schizotypal personality disorder

Pathology

• poor understanding of interpersonal relationships
• inability to interpret behaviors & motivation

Clinical manifestations

• features must be present since young adulthood to meet criteria for personality disorder
• characteristic appearance, behaviors, & beliefs that are strange, unusual or inappropriate
• usually few, if any, close relationships
• elderly:
  • beliefs can become delusional & lead to conflict with others
  • relationships with caregivers can be strained or absent

Complications

• anxiety
• depression
• psychosis in response to psychosocial stress
• social isolation
• schizophrenia (rare)

Management

• assess for & treat comorbid psychosis
• do not force social interactions
• offer support & problem-solving assistance
• do not challenge paranoid ideation
• solicit & empathize with emotions, turmoil, fear
• cognitive behavioral therapy
• antipsychotics as needed
• antidpressants as needed
• anxiolytics as needed

More general terms

• cluster A personality disorder