F21 Schizotypal Disorder

A disorder characterized by eccentric behaviour and anomalies of thinking and affect which resemble those seen in schizophrenia, thought no definite and characteristic schizophrenic anomalies have occurred at any stage. There is no dominant or typical disturbance, but any of the following may be present:

(a) inappropriate or constricted affect (the individual appears cold and aloof);
(b) behaviour or appearance that is odd, eccentric, or peculiar;
(c) poor rapport with others and a tendency to social withdrawal;
(d) odd beliefs or magical thinking, influencing behaviour and inconsistent with subcultural norms;
(e) suspiciousness or paranoid ideas;
(f) obsessive ruminations without inner resistance, often with dysmorphophobic, sexual or aggressive contents;
(g) unusual perceptual experiences including somatosensory (bodily) or other illusions, depersonalization or derealization;
(h) vague, circumstantial, metaphorical, overelaborate, or stereotyped thinking, manifested by odd speech or in other ways, without gross incoherence;
(i) occasional transient quasi-psychotic episodes with intense illusions, auditory or other hallucinations, and delusion-like ideas, usually occurring without external provocation.

The disorder runs a chronic course with fluctuations of intensity. Occasionally it evolves into overt schizophrenia. There is no definite onset and its evolution and course are usually those of a personality disorder. It is more common in individuals related to schizophrenics and is believed to be part of the genetic "spectrum" of schizophrenia.

Diagnostic Guidelines

This diagnostic rubric is not recommended for general use because it is not clearly demarcated either from simple schizophrenia or from schizoid or paranoid personality disorders. If the term is used, three or four of the typical features listed above should have been present, continuously or episodically, for at least 2 years. The individual must never have met criteria for schizophrenia itself. A history of schizophrenia in a first-degree relative gives additional weight to the diagnosis but is not a prerequisite.

Includes:
* borderline schizophrenia
* latent schizophrenia
* latent schizophrenic reaction
* prepsychotic schizophrenia
* prodromal schizophrenia
* pseudoneurotic schizophrenia
* pseudopsychopathic schizophrenia
* schizotypal personality disorder

Excludes:
* Asperger's syndrome
* schizoid personality disorder