Schizotypal personality disorder
- A pervasive pattern of social and interpersonal deficits marked by acute discomfort with, and reduced capacity for, close relationships as well as by cognitive or perceptual distortions and eccentricities of behavior
- Five (or more) of the following criteria, beginning in early adulthood and present in a variety of contexts:
- Ideas of reference (excluding delusions of reference).
- Odd beliefs or magical thinking that influences behavior and is inconsistent with subcultural norms (e.g., superstitiousness, belief in clairvoyance, telepathy, or “sixth sense”: in children and adolescents, bizarre fantasies or preoccupations).
- Unusual perceptual experiences, including bodily illusions.
- Odd thinking and speech (e.g., vague, circumstantial, metaphorical, overelaborate, or stereotyped).
- Suspiciousness or paranoid ideation.
- Inappropriate or constricted affect.
- Behavior or appearance that is odd, eccentric, or peculiar.
- Lack of close friends or confidants other than first-degree relatives.
- Excessive social anxiety that does not diminish with familiarity and tends to be associated with paranoid fears rather than negative judgments about self.
- Does not occur exclusively during the course of schizophrenia, a bipolar disorder or depressive disorder with psychotic features, another psychotic disorder, or autism spectrum disorder
Psychiatric Disorders with Psychotic Symptoms
- Acute psychosis
- Schizoaffective disorder
- Delusional disorder
- Schizotypal personality disorder
- Schizoid personality disorder
- Bipolar disorder with psychotic features
- Neurodevelopmental disorders
- Personality change due to another medical condition
- Substance use disorders
- Other personality disorders and personality traits
- A clinical diagnosis; however if entertaining other organic causes may initiate workup below
- Point-of-care glucose
- Chem 7
- ECG (for toxicology evaluation)
- ASA level
- Tylenol level
- Urine toxicology screen/Blood toxicology screen
- Urine pregnancy/beta-hCG (if female of childbearing age)
- Ask for clarification of any unclear terminology, be genuinely curious
- Know patient may underreport symptoms due to desire to end social interaction with you
- Referral for outpatient psychiatric treatment, which can include psychotherapy, antidepressants, and antipsychotics medications
- American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Publishing.