Personality disorder means more than eccentricity or quirkiness. It is categorised by the deep-rooted and continuing patterns of specific behaviour and beliefs, which differ from the recognised social behavioural standards. Personality disorders can affect the victim’s life quality dramatically. 

There are ten personality disorders, which the American Psychiatric Association has categorised into three clusters. A cluster is a group of disorders having the same presentation.

• Cluster A: Presentation is eccentric or odd
• Cluster B: Presentation is emotional, erratic, or dramatic
• Cluster C: Presentation is fearful and anxious

The personal disorder is enduring issues of interpersonal and self-identity functioning. All share four common features but the intensity of presentation differs from one person to another:

• Impaired emotional response
• Distorted thought patterns
• Interpersonal functioning issues
• Compromised impulse control

Schizoid and schizotypal personality disorder both belong to cluster A. They sound similar and even share some symptoms but there are several differences. 

Symptoms and characteristics 

Schizoid personality disorder (SzPD) includes a disconnection pattern from a social relationship and their emotional range is limited. You can perceive the following symptoms:

• Lack of interest in sexual relationships
• Choose to stay alone
• Do not engage in pleasurable activities
• Feel indifference to criticism or praise
• Lack of closeness with family members or friends
• Refrain from displaying love or warmth

The characteristics of SzPD make it hard for the sufferer to maintain or form healthy relationships. They appear to be lonely and gain pleasure from electronics, computers, and maths instead of people. The diagnosis of SzPD condition is uncommon because the majority of those suffering from this condition don’t identify it to be an issue.

The symptoms of STPD overlap SzPD because both conditions curb the ability of a person to form relationships. Nevertheless, the characteristics of STPD involve some extra distorted thinking aspects: 

• Odd beliefs of others or oneself
• Believe others are speaking about them
• Paranoia or suspiciousness
• A high amount of social phobia
• Unusual body sensations
• Peculiar appearance
• Confused speaking, thinking or behavior patterns

People struggling with STPD can experience temporary psychosis, where they feel, hear, or see things that are not there. They even reveal extra symptoms of depression and anxiety. 

Schizoid versus schizotypal 

• Comfort level – A person with SzPD hardly cares about this condition or tries to enhance their life. Alternatively, the one struggling with STPD finds their situation uneasy, because they feel extremely anxious and depressed in maintaining personal or social relationships. Therefore the possibility that people with STPD seek treatment is more.
• Behaviour – The set of thoughts and actions of people with STPD are eccentric, odd, and bizarre. These people seem different in a crowd concerning appearance and communication with others. 

Diagnostic assessment

A thorough clinical assessment is necessary, which involves evaluating the behaviour and functioning patterns. Even other possible presentation causes are considered. A medical examination is also a part of a comprehensive assessment. 

The mental and behavioural disturbances can be due to medical conditions, which rules out personality disorder diagnoses. So, how does the clinician rule out or diagnose a psychiatric disorder, which gets presented in the same fashion? 

• Schizophrenia (Schizoid) – People with SzPD generally don’t experience perceptual or cognitive disturbances like hallucinations or paranoia.
• Schizotypal (STPD) – People with STPD experience perceptual or mental disturbances.
• Autism Spectrum Disorder (ASD) – People with SzPD avoids social functioning due to general disinterest. On the other hand, social functioning impairment is severe in people with STPD.
• Avoidant personality disorder (AVPD) – People with SzPD wants social interaction but are afraid of rejection or embarrassment. On the other hand, Schizotypal person is totally unconcerned about social contact. 
• Depression – It is a pervasive mood disturbance, which is not visible in SzPD. Majority of Schizotypal disorder suffer from an episode of extreme depression once in their lifetime. 

Specific criteria outlined in DSM-5 are applied to diagnose schizoid or schizotypal personality disorder. Minimum four of the given criteria need to be present.

• Prefer solitary activities even jobs
• No interest in forming a close relationship even with family
• Hardly enjoys activities
• Lacks close friends or relative
• Appears emotionally cold or detached or reveals a flattened effect
• Looks uninterested towards compliment or condemnation

If the person is under 18 years of age, the pattern of personality disorder has to be present for a minimum of one year. Remember, antisocial personality disorders cannot be detected in young teens under 18.

What are the causes of SzPD and STPD?

Personality can be defined as a combination of emotions, thoughts, and behaviour, which makes a person unique. It is how you perceive yourself as well as understand, view, and communicate with the outside world. 

Personality gets formed during childhood and is shaped via your genes and the environment you grow in. the development of SzPD or STPD or other disorders can be due to vulnerable genes or a situation in life. Other factors that increase the development of personality disorder include:

• Family history related to mental illnesses or personality disorders
• Diagnosis of childhood conduct disorder
• Unstable, chaotic or abusive family life from childhood
• Variations in brain structure and chemistry

What are the treatment options?

Like any other psychological conditions, personality treatment options for cluster A exists. Those interested in seeking treatment can use a combination of medication and therapy.

For SzPD treatment 

• Talk therapy – It helps to detect and encounter faulty beliefs regarding relationships. Besides start seeing how beneficial close relationships are.
• Medications – Drugs are prescribed for encountering the symptoms of depression and anxiety.

For STPD treatment

• Cognitive-behavioural therapy – It helps to change problematic behavior, learn communication skills, and challenge biased thinking patterns that constrain interactions. 
• Family therapy – It helps to develop trust and improve emotional closeness with family members.
• Medications – Therapists may prescribe anti-depressants. Anti-psychotics, anti-anxiety, or mood stabiliser medications for handling the symptoms. 

 Bottom line

• Though SzPD and STPD have a lot of similarities, there are lots of differences too. Both belong to a cluster featuring odd and weird behavior and beliefs. 
• SzPD doesn’t desire close relationships, whereas the ones with STPD are interested in connecting but they cannot foster relationships due to their symptoms. Nevertheless, STPD people seek treatment because their symptoms are more severe than SzPD conditions. 

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Image credit: Freepik

Dennis Relojo-Howell is the founder of Psychreg. He interviews people within psychology, mental health, and well-being on his YouTube channel, The DRH Show.