Schizotypal disorder - signs, help, prognosis

The schizotypal form of personality disorder belongs to the category of chronic diseases of the schizophrenic type. This pathology has a slow development and manifests itself in the form of psychopathy, hypochondria, neurotic and affective disorders, as well as mild symptoms of paranoia. This disease is often called a latent or sluggish form of schizophrenia. The first symptoms of the disease appear in adolescence, but they may be subtle to others. According to statistics, this form of personality disorder is highly prevalent among the stronger sex. Schizoid and schizotypal personality disorder is the topic of this article, which will discuss all aspects associated with these pathologies.

Schizotypal disorder is a chronic, slowly developing disorder of the schizophrenia spectrum.

Causes

The causes of schizotypal disorder literally lie in the genes. The disease, like schizophrenia, is an endogenous pathology that is inherited.

Very often it is possible to establish that one of the blood relatives of such a patient suffered from schizophrenia, affective disorders, or was distinguished by eccentricities and oddities.

When a patient comes to the attention of psychiatrists and close relatives begin to visit him, often one of them is distinguished by inappropriate, conspicuous behavior.

F25 Schizoaffective disorders

Episodic disorders in which schizophrenic and manic symptoms are equally pronounced, on the basis of which it is impossible to diagnose only schizophrenia or only a depressive or manic episode. Other conditions in which affective symptoms are superimposed on existing schizophrenia, coexist or alternate with other types of chronic delusional disorders are classified under headings F20-F29. Psychotic symptoms in the form of severe mood disturbances in affective disorders do not provide grounds for diagnosing schizoaffective disorder.

More details

Symptoms

According to ICD-10, diagnosis is carried out based on the characteristic signs of the disorder:

• various oddities and peculiarities are observed in a person’s behavior and appearance, egocentrism is possible;
• there are strange views and beliefs that are not consistent with generally accepted norms, thinking can acquire a magical character, that is, a person begins to associate many absolutely natural things with the influence of some magical forces, which is incomprehensible to others;
• excessive suspicion is characteristic, paranoid ideas can be traced;
• the person looks aloof, he is emotionally cold, and his reactions are often inadequate;
• one can note the impoverishment of contacts, a tendency towards social withdrawal;
• the thinking of such people can acquire an overly detailed, amorphous, detailed character;
• There may be perceptual anomalies such as body illusions, derealization, or depersonalization;
• various obsessions are noted, the distinctive feature of which is the absence of internal resistance;
• without external provocation, rare episodes of hallucinations (most often auditory), illusions, and delusional ideas may be observed.

It is not necessary for a person to have all these symptoms, it is enough that 4 or more of the signs I listed above have been observed for at least 2 years.

To make a diagnosis of schizotypal disorder, it is first necessary to rule out schizophrenia.

In the current International Classification of Diseases, 10th revision (ICD-10), schizotypal disorder is coded as F21.

Classification and stages of development

Anxious personality disorder

The disorder can develop in different ways. There is the following classification of schizotypal deviations:

• A disorder that occurs as a neurosis;
• An illness resembling psychopathy;
• Sluggish or latent form of schizophrenia;
• Violation of social functions, resulting in partial or complete loss of ability to work.

At the initial stage of the disease, the patient’s behavior practically does not change, only somewhat strange habits, obsessions and rituals may appear. At the stage of development of the disease, there is a significant decrease in performance and productivity at work, associated with the person’s reluctance to fulfill his job responsibilities and social maladjustment. The third stage is a severe form of the disease, developing into schizophrenia. In some cases, the patient may need treatment in a hospital (for example, when attempting suicide under the influence of depression).

Differential diagnosis

Differential diagnosis of schizotypal disorder is most often carried out with schizophrenia, obsessive-compulsive disorder, and schizoid psychopathy.

Differences from schizophrenia

Why was the disease, previously called sluggish schizophrenia, given the name schizotypal disorder and separated into a separate category? Everything is very simple. The fact is that with schizotypal disorder, although personality changes develop, they never reach the same depth and severity as in schizophrenia, and deep emotional devastation never occurs. That is why these 2 pathologies were differentiated.

Schizotypal personality disorder is considered as a slow and relatively favorably developing psychosis of the endogenous circle. That is, a person with this diagnosis can lead an almost normal life, maintain social adaptation, work, and will not become deeply disabled, in need of outside help and supervision, as happens with schizophrenia.

With schizotypal disorder there will never be persistent delusions or prolonged vivid hallucinations. Although thinking disorders may occur, in general thinking will be preserved.

OCD and schizotypal disorder

Obsessive-compulsive disorder (OCD) is similar to schizotypal disorder in that both pathologies are characterized by the occurrence of various compulsions.

In the early stages of schizotypal disorder, the symptoms of the disease are nonspecific, and obsessions (thoughts, ideas, actions) may be almost the only symptom. However, as the disease develops in schizotypal disorder, internal resistance to these obsessions will be lost, they will no longer be so painful for the person. Over time, other symptoms that are more characteristic of the schizophrenia spectrum will begin to appear - emotional coldness, thinking disorders, psychopathic-like symptoms, etc.

With obsessive-compulsive disorder, criticism of one’s condition and existing obsessions will persist constantly, the person will understand all the “abnormality” of his condition.

Schizoid and schizotypal disorders

Schizoid personality disorder (psychopathy) has some similarities with schizotypal disorder. People suffering from both pathologies are distinguished by eccentricity, self-centeredness, emotional coldness, and are incomprehensible to others. There may be autism, paradoxical emotions and behavior, one-sided interests, and difficulties in contacting people.

If schizoid psychopathy develops from childhood, characteristic signs can be found in a child, a teenager, and in adulthood, then with schizotypal disorder, signs of the disease rarely develop in childhood, and specific symptoms generally appear only after years of development of the disease.

In adolescence, adolescence, and even in youth, significant difficulties may arise in the differential diagnosis of these two mental pathologies, but over the years, the differential diagnosis will become easier, because with schizotypal disorder, specific symptoms appear over time.

Features of the disease

During the course of schizotypal personality disorder, 3 main periods are conventionally distinguished:

1. latent (hidden) - the first signs of the disease appear, but they do not have specificity;
2. active - the period of full development of the disease, when maximum symptoms are observed;
3. period of stabilization - delusional, hallucinatory experiences, all kinds of illusions subside, and personal changes come to the fore.

Latent period

In the initial stages of the disease, most patients do not show signs of social or intellectual decline; moreover, there may even be a tendency towards professional growth.

The main manifestations of schizotypal disorder that occur during the latent period:

• signs of the schizoid circle - selfishness, difficulties in communication and interaction with other people, autism, paradoxical behavior;
• hysterical manifestations - demonstrative behavior, various hysterical reactions;
• signs similar to psychasthenia - a tendency to doubt, anxiety, pedantry;
• paranoid traits - inflated self-esteem, suspicion, one-sidedness of interests and activity, as in paranoid personality disorder.

Affective manifestations

Affective disorders may be observed - neurotic or somatized depression, which is regarded as a reaction to overwork, and hypomanic states.

Symptoms of depression are depression, tearfulness, self-doubt, irritability, and a tendency to introspection. The presence of depression, excessive self-doubt, and pessimistic thoughts can lead to the development of suicidal behavior.

Hypomanic states are characterized by productive, but one-sided “tireless activity”, increased activity, and excessive optimism. At the same time, obsessions, rituals, and phobias may appear, accompanied by insomnia, increased excitability, and transient somatized symptoms (vegetative crises, dysfunction of internal organs, pain syndrome).

Active period of the disease

The disease can occur either continuously or in the form of attacks (exacerbations).

Attacks of schizotypal disorder in adolescence and young adulthood are characterized by signs of hypochondria, reluctance to do anything, and disturbances in thinking. Senestopathies (various unusual causeless sensations in the body) may be observed - burning, crawling, transfusion, crunching, etc.

Attacks that occur in adulthood are more often accompanied by affective and paranoid disorders (delusions of jealousy, litigiousness).

Common symptoms of exacerbation:

• Obsessions - obsessive desires, all kinds of contrasting thoughts, suddenly arising phobias, obsessive thoughts of blasphemous content, fear of going crazy. As the disease progresses, obsessions lose their affective coloring and become monotonous. Quite often, the component of fighting obsession (overcoming) is lost.
• Depersonalization is a disorder of self-awareness. It seems to patients that they are not the same as before, there is no wealth of imagination, intelligence, appearance changes, the ability to experience emotions, to feel pleasure and displeasure is lost. It may seem to such people that they cease to feel like an individual, that they perceive the world only from the outside, and act out the roles of others.
• Hypochondriacal manifestations - autonomic disorders (increased sweating, sudden shortness of breath, rapid or slow heartbeat, nausea, anorexia, bulimia, sleep disorders), conversion symptoms (tangle in the throat, trembling hands, loss or decrease in sensitivity in certain areas, loss of voice), diffuse pain in various organs and areas.
• Hysterical manifestations - gross psychopathic disorders (deceit, vagrancy, adventurism), demonstrativeness, inability to read or write (without the presence of an organic lesion), hysterical attacks, heaviness in the head, nausea after stressful situations.

Features of schizotypal disorder:

1. the disease has a long latent period, activation of the process occurs, as a rule, only at distant stages of the disease;
2. the development of signs of schizotypal disorder occurs from less specific to more specific; at the onset of the disease, the symptoms are more similar to neurotic disorders, which is why difficulties arise in making the correct diagnosis;
3. the disease has a wave-like development;
4. Throughout the course of the disease, a number of symptoms called axial symptoms will be observed, which represent the basis of the personality defect.

The core symptoms of schizotypal disorder are disorders of self-awareness, obsessions, and somatized mental disorders.

Mental disorders

Examination of citizens suffering from mental disorders is carried out after examination on an outpatient or inpatient basis in a specialized medical organization (specialized department of a medical organization).

Disease schedule article	Name of diseases, degree of dysfunction	Category of suitability for military service
		I Count	II Count	III Count
14	Organic mental disorders:
	a) with pronounced persistent mental disorders	D	D	D
	b) with moderately severe mental disorders	IN	IN	IN
	c) with mild short-term painful manifestations	G	G	G
	d) with persistent compensation of painful disorders after acute brain disease or closed craniocerebral injury	B-4	B	B

The article provides for psychoses, other mental disorders, changes in personality and behavior caused by damage and dysfunction of the brain (trauma, brain tumors, encephalitis, meningitis, neurosyphilis, as well as senile and presenile psychoses, vascular, degenerative, other organic diseases and brain lesions ).

The fact of treatment (treatment) for injuries, neuroinfections, organic diseases and brain lesions is confirmed by medical documents.

Point “a” includes pronounced, protracted psychotic states, as well as mental disorders manifested by persistent, pronounced intellectual-mnestic disorders or pronounced personality changes of a psycho-organic type.

Point “b” includes conditions with moderately severe asthenic, affective, dissociative, cognitive, personality and other disorders, as well as psychotic conditions with a favorable course.

Point “c” includes transient, short-term psychotic and non-psychotic disorders that arise as a result of acute organic diseases or brain injuries, resulting in recovery or mild asthenia in the absence of signs of organic damage to the central nervous system.

Point “d” includes states of persistent (at least 1 year) compensation of painful manifestations after an acute illness or brain injury in the absence of mental disorders and phenomena of organic damage to the central nervous system, when there are only isolated scattered organic signs, without dysfunction.

Disease schedule article	Name of diseases, degree of dysfunction	Category of suitability for military service
		I Count	II Count	III Count
15	Endogenous psychoses: schizophrenia, schizotypal disorders, schizoaffective, delusional, acute and transient psychotic disorders and affective disorders (mood disorders)	D	D	D

Disease schedule article	Name of diseases, degree of dysfunction	Category of suitability for military service
		I Count	II Count	III Count
16	Symptomatic and other mental disorders of exogenous etiology:
	a) with pronounced persistent painful manifestations	D	D	D
	b) with moderate, prolonged or repeated painful manifestations	IN	IN	B (V - IND)
	c) with moderate or slightly pronounced, prolonged asthenic condition	G	G	G
	d) with a mild and short-term asthenic state that ends in recovery	B-4	B	A

The article provides for psychoses and other mental disorders due to common infections, intoxications (except those caused by the use of psychoactive substances), somatic diseases of various origins, HIV infection, and other causes.

The documents on the results of the examination and examination indicate the reason that led to the development of the mental disorder.

Point “a” includes psychotic disorders with pronounced clinical manifestations and a long course, including pronounced personality changes.

Point “b” includes moderately severe or repeated psychotic and non-psychotic disorders, leading to pathological personality changes of an organic type or a pronounced long-term (more than 3 months) asthenic state (cererasthenia), including phenomena of organic damage to the central nervous system.

In the case of a favorable course of the disease, when stable compensation of painful manifestations occurs, officers, warrant officers, midshipmen can be recognized as fit for military service with minor restrictions.

Point “c” includes moderately or slightly expressed, prolonged (up to 3 months) asthenic conditions after an infection in the absence of signs of organic damage to the central nervous system. In relation to persons who have suffered acute poisoning with alcohol or narcotic (toxic) substances, a conclusion on the need to provide sick leave is not made.

Point “d” includes mental disorders that arise as a result of an acute illness, occurring with mild and short-term (up to 2-3 weeks) asthenia and ending in recovery.

This point also includes the presence of a history of mental disorders indicated in the article in the absence of pathology from the neuropsychic sphere and internal organs. The favorable outcome of these mental disorders must be confirmed by examination in medical organizations.

Disease schedule article	Name of diseases, degree of dysfunction	Category of suitability for military service
		I Count	II Count	III Count
17	Neurotic, stress-related and somatoform disorders:
	a) with pronounced persistent painful manifestations	D	D	D
	b) with moderate, prolonged or repeated painful manifestations	IN	IN	IN
	c) with moderate, short-term painful manifestations	IN	IN	B
	d) with mild and short-term painful manifestations that ended in recovery	B-4	B	A

The article covers reactive psychoses, neurotic, dissociative and somatoform disorders, psychogenic depressive states and reactions, neurotic personality development, chronic post-reactive personality changes, as well as post-traumatic stress disorder.

Point “a” includes reactive states with a protracted course, as well as pronounced neurotic, dissociative and somatoform disorders that cannot be treated.

Point “b” includes psychotic disorders:

• with a short-term and favorable course, as well as depressive episodes of mild severity;
• moderately expressed, long-term or repeated neurotic disorders, when painful manifestations, despite treatment in a hospital setting, persist and are expressed to a degree that makes it difficult for the person being examined to perform the duties of military service.

Point “c” includes moderately expressed, short-term neurotic disorders with a favorable course, ending in compensation.

Point “d” includes mild, short-term adaptation disorders that respond well to treatment and result in recovery.

Disease schedule article	Name of diseases, degree of dysfunction	Category of suitability for military service
		I Count	II Count	III Count
18	Personality disorders:
	a) pronounced, with a tendency to repeated long-term decompensations or pathological reactions	D	D	D
	b) moderately expressed with unstable compensation	IN	IN	IN

The article provides:

• personality disorders;
• disorders of habits and desires;
• disorders of gender identity and sexual preference;
• behavioral disorders associated with sexual orientation;
• behavioral and emotional disorders beginning in childhood and adolescence;
• disorders of psychological development.

The examination of military personnel is carried out after an examination in a hospital setting, a study of the personal file, service and medical characteristics.

Point “a” includes pronounced, non-compensable disorders.

Point “b” includes:

• moderate forms of personality disorders, manifested by affective breakdowns, reactive states, and severity of vegetative reactions;
• transient (partial) personality disorders;
• disorders of gender identity and sexual preference. However, sexual orientation in itself is not considered a disorder.

Persons with psychopathic-like conditions (personality changes) causally related to specific external factors (infections, intoxications, injuries, etc.) are examined according to those items of the disease schedule that provide for the corresponding nosological forms of neuropsychic pathology.

Cases of attitudinal, deliberate behavior, manifestations of indiscipline that do not arise from the entire pathological structure of the personality cannot be assessed as signs of a personality disorder.

Disease schedule article	Name of diseases, degree of dysfunction	Category of suitability for military service
		I Count	II Count	III Count
19	Mental and behavioral disorders caused by the use of psychoactive substances:
	a) with severe and moderate persistent mental disorders	D	D	D
	b) with minor mental disorders and (or) clearly harmful consequences for mental or physical health	IN	IN	IN

The article provides for mental disorders resulting from the use of one or more psychoactive substances.

Point “a” includes chronic alcoholic psychoses, chronic alcoholism, drug addiction and substance abuse with pronounced and moderate personality changes, intellectual and mnestic disorders.

Point “b” includes:

• acute alcoholic psychosis, chronic alcoholism, drug addiction and substance abuse with slightly pronounced personality changes;
• abuse of narcotic and toxic substances (cases of repeated use of psychoactive substances, accompanied by clear harmful consequences in the absence of dependence syndrome).

Single or episodic use of psychoactive substances (narcotic or toxic drugs) cannot serve as a basis for the application of this article.

Disease schedule article	Name of diseases, degree of dysfunction	Category of suitability for military service
		I Count	II Count	III Count
20	Mental retardation:
	a) in deep, severe and moderate severity	D	D	D
	b) mildly severe	IN	IN	IN

Point “a” includes all forms of deep, severe and moderate mental retardation. In case of significant and obvious intellectual defects, the question of the unfitness for military service of those examined under Column I of the disease schedule can be resolved without an examination in an inpatient setting.

Point “b” includes mild mental retardation. When establishing a diagnosis, clinical diagnostic criteria in combination with the results of an experimental psychological study of thinking and intelligence (intelligence quotient in the range of 50 - 69 according to the results of a complete psychometric study of intelligence according to D. Wechsler) are of decisive importance. If, when establishing this diagnosis, the results of a medical examination do not correspond to the characterizing data, an inpatient examination is mandatory.

• Infectious and parasitic diseases
• Neoplasms
• Diseases of the blood, hematopoietic organs and certain disorders involving the immune mechanism
• Endocrine system diseases, nutritional disorders and metabolic disorders
• Mental disorders
• Nervous system diseases
• Diseases of the eye and its auxiliary organs
• Diseases of the ear and mastoid process
• Diseases of the circulatory system
• Respiratory diseases
• Digestive diseases
• Diseases of the skin and subcutaneous tissue
• Diseases of the musculoskeletal system, connective tissue, systemic vasculitis
• Diseases of the genitourinary system
• Pregnancy, childbirth and the postpartum period
• Consequences of injuries, poisoning and other influences of external factors
• Application

Disability

It is necessary to understand that disability for schizotypal personality disorder is not given to everyone and not always.

It all depends on the course of the disease (paroxysmal or continuous), on what symptoms will be leading in the clinical picture of the disease, how socially adapted the person is, how often he needs hospital treatment.

Each person is individual, and each person’s disease develops according to its own pattern. Therefore, one patient can adapt well, find an interesting job and not need financial support from the state; the other will be deprived of all this, moreover, his disease will develop more actively, and naturally, disability will be shown to the second, and not to the first.

To obtain a disability group, you need documentary evidence of how the disease develops, and therefore you cannot do without seeking medical help from a psychiatrist.

Disability in schizophrenia

Disability is irreversible or persistent pathological changes in the body or psyche of the patient, reducing his socialization, ability to work, movement and ability to self-care.

Disability for schizophrenia is issued in the following cases:

• the course of the disease is more than 3 years;
• frequent and prolonged psychoses with hospitalization;
• pronounced negative symptoms: decreased energy potential, lack of commitment to work, social isolation;
• reduction of criticism during remission;
• persistent asthenic and affective disorders outside of psychosis;
• pronounced personality defect: lethargy, unemotionality, loss of initiative, coldness, irritability;
• change in behavior in the form of mannerism, whimsicality, foolishness, aggression and self-aggression, lack of harmony with people;
• prolonged catatonia or psychomotor agitation;
• loss of previous abilities and skills for self-care.

40% of patients with schizophrenia have a mental disability. Usually a 2nd non-working group is assigned. In milder cases of persistent changes in the patient’s psyche, disability group 3 is assigned.

Disability group 1 can also be assigned. When the disease proceeds with virtually no visible remissions, apatoabulic syndrome is expressed, when the patient practically does not leave the house and cannot provide himself with food, basic hygiene and the preservation of his health, or, due to continuous hallucinatory-delusional and catatonic states, the connection with the objective is completely lost the world and your personality.

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Forecast

Schizotypal disorder is a chronic disease from which it is not yet possible to completely recover. It is necessary to understand that the disease, although slowly, will progress, but over time the process will stabilize.

Compared to schizophrenia, the prognosis for schizotypal personality disorder is much more favorable: such a pronounced and irreversible personality defect does not form as in schizophrenia.

Many people diagnosed with schizotypal personality disorder receive higher education, a profession, work, including in their specialty, have families, children, and are generally socially adapted.

Of course, it is much better to be physically and mentally healthy, but if symptoms of this disease have already appeared, then in no case should you give up, give up a full life and wait for a medical commission to confirm the presence of disability. You need to work on yourself, take active (during exacerbations) and supportive treatment, try to lead a normal lifestyle.

Once again, the distinguishing feature of schizotypal disorder from schizophrenia is a much less pronounced personality defect.

Yes, a person can become more apathetic, less active, and sometimes more anxious. Depressive episodes and obsessions may occur. They can, but that doesn't mean they necessarily will. That is why the prognosis for this disorder is much more favorable.

Features of schizotypal personality disorder

Schizotypal disorder is a chronic, slowly developing disease of the schizophrenia spectrum, the main manifestations of which are neurotic, hypochondriacal, psychopathic, affective and unexpressed paranoid symptoms.

Synonyms for schizotypal disorder are sluggish schizophrenia, latent schizophrenia, low-progressive schizophrenia. This is what this disease was previously called.

Most often, the disease develops before the age of 20, but even at a later age the first signs of mental illness may appear.

This pathology is slightly more common among men than among women.

How to continue to live?

The first and most important thing is to accept the fact of the disease. Everything has already happened and it cannot be changed. People live with diabetes, multiple sclerosis, and oncology. They know that they need to adhere to a certain lifestyle, take medications constantly, and monitor their condition. And if things get worse, they seek medical help.

It's the same with schizotypal disorder. Maintenance treatment depends on which symptoms come to the fore: some need antipsychotics, others antidepressants. There are also patients who do not need therapy at this stage of the disease. What a particular patient needs can only be decided by the doctor observing him!

As a psychiatrist, I cannot give definite recommendations in terms of treatment in advance. It is always necessary to act according to the situation, based on the existing symptoms.

The main thing is to keep in touch with your psychiatrist, contact him if there are any deviations from your normal state.

Don't give up

The most important thing is not to give up after learning about the diagnosis. This is not the end, but just another stage of your life. Treat your illness as an opportunity to reconsider your outlook on life, learn to appreciate what you have and deal with your desires.

If you fixate on the disease and return to it all the time, then there can be no talk of any positive prognosis, I’m telling you this as a psychiatrist. And it will not be the disease itself that is to blame, but your attitude towards it.

Do you think it is easy for a person after a stroke to develop speech or movements? However, if you have the desire, if you constantly train and aim for a certain result, then a miracle happens.

It's the same with schizotypal disorder. Knowing what negative changes have occurred, it is necessary to aim to systematically work with them, to overcome the obstacles and symptoms that have arisen.

Constant work on yourself

Each of our big victories consists of small steps towards the goal. Remember that you can restore not only the function of an arm or leg, you can also restore your emotions.

Do you feel like you have become apathetic? This means that it is necessary to overcome this condition. Not with the help of alcohol or drugs, but by resorting to positive emotions. And you yourself must bring these emotions into your life. No one from the outside will come and make you rejoice!

What do you like, what gives you positive emotions, what would you like to do? Travel, hobbies, unfulfilled goals? Understand that the moment for this has already arrived. You need to start thinking now, making a plan on how to achieve your goal. Perhaps you need to take a more responsible approach to planning and thinking through the details. But this should not be a reason to give up on your dreams.

Focus on your own life, not on the disease

Don't be afraid to plan for fear that frustration will ruin everything. Even if you have had exacerbations in the past, this does not mean that they will happen again. And if any problems arise, then if you consult a doctor in a timely manner, you can quickly stop them. That's all.

You don’t give up on your plans just because in 20 or 40 years you may have a heart attack or stroke!

In the same way, a mental disorder can occur in any person. The reason for this may be a hereditary predisposition, a somatic illness or severe psychological trauma. Anything can happen in the future. However, you must always remember that thoughts are material. If we constantly think about the bad, about our illness, it will definitely remind us of itself.

If you focus on your desires, plans, and think positively, then the chances of becoming successful and overcoming the disease are much higher. Remember that thoughts and words shape your reality. Be very careful with them!

Your new way of life

Another aspect I want to emphasize is lifestyle.

We cannot always influence heredity, what our parents passed on to us. But what kind of life we ​​lead depends entirely on ourselves.

If you want to improve the quality of your life and overcome your disorder, you need to completely reconsider your lifestyle.

The very first thing is to give up external stimulants, which include alcohol and drugs. They are taboo for you. These substances change the level of consciousness and have a toxic effect on the brain. As a result, the disease can become unpredictable. And you don’t need to persuade yourself or me: it’s not a matter of dose or non-alcoholic beer. You either completely give up alcohol or not. And it's your own choice.

The second is a balanced diet. You must eat regularly, properly, consume enough proteins, microelements and vitamins. You shouldn't overeat either. Your main task is to eat so that you are physically healthy and feel good.

Physical activity should be a mandatory part of your life. Where to stop? The choice is yours. Swimming, walking, tennis, going to the gym, yoga. The main thing is that you like what you do.

Regular and adequate sleep

The mental sphere in this disorder does not function quite the same as in healthy people. However, full recovery is necessary for everyone. And it is sleep that can provide this.

To avoid unexpected disruptions and to ensure that the disease is always under control, it is necessary to carefully monitor the quality and duration of sleep . Try to go to bed and get up at the same time, preferably no later than 11 p.m., so as not to disrupt your biorhythm and interfere with the normal production of neurotransmitters.

If you have any sleep problems, you should discuss this issue with your doctor.

Stress and attitude towards it

Stress is an integral part of our lives. What matters is not what problems we face, but our personal attitude towards them. It is our attitude to stress that gives rise to excessive anxiety and self-doubt, which destroy a person from the inside.

The main reason for increased anxiety is the overestimation of the importance of a particular event or person in our life. If something does not have personal significance, then it rarely causes excitement.

The easiest way to overcome inflated importance is in 2 ways:

• Think through the worst case scenario and come to terms with it. What will happen if what we fear happens. How will our lives change? What problems and opportunities will arise. Maybe not everything is so scary anymore.
• Backup option. If you develop a fallback option, then you will be able to deal with a possible loss more easily. If it doesn't turn out the way I want, it will be even better!

There aren't many things that truly deserve our excitement.

If you often worry about little things, read the article about effective methods for overcoming excessive anxiety.

Treatment

Treatment of schizotypal disorder should be carried out under the strict supervision of a psychiatrist.

Some people believe that schizotypal disorder can be left untreated because it does not develop as quickly as schizophrenia. And here lies the biggest mistake, because the disease causes enormous discomfort both to the person himself and to his loved ones.

Various obsessions, illusions, hallucinations, depressive experiences, psychopathic behavior, outbursts of aggression and many other symptoms are successfully corrected under the influence of modern drugs.

Such intensive treatment as for schizophrenia is not required. But leaving the disease completely without drug support is dangerous. If only because painful experiences can cause suicide attempts.

Can the disorder be cured? Alas, the disease is chronic, and it has not yet been possible to develop drugs that could completely stop its development. But to significantly reduce the number and severity of exacerbations, slow down the progression, and reduce emotional and behavioral disorders is a feasible task.

Which drugs are most effective?

Neuroleptics come first. These drugs eliminate productive symptoms - hallucinations and delusions.

In the presence of depressive symptoms and various obsessions, the use of antidepressants is indicated.

The choice of drug, dose and frequency of administration should be made individually by a psychiatrist. There can be no talk of any self-medication.

Psychotherapy

Psychotherapy for schizotypal disorder can to some extent correct existing disturbances in the emotional sphere and behavior, and helps a person adapt to society.

During an exacerbation of the disease, it is not advisable to engage in psychotherapy, because at this time productive symptoms are activated, a person’s criticism of existing mental disorders and his condition worsens significantly, and therefore it is almost impossible to work with thinking, to influence it rationally.

Individual psychotherapy is most recommended for patients with schizotypal disorder, when sessions are held one-on-one, creating a favorable microclimate and a trusting relationship between the psychotherapist and the patient.

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Anna Nikolenko (Zaykina)

The author is a practicing psychiatrist with 12 years of experience. Master of Medicine and compassionate doctor. More information about the author is on this page.