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Hello.

 

I was recently diagnosed with schizoptypal and paranoid features, so yeah.

 

In my country schizotypal is not a personality disorder, it is a psychotic disorder grouped with schizophrenia. Why is it a personality disorder in DSM, but not ICD? And is this board using the DSM or the ICD definition? Like, where should i post if i want to talk about schizotypal disorder? I posted it here because i figured more people were american, so i hope thats okay. But, yeah. 

 

I'm just wondering if someone else has this/knows a lot about it. I have a hard time finding information on this disorder thats not just listing the symptoms. There doesnt seem to be many people that has it? I was told by a psych that schizotypal has all the negative symptoms of schizophrenia, but not fully positive symptoms. But i have had a fully psychotic episode, that has been written down in my files as a fully psychotic episode, so obviously i do have positive symptoms, so thats a bit confusing. But maybe its because my psychosis lasted for a few months and then went away again without medication? Though they want to start me on anti-psychotics anyways. Any thoughts?

 

I also have a question about some of the symptoms:

 

- Obsessive ruminations without inner resistance, often with dysmorphophobic, sexual or aggressive contents;

 

I dont understand this at all? What does it mean?

 

Also, i totally relate to this:

 

They may react inappropriately or not react at all during a conversation or they may talk to themselves.

 

I have this problem a lot! I was wondering... Does this symptom have a name? I sometimes talk to myself in public without knowing im doing it, and sometimes i cant respond to people talking to me. It would be super helpful to have a name for this so i could research that more!

 

I hope someone can help me out! Thanks! :)

Edited by Forstyrra
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Not sure what to make of the other things, but I can take a stab at this:

 

 

 

Obsessive ruminations without inner resistance, often with dysmorphophobic, sexual or aggressive contents;

 

"Obsessive ruminations" = obsessive thoughts, things you can't stop thinking about or get out of your head, even if you want to

 

"without inner resistance" = the thoughts don't bother you, unlike OCD thoughts where people think they are horrible people for having the thoughts they have

 

"often with dysmorphophobic, sexual, or aggressive contents" = the thoughts are often about sex or sexual acts, things you do that would hurt others, or... let's break that last one down a bit...

 

-dys = bad or difficult

-morpho = the body

- phobic = fear

 

dysmorphophobic = obsessive fear that one's own body, or a part of it, is disgusting and repulsive or might become disgusting and repulsive

 

 

So what that symptom in total is describing, is thoughts you can't stop thinking about that happen frequently that are about sex or sexual acts, hurting other people, or about fear/loathing/disgust of one's body or a part of it.

 

 

Wikipedia has a definition of schizotypal disorder of ICD-10:

 

 

A disorder characterized by eccentric behavior and anomalies of thinking and affect which resemble those seen in schizophrenia, though 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:
  • Inappropriate or constricted affect (the individual appears cold and aloof);
  • Behavior or appearance that is odd, eccentric or peculiar;
  • Poor rapport with others and a tendency to withdraw socially;
  • Odd beliefs or magical thinking, influencing behavior and inconsistent with subcultural norms;
  • Suspiciousness or paranoid ideas;
  • Obsessive ruminations without inner resistance, often with dysmorphophobic, sexual or aggressive contents;
  • Unusual perceptual experiences including somatosensory (bodily) or other illusions, depersonalization or derealization;
  • Vague, circumstantial, metaphorical, over-elaborate or stereotyped thinking, manifested by odd speech or in other ways, without gross incoherence;
  • 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 people with schizophrenia and is believed to be part of the genetic "spectrum" of schizophrenia. 

 

I bolded that last part because you were concerned about positive symptoms. Not sure if that sounds like you. 

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Ah, ok! Thanks, i think i got that one a bit more now!

 

As for the last point, i dont think so. Or rather, I think it would be pretty accurate for most of my life until recently. I have had lots of semi-psychotic episodes before and my psych has described me as chronically borderline psychotic. But transient = short, right?  The thing is, I recently had a psychotic episode that lasted for 4 months(my first big one), so I wouldn't say it was transient. According to my papers from when i was hospitilazed, I was there with "visual and auditory hallucinations and paranoid delusions".

 

My current psych is also considering schizoaffective, so im pretty sure that was a fully psychotic episode. Idk. I found one link that said that you can have brief psychotic episodes also, but is 4 months really considered "brief"? If so... damn.... cause that seemed really long to me, haha

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Hello.

 

I was recently diagnosed with schizoptypal and paranoid features, so yeah.

 

In my country schizotypal is not a personality disorder, it is a psychotic disorder grouped with schizophrenia. Why is it a personality disorder in DSM, but not ICD? And is this board using the DSM or the ICD definition? Like, where should i post if i want to talk about schizotypal disorder? I posted it here because i figured more people were american, so i hope thats okay. But, yeah. 

 

I'm not a mod, just someone who's been around a little while. But from my experience, the mods and admins are very cool about where posts go. This is a fine place to post. And even if they did move it, that's not a punishment thing. It's them wanting to put your post where it'll get the best traffic.

 

It's possible that StPD will eventually end up being classed officially as a schizo-spectrum disorder in the DSM. A former pdoc I had explained it that way to me. This is just my understanding after what I've read and discussed with my docs, so take it with a grain of salt, but I think it's still considered a PD here in the States because, though it's less severe than other schizo-spectrum disorders, it possesses a chronic course, and fits the shared characteristics of PDs, which, according to the DSM (IV, my info is old, sorry), are:

  • An enduring pattern of psychological experience and behavior that differs prominently from cultural expectations, as shown in two or more of: 
  1. cognition (i.e. perceiving and interpreting the self, other people or events); 
  2. affect (i.e. the range, intensity, lability, and appropriateness of emotional response); 
  3. interpersonal functioning; 
  4. or impulse control.
  • The pattern must appear inflexible and pervasive across a wide range of situations, and lead to clinically significant distress or impairment in important areas of functioning.
  • The pattern must be stable and long-lasting, have started as early as at least adolescence or early adulthood.
  • The pattern must not be better accounted for as a manifestation of another mental disorder, or to the direct physiological effects of a substance (e.g. drug or medication) or a general medical condition (e.g. head trauma).

By comparison, the ICD-10 lists:

  • Markedly disharmonious attitudes and behavior, generally involving several areas of functioning; e.g. affectivity, arousal, impulse control, ways of perceiving and thinking, and style of relating to others;
  • The abnormal behavior pattern is enduring, of long standing, and not limited to episodes of mental illness;
  • The abnormal behavior pattern is pervasive and clearly maladaptive to a broad range of personal and social situations;
  • The above manifestations always appear during childhood or adolescence and continue into adulthood;
  • The disorder leads to considerable personal distress but this may only become apparent late in its course;
  • The disorder is usually, but not invariably, associated with significant problems in occupational and social performance.

If that helps. 

 
 

I'm just wondering if someone else has this/knows a lot about it. I have a hard time finding information on this disorder thats not just listing the symptoms. There doesnt seem to be many people that has it? I was told by a psych that schizotypal has all the negative symptoms of schizophrenia, but not fully positive symptoms. But i have had a fully psychotic episode, that has been written down in my files as a fully psychotic episode, so obviously i do have positive symptoms, so thats a bit confusing. But maybe its because my psychosis lasted for a few months and then went away again without medication? Though they want to start me on anti-psychotics anyways. Any thoughts?

 

I was initially diagnosed Schizotypal about eighteen months ago; prior to that, I'd been diagnosed Schizoid since, I think, sometime in 2010 or 2011. So I'm not an expert, but I've had a chance to talk this over a little more with my pdoc and tdoc than you have, it sounds like. 

 

I've also had psychoses. Mine have been very brief--though I've had the fortune to have swift medical recourse, which is a factor. However, even though I've had those psychotic issues, I maintain my StPD diagnosis because, overall, I better fit that disorder than I would, say, schizoaffective. 

 

For me, positive symptoms tend to manifest as quasipsychotic body illusions, hallucinations, voices, etc. They're considered quasipsychotic because I'm able to reality test, whether I readily believe that testing or not. However, under severe enough stress, those symptoms have developed into full on psychosis. My old pdoc called it brief reactive psychosis, and told me that it could be part of Schizotypal PD, for some. I've read literature on both sides of that argument. I think a psychosis is considered brief if it lasts less than a month. 

 

As for the antipsychotics, I will say that they've helped. They don't do jack diddly for the negative symptoms I suffer, but they have helped me in the past with the paranoid thoughts and, to a limited extent, the quasipsychotic hallucinations. I say it's definitely worth a shot for you, especially where you've already had a psychosis. 

 

It's been my experience that yes, StPD is a very lonely illness. I've only met a couple people here who have had it. There are forums dedicated solely to the illness, but they don't tend to be well trafficked. None have been a fraction so well informed as CB, either. 

 

 

I also have a question about some of the symptoms:

 

- Obsessive ruminations without inner resistance, often with dysmorphophobic, sexual or aggressive contents;

 

I dont understand this at all? What does it mean?

 

I have this symptom. Wooster already described it very well, but I can give an example, if that will help. Here is one I've had several times. It's spoiler tagged for gross out factor. 

 

I go through periods of obsessing over cutting out my left eye. This is tied into a persistent belief I have, that I am a nonhuman being possessing a human body, and that my "real" self is missing its left eye. When I have these thoughts, they can be persistent to the point of interfering with my ability to focus on other things. I make elaborate plans of how I could do it, how to ensure I did it "properly," how I could best arrange care for it afterward so that my family didn't get involved until the mess had been cleaned up, all that. I can quote you the statistical likelihood that my other eye will have an autoimmune reaction and also go blind. Also the probable procedures that would be done, and the likely cost. These thoughts intrude; I can be talking to someone about something entirely different, and suddenly I realize that I haven't heard a word they've said because I was thinking about this again. 

 

I also tend to get sucked into vivid, absorbing daydreams of violent encounters. In order to facilitate understanding, I will sit up researching obsessively, so that I know my physics and anatomy are correct. I often write them into gory stories, or tame them down and incorporate them into more viable writing projects.

 

I also find it important to note here that I am not personally disturbed by these thoughts, and I'm not ashamed of them. I feel attached to them, in a way, because they hold my obsessive interest, and I've gone to some lengths in my writing to get them down, but that's the extent of my reaction. This is not meant to sound glamorizing, so I hope you don't take it that way. But this is actually something of a pleasant diversion for me, at times. I forget, sometimes, that other people are not so inured as I am. My therapist asked me about this symptom once when I confessed to having urges to cut out my eye. I explained it to her, and she was disturbed, I think mostly because of the effort of research I'd put into them. I've never told anyone directly, but there have been several times when I accidentally displayed way too much knowledge of something gross or weird and got a funny look. 

 

 

Also, i totally relate to this:

 

They may react inappropriately or not react at all during a conversation or they may talk to themselves.

 

I have this problem a lot! I was wondering... Does this symptom have a name? I sometimes talk to myself in public without knowing im doing it, and sometimes i cant respond to people talking to me. It would be super helpful to have a name for this so i could research that more!

 

 

I don't think it has a name; or if it does, I don't know it. Sorry. I do this too, though. I'm especially guilty of inappropriate reactions. Sometimes it's just that I fail to deliver the expected or "appropriate" emotional reaction, but sometimes it's because people's words don't always reach my ears exactly as they were delivered. They dissolve into static, and I'm left with a deer in the headlights feeling as I try to figure out what they might have said, and give the right reaction. It's nerve wracking at times. 

 

I've written a lot, I realize. I'm sorry to spam your thread. I hope some of this is helpful. In my experience, this disorder is poorly described and poorly understood. It has often felt to me, even here where I've found some smart, understanding people, that I'm breaking trail alone in my progress with it. Part of that trouble is that, for me, social issues are a major problem. It's difficult to trust people, and I tend to forget that not everyone is faking their reactions, opinions and feelings because of paranoia/anxiety/dissociative issues/horrible crawling discomfort with being visible to other people. Part of it is that there are several aspects to this disorder that are just damned difficult to understand without personal experience, and recounting anecdotes tends to lead to unproductive ends. 

 

I hope you will find yourself welcome here. 

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Thank you so much for writing all this for me! It was actually super helpful!

 

I relate so much the thinking about mutiliation and stuff that you wrote about being obsessive. that makes perfect sense to me. I always wanted to cut out my eyes, because i felt like my 'real'  eyes were underneath my physical eyes and if i cut them out i would see more clearly. I often think about things like that, even if they dont make sense for anyone else. They aren't that disturbing to me either. Well, not always anyways. I also had a major fascination with wanting to severely self-mutilate in artistic ways and i use a lot of time thinking about it. My most recent one is wanting to drain my own blood and how i can do that safely. 

 

I'm sorry that you're lonely with this diagnosis. I feel that way too right now. With the other diagnosis i've had i could easily find support and information beyond just lists of diagnostic criteria, but it seems harder with schizotypal. I was reccmonded that i just research schizophrenia, especially the negative symptoms, and see how they deal with it. But its not really the same, you know?

 

As for the psychosis part i very much relate to what you wrote, as thats how i experience it most of the time. I'm guessing thats why i got the diagnosis, because i have those quasi-psychotic episodes a LOT.

 

My last one felt a bit different, though. I heard voices all day, that i believed to be angels. They would give me orders, sometimes babble for no reason, and sometimes talk about me. I believed there was a war between demons and angels and that i had to do many rituals to get clean so that the angels could use me as a vessel. In the beginning i had some insight, but after a while i didn't at all and i believed my boyfriend and best friend where just trying to sabotage me because they knew i was a prophet. I still am not totally convinced its not true, but i dont hear the angels as voices anymore. I saw a demon a few days ago, but i have more insight now so im not psychotic anymore.

 

Still, this was the first time it was that intense so maybe they want to wait and see if it happens again. Before this one, my psychosis/semi-psychosis was brief. Usually just a couple of days, sometimes only a few hours and sometimes a couple of weeks at most. This is the first time it was 4 months, ugh. I'm not gonna lie, it scares me a lot so i just hope it never happens again! It'sall very new and confusing to me. I'm just trying to get by and understand myself better, but i guess i shouldn't put too much weight on diagnosis. After all, they are more guidelines and are not 100& correct.

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I'm glad I was able to help you out a bit. :) 

 

I'm sorry that you're lonely with this diagnosis. I feel that way too right now. With the other diagnosis i've had i could easily find support and information beyond just lists of diagnostic criteria, but it seems harder with schizotypal. I was reccmonded that i just research schizophrenia, especially the negative symptoms, and see how they deal with it. But its not really the same, you know?

 

I've also noticed that there aren't many resources for Schizotypals, and what there is tends to be the same information, for the most part. I have found some useful resources, though. I'll do some digging in my bookmarks and see if I can find some goodies. It could be that it's hard to find information because it's an uncommon diagnosis, but the statistical prevalence of StPD is around 3%, versus schizophrenia's 0.3-0.7% (this according to a quick Google search, so take it with salt). I'm not sure why information seems so thin on the ground, and so frequently clinical and list-like. I've read all I could find, and by comparing it to my own experiences and behaviors, have been able to gather a kind of profile for what this illness looks like for me. But there have definitely been times when I've wished there were more information out there, so that I could at least get my head around it a little better. Making my own way with a MI that not even my doctors have seemed to understand was not among my life's goals.  :lol: I've read a lot about schizophrenia, as well; even though, like you say, it's not the same as having literature out about StPD, the raw info (especially about negative symptoms) has been educational for me. It's at least given me an idea of what the illness looks like from the outside. 

 

 

As for the psychosis part i very much relate to what you wrote, as thats how i experience it most of the time. I'm guessing thats why i got the diagnosis, because i have those quasi-psychotic episodes a LOT.

 

My last one felt a bit different, though. I heard voices all day, that i believed to be angels. They would give me orders, sometimes babble for no reason, and sometimes talk about me. I believed there was a war between demons and angels and that i had to do many rituals to get clean so that the angels could use me as a vessel. In the beginning i had some insight, but after a while i didn't at all and i believed my boyfriend and best friend where just trying to sabotage me because they knew i was a prophet. I still am not totally convinced its not true, but i dont hear the angels as voices anymore. I saw a demon a few days ago, but i have more insight now so im not psychotic anymore.

 

 

See, my own personal experiences with psychosis have been different, but the general feeling of it has been the same as you describe here. By that I mean that, when I've been actually psychotic, I haven't had any insight, but even when not psychotic, I've had quasipsychotic symptoms, but been able to reality test (whether I fully believe the reality testing or not). This has also been consistent with other accounts of psychosis that I've read from fellow posters here. It's just that I pretty well only have quasipsychotic issues. I have to be under a lot of stress to have full-on psychosis. 

 

Still, this was the first time it was that intense so maybe they want to wait and see if it happens again. Before this one, my psychosis/semi-psychosis was brief. Usually just a couple of days, sometimes only a few hours and sometimes a couple of weeks at most. This is the first time it was 4 months, ugh. I'm not gonna lie, it scares me a lot so i just hope it never happens again! It'sall very new and confusing to me. I'm just trying to get by and understand myself better, but i guess i shouldn't put too much weight on diagnosis. After all, they are more guidelines and are not 100& correct.

 

For what it's worth, my pdocs and therapists have tended to take psychosis seriously, as something to be acted upon quickly, but they've also been supportive of my wishes, med and treatment wise. 

 

I'm quasipsychotic on a day to day basis, off and on. The last few days, for example, I've had some auditory and visual issues. Sometimes I go through periods of a couple weeks where I don't have anything, but for the most part I have small things very frequently. I relate to wanting to get by and understand yourself better. It's very frustrating, at times. I tell myself the same thing--that diagnosis is just a shorthand for the doctors to help figure out a course of treatment--but still, sometimes I wish there were answers of some kind. Not even necessarily easy ones, but answers, period. I think most MI is mysterious to a degree, and there are times when it's left to the individual to figure out; the fact that only a handful of diagnoses tend to get broad/mainstream attention probably contributes to the dearth of information. 

 

Regardless, I hope you're successful in finding what you need, and like I said, I'll go through my bookmarks and that to see which of my good resources I have saved, still. In the meantime, good luck in your own search. :) 

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I'm sorry! I forgot to give you that list of links. *facepalm* 

 

Here are a couple: 

 

 - This one is an overview, so it's not awesome, but it does go into things a little more than, say, Wiki. http://www.mentalhealth.com/home/dx/schizotypalpersonality.html

 - This article discusses dual diagnosis of substance abuse. It also goes into StPD a lot more, and offers some good reading. It's a little dense, so I wouldn't take it on if you have trouble concentrating or taking in a lot of reading. (I don't know about you, but my cognitive function is pretty bad when I'm symptomatic.) http://web.archive.org/web/20031003193032/http://www.toad.net/~arcturus/dd/schtypal.htm

 - This one is a little graph with some discussion attached. It's brief, but I found some food for thought in it.  http://www.millon.net/taxonomy/schizotypal.htm

 

I thought there was another one, but I can't find it in my bookmarks.

 

I want to emphasize, though, that one of the things about any PD is that each individual who has it expresses it slightly differently, just like any other MI. So there are always going to be things that don't click. 

Edited by Mim
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You're most welcome. Like I said, this can be an isolating diagnosis, and the information I've found has been pretty thin on the ground much of the time. My docs haven't seemed to know much about it, and what I've found to read has been a crapshoot. So when I do find something that doesn't just say the same few things, or make me feel like an incurable freak, I keep it, haha.

I hope you're able to find some results with your doc.

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  • 5 weeks later...

I am kinda late to the party, but I wanted to drop in and say that I have the diagnosis of Schizotypal PD as well.  It was pretty confusing the first year after getting diagnosed.  I had trouble figuring out what what was part of the disorder and what was normal.  That helped me get a grip on what has been going on and what I can do to treat myself, since many doctors have not been of much help in my experience.

 

I also agree with much of what Mim has said, and that I too feel like there is little information on the disorder, and it is a very lonely condition to have as well.  I often find myself frustrated with how I deal with being around other people; I want to want to be around people, but fear and distrust make it not worth the effort to try to connect with people (I hope that made sense).

 

My experience with the illness is also that it comes and goes day to day.  It seems like some symptoms, like voices in my head and nasty depression, come in cycles and can stay for months.  The worst quasi-psychotic event lasted about 3 or 4 weeks and was brought on by chronic stress when I was not on medication. The biggest problems I usually deal with are related to negative symptoms.

 

It is lonely, but I wanted to post to let you, and others, know that people with Schizotypal PD are out there and are looking for answers too.  I am not a frequent visitor to these forums, but if you have a question, I can try to answer it from what I know.

 

Mim, thanks for the resources you linked.  I am always on the lookout for these.

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