Giving ordinary events unusual personal significance without holding a fixed delusional belief.
DSM-5-TR · Cluster A · personality disorder
Could I have schizotypal personality disorder?
Schizotypal personality disorder is characterised by marked discomfort with close relationships together with cognitive or perceptual peculiarities and eccentric behaviour. Having some of these traits does not mean that someone has a personality disorder: DSM-5-TR requires an enduring, pervasive and clinically significant pattern.
Cluster AMistrust, detachment or eccentricity
5/9
DSM-5-TR
What are the DSM-5-TR features?
DSM-5-TR requires at least 5 of the 9 specific features, together with the general requirements for a personality disorder.
Specific criteria — paraphrased
Odd beliefs or magical thinking that influence behaviour and are not explained by cultural norms.
Unusual perceptual experiences, including unusual bodily sensations.
Odd thinking or speech that may be vague, metaphorical, over-elaborate or stereotyped.
Suspiciousness or paranoid-style thinking.
Limited or sometimes contextually incongruent affect.
Odd, eccentric or peculiar behaviour or appearance.
Very few close friends or confidants apart from close relatives.
Marked social anxiety that persists with familiarity and is mainly linked to paranoid fears.
Diagnostic reference: DSM-5-TR (American Psychiatric Association, 2022). The wording above is intentionally concise and paraphrased.
The specific criteria are not sufficient on their own
- The pattern is enduring, inflexible and present across different contexts — not only during a crisis or in one particular relationship.
- It causes significant distress or impairment in social, occupational or other important areas of functioning.
- The pattern is stable over time and can be traced back at least to adolescence or early adulthood.
- It is not better explained by another mental disorder, a substance/medication effect or a medical condition.
Differential diagnosis
Schizotypal personality disorder or a psychotic disorder?
Differential diagnosis notably includes schizophrenia and mood disorders with psychotic features. In those disorders, delusions, hallucinations or other psychotic symptoms are more prominent. Schizotypal personality disorder is also distinguished from paranoid and schizoid personality disorders by its cognitive, perceptual and behavioural peculiarities.
Clinical assessment
How is the diagnosis made?
Diagnosis is not based on a checklist or a single questionnaire. It requires clinical interviewing, review of the person’s long-term pattern and functional impact across settings, and differential diagnosis. Personality questionnaires and tests can support that assessment.
The 10 specific DSM-5-TR personality disorders
Explore the other personality disorders
Personality disorders can share features and sometimes overlap, making differential diagnosis essential.
Are you wondering about your personality functioning?
An emotional and personality assessment can compare several hypotheses, clarify the overall pattern and avoid drawing conclusions from a few isolated traits.
