a person’s life
  • Stable: despite fluctuations of intensity symptoms are rarely, if ever fully absenttabl
  • Resulting from poor adaptation: impaired personal identity, or inability to develop interpersonal skills

Similarities in Treatment

Schizotypal personality disorder treatment and schizophrenia treatment are similar in many situations as some treatments work for both disorders. 

For example, antipsychotic medication is the primary schizophrenia medication used. These medications are also one of the main schizotypal medications, along with mood stabilizers. The differences between the treatment of these disorders lie primarily in the psychotherapy component of treatment. 

A person with schizophrenia is most likely to benefit from insight-oriented therapies and skill-building sessions that will help improve their ability to cope with symptoms and live independently. 

While some of the general therapeutic approaches may overlap, individuals with schizotypal personality disorder will likely need to focus on social skills training

Key Points: Schizotypal Personality Disorder vs. Schizophrenia

While it can be difficult at first to distinguish between schizotypal personality disorder and schizophrenia, there are several key ways to tell these disorders apart. 

The primary differences between schizotypal personality disorder and schizophrenia include:

  • Schizophrenia includes hallucinations and delusions. Schizotypal personality disorder does not.
  • Schizotypal personality disorder often co-occurs with mood disorders. Schizophrenia rarely co-occurs with mood disorders. 
  • Treatment for schizotypal personality disorder may include the use of mood stabilizers in addition to antipsychotic medications.
  • Therapy for schizotypal personality disorder usually focuses on social skills training. 

Both schizotypal personality disorder and schizophrenia frequently co-occur with substance use disorders. If you or a loved one has a substance use disorder and a co-occurring disorder such as schizotypal personality disorder or schizophrenia, The Recovery Village can help. Ask how we can help you begin recovery today.