Personality disorders clusters. Psychology personality

2. What is personality?
 Personality = Personal traits + Environmental traits.
 Term personality is designed from Latin word
“Persona” means mask. Dictionary meaning of word
personality is personal existence or identity.
 G. W. Allport
 “Personality is dynamic organization within
individual’s traits (Physical and psychophysical traits)
to have unique adjustment to environmental.”
Personality is a science of adjustment”

3.  Dynamic Organization: means developing & changing
different traits & qualities
 physical traits refer to intelligence & general physical
appearance, color of eye, and color of hair.
 Psychosocial traits refer to attitude, interest, nature,
honesty and sociality.
 Unique: every individual has his own set or type of
personality.
 Adjustment to Environment: it is the personality of a
person which adopts itself to changing situation,
adjustment or adaptation becomes as modes of survival.

4. Characteristics of personality:
 Personality is unique; every individual has his own set of
personality characteristics.
 Personality refers qualities of an individual. There are certain
characteristics, which remain relatively permanent.
 Personality represents a dynamic orientation of an organism to
the environment. Most of the characteristics of personality
interact with each other and some of them change in course of
their development. Nature, abilities and all traits are acquired.
Personality is therefore not given to us readymade at birth.
 Personality represents a unique organization of dynamic and
social predispositions.
 Personality by itself is unique and remains as a whole. Each
personality has many traits like physical, mental, intellectual,
emotional & social. All these traits function as a whole.

5. Personality disorder
 Personality disorder results when these personality
traits become abnormal i.e. become inflexible and
maladaptive which cause significant social and
occupational impairment or significant subjective
distress.
 Personality disorders are usually identified only after
16-18 years.
 Earlier the same behaviour described as temperament.

6. Classification (acc. to DSM V )
 Cluster A
 Paranoid personality disorder.
 Schizoid personality disorder
 Schizotypal personality disorder
• Cluster B
 Antisocial personality disorder.
 Histrionic personality disorder.
 Narcissistic personality disorder
 Borderline personality disorder

7. Classification (acc. to DSM V )
• Cluster C
 Anxious personality disorder
 Dependent personality disorder
 Obsessive Compulsive disorders

8. Paranoid Personality Disorders
 These patients show excessive suspiciousness(not
amounting to delusion) in almost all situations and to
all persons.
 They feel that they are being mistreated and are often
hostile and angry.
 They get involved in repetitive litigations and are
perceived as complainers.
 Psychodynamically the underlying defence
mechanism is denial, projection& rationalization.

9. Incidence
 The most common estimations range of all P.D. is about 10-
23%.
 From which about 0.5-2.5% suffer from the paranoid
personality disorder.
 The disorder is more common in men. It is seen in minority
groups and immigrants.

10. Etiology
 The exact etiology is unknown.
 It is more seen in people and families which are
singled out or have a minority status may feel that
they are being discriminated against and may
develop paranoid personality because of their need
for excessive vigilance.
• Childhood traumatic experiences.
• Lack of parental affection in childhood
• Rejection by parents
• Stressful environment

11. Clinical Picture
 These patients show suspicious behaviour
from adolescence.
 During school, they may blame their teachers
for deliberately giving them poor marks.
 They may feel that they are being neglected
by their peers
 As they grow up , they become extra vigilant.
 Every scrap of paper is saved.
 They will suspect their spouse of infidelity.
 May complain against their chief for dishonest
and partiality.
 They are very secretive.

12. Diagnosis
As per ICD-10, PPD is characterized by :-
1. Excessive sensitiveness to set backs and rebuffs.
2.Tendency to bear grudges persistently i.e. refusal to forgive insults
and injuries
3.Suspiciousness and pervasive tendency to distort experience by
misconstruing the neutral or friendly actions of others as hostile.
4.A combative and tenacious sense of personal ‘ right’, out of keeping
with the actual situation.
5.Recurrent suspicions, without justification, regarding sexual fidality
of spouse or sexual partner.
6.Tendency to experience excessive self-importance .
7.Preoccupation with unsubstaintiated ‘conspirational’ explanation of
events both immediate to the patient and in the world at large.
 At least three of the above should be present for diagnosis.

13. DSM-V Criteria for Paranoid PD
 A. A pervasive distrust and suspiciousness of others such that their motives are
interpreted as malevolent, beginning by early adulthood and present in a variety of
contexts, as indicated by four (or more) of the following:
1. Suspects, without sufficient basis, that others are exploiting, harming, or deceiving him
or her.
2. Is preoccupied with unjustified doubts about the loyalty or trustworthiness of friends or
associates.
3. Is reluctant to confide in others because of unwarranted fear that the information will
be used maliciously against him or her.
4. Reads hidden demeaning or threatening meanings into benign remarks or events.
5. Persistently bears grudges (i.e., is unforgiving of insults, injuries, or slights).
6. Perceives attacks on his or her character or reputation that are not apparent to others
and is quick to react angrily or to counterattack.
7. Has recurrent suspicions, without justification, regarding fidelity of spouse or sexual
partner.
 B. Does not occur exclusively during the course of schizophrenia, a bipolar disorder or
depressive disorder with psychotic features, or another psychotic disorder and is not
attributable to the physiological effects of another medical condition.

14. Differential diagnosis
 Delusional disorder
 Paranoid schizophrenia

15. MANAGEMENT
Managem
ent
Psychothera
py
medications
hospitalisat
ion

16. MANAGEMENT
PSYCHOTHERAPY-
• After establishing professional
relationship, developing trust, winning
confidence, demonstrate non-
judgemental attitude and a professional
desire to assist the patient
psychotherapy is initiated.
• Interpretation of feelings may arouse
mistrust & false accusations against
the therapist which have to be dealt
gently and with a realistic approach.

17. MANAGEMENT
GROUP THERAPY
• Include family members,
encourage them to meet
the ‘self help groups’
dedicated to recover from
this disorder.

18. MANAGEMENT
Supportive Psychotherapy
• Analyze the problem dealing
with other people, the patient’s
motivations and possible
sources of paranoid traits,
never challenge the patients
thoughts too directly.

19. MANAGEMENT
Medications
• If client is anxious – anti anxiety
drugs.
• During high stress and extreme
agitation- low dose of antipsychotic,
neuroleptics can be given.
• Selective serotonin reuptake
inhibitors e.g prozac for clients with
angry, irritable and suspicious.
• To reduce symptoms anti-
depressants can be given.

20. MANAGEMENT
 During crisis period or times of
severe symptoms, hospitalization may
be necessary. This can help ensure
patients own safety and that of others,
and make sure that the patient is
getting proper nutrition, sleep and
hygiene.

21. Assessment
 Level of trust in others.
 Level of self esteem
 Suspiciousness
 Fears
 Feelings of powerlessness
 Sleep patterns
 Eating patterns
 Patterns of IPR
 Suicidal ideation
 Social isolation
 Psychomotor disturbance
 Presence of hostilty.
NURSING MANAGEMENT

22. Nursing diagnoses
 Disturbed thought process r/t disruption in cognitive operations
and activities as evidenced by
disorganized and fragmented thoughts .
 Disturbed personal identity r/t inability to distinguish between self
and non-self as evidenced by suicidal and homicidal tendency..
 Risk of violence r/t aggressive behaviour as evidenced by
homicidal tendencies.
 Impaired communication R/T perceptual deficit as evidenced by
word salad.

23. Disturbed thought process r/t disruption in cognitive operations
and activities as evidenced by
disorganized and fragmented thoughts .
INTERVENTIONS RATIONALE
1) Be sincere and honest when
communicating with the client. Avoid vague
remarks.
Delusional clients are extremely sensitive
about others and can recognize insincerity.
Vague ideas reinforces mistrust or delusion.
2) Do not argue with client or try to
convince him that delusions are false or
unreal.
Arguments can interfere with the
development of trust.
3) Do not make promise that you cannot
keep.
Broken promises reinforce the client’s
mistrust of others.
4) Interact with the client on the basis of real
things, don’t dwell into delusional material.
Interacting about reality is healthy for
client.

24. Disturbed personal identity r/t inability to distinguish between self
and non-self as evidenced by suicidal and homicidal tendency
INTERVENTIONS RATIONALE
1) Reassure the client that the
environment is safe by briefly and simply
explaining routines, procedures and so
forth.
The client is less likely to feel threatened
if the surrounding are known.
2) Protect the client from harming
himself or herself or others.
Client safety is a priority. Self destructive
ideas may come from hallucinations or
delusions.
3) Reorient the client to person, place and
time as indicated
4) initially, assign the same staff members
to work with the client.
Consistency can reassure the client.

25. Risk of violence r/t aggressive behavior as evidenced by
homicidal tendencies.
INTERVENTION RATIONALE
1) Maintain low level of environment in
client environment.
This helps in reduction of stimulating
environment and decrease the sensitivity
of client.
2) Observe the client behaviour
frequently.
Helps in keen observation of the client
and thus reduction of violent behaviour.
3)Redirect violent behaviour with
physical outlets for anxiety.
It helps in loss of energy and redirecting
the mind toward another channels.
4) Staff should maintain calm attitude
toward client.
This provide peace and calmness and
promote worthiness among client and
staff.

26. Impaired communication R/T perceptual deficit as evidenced by
word salad.
INTERVENTIONS RATIONALE
1) Motivate client to initiate
conversation.
To know the feelings of client.
2) Encourage the client to participate in
social activities.
3) Do not provoke personalized
questions, agitating questions in the
beginning.
It will result into volition.
4) Never argue or criticize with the client,
related to delusions.
It will results into distrust.
5) Explain to the client, the reason of his
behaviour and the attitude.
To maintain smooth relationship.

27. SCHIZOID PERSONALITY
DISORDER

28. Introduction
In 1908, EUGEN
BLEULER coined the term ,
“schizoid "to designate a
natural human tendency to
direct attention towards
one’s inner life & away
from the external world .

29. Definition
 Schizoid personality disorder is a
personality disorder characterized by
lack of interest in social relationships, a
tendency towards a solitary lifestyle,
secretiveness & emotional coldness.
 Persons with schizoid personality
disorder are often seen by others as
Eccentric, isolated &
lonely.

30. Hallmarks
Pervasive pattern of social
detachment
A restricted range of
expressed emotions
Severe problems in social
relations
Occupational problems
Social isolation Sometimes
favorably affects overall
performance.

31. Epidemiology
 Reported prevalence rates vary
from ‘uncommon’ to (DSM-
4) to 7.5% in general
population
 Acc. To DSM-4 this disorder
is more commonly diagnosed
in MALES than females(2:1).

32. Etiology
 An increased
prevalence among
relatives of probands
with schizophrenia
&schizotypal
personality disorder
has been reported.

33. Clinical features
AREA OVERT COVERT
Self concept Complaint
Stoic
Non-competitive
Self sufficient
Lacking –
assertiveness
Feeling inferior &an
outsider in life
Cynical
Inauthentic
de-personalized
Alternately feeling
empty
Robot-like &full of
omnipotent,
vengeful fantasies
Hidden grandiosity

34. INTER-
PERSONAL
RELATIONS
Withdrawn
Aloof
Few close friends
Impervious to
other’s emotions
Afraid of intimacy
 Sensitive
Deeply curious abt
Others
Intensely needy of
involvement with other
Capable of excitement
with carefully selected
intimates

35. SOCIAL
ADAPTATION
Prefer solitary
occupational
&recreational activities
Marginal or
eclectically sociable in
groups
Tend to be lazy
Lack of clarity of goals
Weak ethnic affiliation
Usually capable of
steady work
Sometimes quiet
creative &may make
unique & original
contributions
Capable of passionate
endurance in certain
spheres of interest

36. LOVE &
SEXUALITY
Asexual , sometimes
celibate
Free of romantic
interests
Averse to sexual
gossip
Secret
pornographic
Interests
Tendency towards
compulsive
Masturbation &
perversions

37. COGNITIVE
STYLE
Absent – minded
Engrossed in fantasy
Vague & stilted
speech
Alterations between
inarticulateness
Autistic thinking
Fluctuations
between sharp
contact with external
reality &
reflectiveness about
the self
Auto centric use of
language

38. Diagnostic criteria
Criteria to diagnose schizoid
personality disorder is as follows:
 Acc. To ICD-10:
 Emotional coldness , detachment or reduced
affection
 Limited capacity to express their either
negative or positive emotions towards
others
 Consistent preference for solitary activities
 Very few friends or relationships & a lack
of desire for such.

39. Indifference to either praise
or criticism
Taking pleasure in few
activities
Indifference in social norms
& conventions
Preoccupation with fantasy
& introspections
Lack of desire for sexual
experiences with another
person

40. DSM-5- manual for diagnosing mental disorders,
defines schizoid personality disorder as:
 A. A pervasive pattern of detachment from
social relationships and a restricted range of
expression of emotions in interpersonal
settings, beginning by early adulthood and
present in a variety of contexts, as indicated
by four (or more) of the following:
1. Neither desires nor enjoys close
relationships, including being part of a family.
2. Almost always chooses solitary activities.
3. Has little, if any, interest in having sexual
experiences with another person.
4. Takes pleasure in few, if any, activities.
5. Lacks close friends or confidants other than
first-degree relatives.

41. 6. Appears indifferent to the praise or
criticism of others.
7. Shows emotional coldness,
detachment, or flattened affectivity.
 B. 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
and is not attributable to the
physiological effects of another
medical condition.

42. TREATMENT
Fairbaim delineated 4 central schizoid
themes:
1. The need to regulate interpersonal
distance as a central focus of concern.
2. The ability to mobilize self preservative
defenses and self reliance.
3. A pervasive tension between the anxiety
laden need for attachment and the
defensive need for distance which
manifests in observable behaviors as
indifference.
4. Over valuation of the inner world at the
expense of the outer world.

43. PHARMACOTHERAPY
Mainly anti-psychotics are used for treatment:
Atypical anti-psychotics : these newer antipsychotics
medications at effective in managing hallucinations,
delusions and other symptoms.
 Olanzapine (5-15 mg)
 Clozapine (300-900 mg)
 Quetiapine (150- 750 mg)
 Risperidone (2-8 mg)

44.  Typical anti-psychotics : These medications are thought to
control symptoms by affecting brain chemicals called
neurotransmitters.
Trifluoperazine (0.25- 10 mg)
Haloperidol (5- 100 mg)
Chlorpromazine (300-1500 mg)

45. Contd…….
 Stimulants : to lift up the mood.
1. amphetaminerall) 20-200 mg
2. Methylphenidate (Ritaline)
3. Dextraamphetamine (Dexadrine)
 Antidepressants :
 ACTION: The major interaction is with the monoamine
neurotransmitter system in the brain particularly nor
epinephrine and serotonin; both will release in the brain
and helps to regulate mood, sensory processing and
appetite.
1. Tricyclic antidepressants. For example, Desipramine
(Norpramine); Imipramine (Tofranil)

46. Contd…
2.Selective serotonin reuptake inhibitor. For example,
Fluoxetine (Prozac); Citalopram (celexa).
3.Monoamineoxidase inhibitors(MAO inhibitors). For
example, Phenelzine (Nardil); Isocarboxazid
(Marplan)

49. Group therapy for schizophrenia has been most
useful over the long term course of illness.
The social interaction, sense of cohesiveness,
identification and reality testing achieved within the
group setting have proven to be highly therapeutic
processes for these clients.

50. Solitary non-competitive activities in the begining that take
some concentration should be given to the client. Such as:
• Cross word puzzles
• Photographing
• Typing
• Drawing
• Reading, poetry
• Listening to music
• When client feels less threatened chess and other activities
which require higher concentration.

51. Course & Prognosis
 The onset of schizoid personality disorder usually occurs in
early childhood
 As with all personality disorders, schizoid personality
disorder is long lasting but not necessarily lifelong.
 The proportion of patients who incur schizophrenia is
unknown.

53. HISTORY:
• Name, age, address of patient, name of informant if any
and their relationship to the patient.
• History of present condition
• Family history
• Personal history
• Past illness
• Personality
• Drugs, alcohol and tobacco use.

54. NURSING CARE PLAN

55. 1. ALTERATION IN THOUGHT PROCESS RELATED TO INABILITY TO
CONCENTRATE,AS EVIDENCED BY IN ABILITY TO SOLVE PROBLEM.
NURSING INTERVENTIONS RATIONALE
Be sincere and honest when
communicating with the client.
Evasive comments or hesitation
reinforces mistrust or delusions
Be consistent in setting expectations,
enforcing rules, and so forth.
Clear, consistent limits provide a secure
structure for the client.
Do not make promises that you cannot
keep.
Broken promises reinforce the client’s
mistrust of others.
Recognize the client’s delusions as the
client’s perception of the environment.
Recognizing the client’s perceptions can help
you understand the feelings he or she is
experiencing
Interact with the client on the basis of real
things; do not dwell on the delusional
material.
Interacting about reality is healthy for the
client.

56. NURSING INTERVENTIONS RATIONALE
Be sincere and honest when
communicating with the client.
Evasive comments or hesitation reinforces
mistrust or delusions
Be consistent in setting expectations,
enforcing rules, and so forth.
Clear, consistent limits provide a secure
structure for the client.
Do not make promises that you cannot
keep.
Broken promises reinforce the client’s
mistrust of others.
Recognize the client’s delusions as the client’s
perception of the environment.
Recognizing the client’s perceptions can help
you understand the feelings he or she is
experiencing
Interact with the client on the basis of real
things; do not dwell on the delusional material.
Interacting about reality is healthy for the client.

57. INTERVENTIONS RATIONALE
Engage the client in one-to-one activities at
first, then activities in small groups, and
gradually activities in larger groups
A distrustful client can best deal with one
person initially. Gradual introduction of
others when the client can tolerates is less
threatening
Never convey to the client that you accept
the delusions as reality.
Indicating belief in the delusion reinforces
the delusion
Ask the client if he or she can see that the
delusions interfere with or cause problems
in his or her life
Discussion of the problems caused by the
delusions is a focus on the present and is
reality based.

58. INTERVENTIONS RATIONALE
Protect the client from harming
himself or herself or others
Client safety is a priority. Self-
destructive ideas may come from
hallucinations or delusions.
Remove the client from the group if
his or her behavior becomes too
bizarre, disturbing, or dangerous to
others.
The benefit of involving the client
with the group is outweighed by the
group’s need for safety and
protection.
Spend time with the client even
when he or she is unable to respond
coherently. Convey your interest and
caring.
Your physical presence is reality.
Nonverbal caring can be conveyed
to the client even when verbal caring
is not understood.

59. INTERVENTIONS RATIONALE
Initially, assign the same staff members to work
with the client.
Consistency can reassure the client.
Begin with one-to-one interactions, and then
progress to small groups as tolerated (introduce
slowly).
Initially, the client will better tolerate and deal
with limited contact.
Gradually, as the client can tolerate it, provide
opportunities for him or her to accept
responsibility and make personal decisions.
The client needs to gain independence as soon as
he or she is able. Gradual addition of
responsibilities and decisions gives the client a
greater opportunity for success.
Direct activities toward helping the client accept
and remain in contact with reality.
Increased reality contact decreases the client’s
retreat into unreality.

60. 3. Disturbed sensory perception related to change in incoming
stimuli as evidenced by diminished response to such stimuli.
INTERVENTIONS RATIONALE
Explore the content of client’s hallucinations
during the intial assessment to determine nature
of hallucinations.
To determine the nature of hallucinations.
Beware of all stimuli, including sounds from
othe rrooms.
Many normal stimuli can trigger or intensify
hallucinations.
If the client appears to be hallucinating, engage
the client by in conversatiion or other activity.
Its more difficult for the client to respond to
hallucinations when or he or she is engaged in
real activities and interactions.
Provide simple activities that the client can
realistically accomplish.
Long and complicated tasks may be frustrating
for the client.

61. 4. Risk of violence related to aggressive behavior as evidenced
by homicidal tendencies.
INTERVENTIONS RATIONALE
Maintain low level of stimuli in client’s
environment.
Helps in reduction of sensitivity to client.
Observe the client’s behavior frequently. Helps in keen observation of the client, thus
,decrease of violence behavior.
Redirect violent behavior with physical outlets
for anxiety.
It helps in loss of energy and redirecting mind
towards another channel.
Staff should maintain calm attitude towards
client.
Helps in decreasing voilent and aggressive
behaviour of client.

62. INTERVENTIONS RATIONALE
Allow the patient to come to the food trolley to take
the food.
Helps in gaining the confidence of the client.
Provide food according to the choice of the client
i.e. menu planning.
Helps in attracting the patient towards meals.
Make the patient to sit and eat together in a group Helps in reducing suspiciousness
Maintain daily weight record To assess the level of nutrition in client.

63.  Pay attention to warning signs. Identify things that may trigger your catatonic
schizophrenia symptoms, which cause a relapse or prevent you from carrying out your daily
activities. Make a plan ,contact your doctor . Addressing schizophrenia symptoms early on
can prevent the situation from worsening.
 Avoid drugs and alcohol. Alcohol and illicit drugs can worsen schizophrenia symptoms. Get
appropriate treatment for a substance abuse problem.
 Check first before taking other medications. Contact the doctor who's treating you for
catatonic schizophrenia before you take medications prescribed by another doctor or before
taking any over-the-counter medications, vitamins, minerals or supplements. These can
interact with your schizophrenia medications.
 Take your medications as directed. Resist any temptation to skip your medications. If you
stop, schizophrenia symptoms are likely to come back.

64. COPING AND SUPPORT
 Learn about schizophrenia. Education about your condition can empower you and
motivate.
 Join a support group. Support groups can help you reach out to others facing
similar challenges.
 Stay focused on your goals. Stay motivated by keeping your recovery goals in
mind. Remind yourself that you're responsible for managing your illness and working
toward your goals.
 Find healthy outlets. Explore healthy ways to channel your energy, such as
hobbies, exercise and recreational activities.
 Learn relaxation and stress management. Try such stress-reduction techniques as
meditation, yoga.
 Structure your time. Plan your day and activities. Try to stay organized. You may
find it helpful to make a list of daily tasks.

65. Schizotypal Personality Disorder
 Persons with schizotypal personality disorder are
strikingly odd or strange, even to laypersons.
 Magical thinking, peculiar notions, ideas of reference,
illusions, and derealization are part of a schizotypal
person's everyday world.

66. Clinical Features
 Patients with schizotypal personality disorder exhibit disturbed
thinking and communicating.
 Although frank thought disorder is absent, their speech may be
distinctive or peculiar, may have meaning only to them, and
often needs interpretation.
 As with patients with schizophrenia, those with schizotypal
personality disorder may not know their own feelings and yet are
exquisitely sensitive to, and aware of, the feelings of others,
especially negative affects such as anger.
 These patients may be superstitious or claim powers of
clairvoyance and may believe that they have other special powers
of thought and insight.
 Their inner world may be filled with vivid imaginary
relationships and child-like fears and fantasies.

67.  They may admit to perceptual illusions or macropsia
and confess that other persons seem wooden and all
the same.
 Because persons with schizotypal personality disorder
have poor interpersonal relationships and may act
inappropriately, they are isolated and have few, if any,
friends.
 Patients may show features of borderline personality
disorder, and indeed, both diagnoses can be made.
 Under stress, patients with schizotypal personality
disorder may decompensate and have psychotic
symptoms, but these are usually brief.
 Patients with severe cases of the disorder may exhibit
anhedonia and severe depression.

68. Diagnostic Criteria
 A. 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, beginning by early adulthood and present in a variety of
contexts, as indicated by five (or more) of the following:
1. Ideas of reference (excluding delusions of reference).
2. 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).
3. Unusual perceptual experiences, including bodily illusions.
4. Odd thinking and speech (e.g., vague, circumstantial, metaphorical,
overelaborate, or stereotyped).
5. Suspiciousness or paranoid ideation.
6. Inappropriate or constricted affect.

70. 7. Behavior or appearance that is odd, eccentric, or
peculiar.
8. Lack of close friends or confidants other than first-
degree relatives.
9. Excessive social anxiety that does not diminish with
familiarity and tends to be associated with paranoid
fears rather than negative judgments about self.
 B. 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.

71. Course and Prognosis
 A long-term study by Thomas McGlashan reported that 10
percent of those with schizotypal personality disorder
eventually committed suicide.
 Retrospective studies have shown that many patients
thought to have had schizophrenia actually had schizotypal
personality disorder and, according to current clinical
thinking, the schizotype is the premorbid personality of
the patient with schizophrenia.
 Some, however, maintain a stable schizotypal personality
throughout their lives and marry and work, despite their
oddities.

72. Treatment
 Psychotherapy
The principles of treatment of schizotypal personality disorder do
not differ from those of schizoid personality disorder, but clinicians
must deal sensitively with the former. These patients have peculiar
patterns of thinking, and some are involved in cults, strange
religious practices, and the occult. Therapists must not ridicule
such activities or be judgmental about these beliefs or activities.
 Pharmacotherapy
Antipsychotic medication may be useful in dealing with ideas of
reference, illusions, and other symptoms of the disorder and can be
used in conjunction with psychotherapy. Antidepressants are
useful when a depressive component of the personality is present.