We all have our little idiosyncrasies. However, when somebody starts to withdraw from society, speak, think, act and dress in an odd way, it is possible they are showing the symptoms of schizotypal personality disorder.

Before we start, it is worth mentioning that schizotypal personality disorder may share similar symptoms to other disorders. For example, schizophrenia and schizoid personality disorder. However, they are not the same. So how do you characterise the signs of this disorder?

Three Main Schizotypal Personality Disorder Symptoms

The symptoms can be broken down into three main groups:

  1. A limited capacity to form and maintain close relationships
  2. A distorted way of perceiving or thinking about events
  3. Exhibiting off-putting eccentric behaviour

However, to be diagnosed as having a schizotypal personality disorder, you have to suffer from at least 5 of the following symptoms:

  • Problems maintaining relationships outside of the family
  • Lives a hermit or loner lifestyle
  • Detached, isolated from society
  • Suffers from persistent social anxiety that does not decrease with familiarity
  • Social anxiety is connected to paranoia
  • Flat affect or emotions or inappropriate emotional reaction
  • Odd speech style, i.e. rambling incoherently, unusual way of talking
  • Off-putting odd and eccentric behaviour, beliefs, mannerisms or thinking
  • Dresses in a peculiar way, wearing outlandish, ill-matched or unkempt clothes
  • Misinterprets events, believes something that is meaningless has a direct impact on them
  • Paranoid and suspicious about those around them, questions loyalty
  • Magical thinking, superstitious, has a belief in clairvoyance and telepathy and the paranormal
  • Allows these beliefs to influence their thinking and judgment
  • Feels that they can influence events (ideas of reference)
  • An odd thinking style, for example, stereotypical, black and white thinking, vague, over-elaborates, metaphorical or circumstantial
  • Believes they can sense an absent person’s presence

These Symptoms in More Detail

Inability to form relationships

The major problem someone with this disorder faces is an inability to form close relationships. However, it is not surprising that the schizotypal person has problems with relationships. Consider the other presenting factors in this disorder.

For example, the odd speech and thinking, misinterpreting events and dressing in an eccentric manner. These all contribute to problems forming relationships. But are their problems due to their discomfort managing these symptoms or the discomfort of others around them? Experts are not sure. I suspect it is a combination of the two.

Social Isolation

What experts do know is that a person suffering from schizotypal personality disorder feels anxious in social situations. It is likely, therefore, that alongside all the other social and personal deficits, they prefer their own company. This leads to a hermit or loner lifestyle.

As a result, this has a knock-on effect on relationships. They feel uncomfortable in social situations. Of course, this doesn’t help with forming close relationships. However, the main reason for this anxiety is paranoia and suspicion regarding other people’s behaviour towards them. Not the fact they feel shy and awkward in social situations.

Odd behaviour

There are many symptoms of odd behaviour that show up in schizotypal personality disorder. For example, a flat affect in speech is common. Others around them will think they are cold and aloof because of this.

Likewise, speaking inappropriately or showing the wrong emotion at the wrong time. A little like giggling at a funeral. The way they speak is also odd. They might use a lot of metaphors to converse, speak with a lot of useless nonsense or ramble on with too much detail.

Their dress will be mismatched or outlandish. They’ll think nothing of wearing pyjamas to the theatre or a ball gown to the supermarket. They might be dishevelled or dirty. They won’t care about personal hygiene, preferring to spend their time researching the important things like alien invasions and the end of the world.

Ideas of reference

People with a schizotypal personality disorder will often believe that meaningless events hold great significance, especially for them. It is as if they are being given clues and signs to interpret and only they can solve them. This is similar to ‘magical thinking’ where people believe that their thoughts, ideas, wishes or actions have the power to influence outside events.

I remember working in an office years ago and a guy I had worked only a few times with came up to me and asked if I had left an elastic band on his desk. I didn’t understand the question. He said the band was in the shape of a love heart and that he understood what I was trying to tell him.


Superstition is another symptom of schizotypal personality, alongside a preoccupation with the paranormal. People who suffer from this disorder are obsessed with clairvoyants, magic, numbers, the universe, and the unknown; anything that cannot be easily explained.

They may also hold odd beliefs; ones that do not conform to societal rules. But they won’t care what others think.

Odd thinking style

People with this disorder think differently to us. They might use black and white thinking, or perceive time and space in different terms (perpetual aberration). They also suffer from a concentration on physical symptoms, such as pain or fatigue (somatic symptoms), which then causes them great emotional distress.

They are often paranoid and believe in conspiracy theories, particularly relating outlandish tales about themselves. For example, they might suppose that an innocent phone call by a relative is talking about them to the CIA.

Who Is Likely to Suffer from Schizotypal Personality Disorder?

Just under 4% of the world’s population suffers from this disorder. There is a slightly higher occurrence in men (4.2%) than women (3.7%). You are more likely to suffer from this disorder if you are a black woman, have a low income, are divorced, separated or widowed.

With adjustments made for variables, the schizotypal disorder is shown to be significantly associated with other disorders. This includes narcissistic personality disorder, bipolar disorder and PTSD. Conversely, there are lower occurrences in Asian men.

What Are the Causes of This Disorder?

Experts believe a combination of factors contributes to a cause of this disorder:

  • Biology
  • Genetics
  • Environment


Research shows that mothers exposed to influenza during their 6th-month gestation pregnancy term have higher associations with schizotypal traits in males.


Early studies show that diagnoses of this disorder are higher when some form of schizo-disorder runs in the family.


Episodes of stress, psychological trauma or acute anxiety lead to higher incidences of people suffering from this disorder.

Diagnosing and Treating Schizotypal Personality Disorder

There are no blood or genetic tests that can diagnose this disorder. In fact, someone who has several of the symptoms of schizotypal personality disorder should seek a proper diagnosis from a trained mental health practitioner. Psychologists and psychiatrists have the expertise to diagnose this rather tricky mental health disorder.

The problem with treating this kind of disorder is that usually, the person suffering from it does not seek treatment themselves. Therefore, it is up to the family or friends of the sufferer to help the person get treatment.

Treatment of schizotypal personality disorder can be a combination of psychotherapy to understand what is happening and medication to calm the symptoms. For severe cases, treatment may not be effective. Therefore, the only way forward is to assist people suffering to live a satisfying and productive life on their own.

Final Thoughts

Decades ago, anyone who appeared different would be locked up regardless of what was wrong with them. Nowadays, we are learning more and more about the human brain and mental disorders. This is allowing experts to help those who are suffering to improve their living standards, which can only be a step in the right direction for everyone.


  1. www.mayoclinic.org
  2. pdfs.semanticscholar.org
  3. www.health.harvard.edu
  4. www.webmd.com

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