User:Aford4706/Schizotypal personality disorder
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Article Draft
History
The term "schizotype" was first coined by Sandor Rado in 1956 as an abbreviation of "schizophrenic phenotype". STPD is classified as a cluster A personality disorder, also known as the "odd or eccentric" cluster. (moved this from the Lead to the new History subheading and unsure as to how to mark that)
STPD as a proper diagnosis was first introduced in 1980, with the release of the DSM-III. The diagnosis was created to fill the gap between Borderline Personality Disorder (BPD) and moderate schizophrenia-like symptoms. Because of this, many early studies were either seeking to distinguish it from other diagnoses, specifically BPD, or identify its utility in recognizing non-clinical people who were genetically predisposed to schizophrenia. [1]
Very few changes were made from the DSM-IV-TR to the DSM-V in terms of the diagnostic criteria. [1]
Diagnosis
STPD as a personality disorder
suspiciousness or paranoid ideation- inappropriate or constricted affect
- strange behavior or appearance
lack of close friends- excessive social anxiety that does not diminish with familiarity and tends to be associated with paranoid fears rather than negative judgments about self
The symptoms of "lacking close friends" and "suspiciousness or paranoia" have been used for diagnosing STPD by the DSM-V. These criteria overlap with symptoms for Paranoid personality disorder and Schizoid personality disorder, making these symptoms not as useful when distinguishing STPD from other personality disorders. [1]
Treatment
Medication
While people with schizotypal personality disorder and other attenuated psychotic-spectrum disorders may have a good outcome with neuroleptics in the short term, long-term follow-up suggests significant impairment in daily functioning compared to schizotypal and even schizophrenic people without neuroleptic drug exposure. Positive, negative, and depressive symptoms were shown to be improved by the used of olanzapine, an neuroleptic. [2] Those with comorbid OCD and STPD were most positively affected by the use of olanzapine, and showed worse outcomes with the use of clomipramine, a antidepressant.[3]
Antidepressants are also sometimes prescribed, whether for STPD proper or for comorbid anxiety and depression. However, there is some ambiguity in the efficacy of antidepressants, as many studies have only tested people with STPD and comorbid obsessive-compulsive disorder or borderline personality disorder. They have shown little efficacy for treating dysthymia and anhedonia related to STPD. [1]
Both of these medications are the most frequently prescribed medication for STPD, though the use and efficacy of them should be evaluated differently for every case.[2]
The use of stimulants have also shown some efficacy, especially for those with worsened cognitive and attentional issues. Patients that suffer from concurrent psychosis should be monitored more closely if stimulants are used as part of their treatment. [1]
Epidemiology
Reported prevalence of STPD in community studies ranges from 0.6% 1.37% in a Norwegian sample, to 4.6% in an American sample. [1]
There is little known about the real world effect that STPD has on individuals. There does seem to be a relationship between STPD and not living on one's own or having a Bachelor's degree. People with STPD also seemed to be paid lower hours wages when compared to a healthy control group. The disorder also seems to be related to lack of employment, though this is specifically related to worsened cognitive impairment. [1]
Chance of STPD were seen highest in Black women, low socioeconomic people, and people separated from their partners, with the lowest rates in Asian men. [1]
Adolescent cannabis users, whether that be a lifetime use, abuse or dependence , have been found to have an increased likelihood of self-reporting and possessing schizotypal personality disorder or traits consistent with STPD.[4]
Sandbox Responses
- Hannahchaise made comment to the age of the citations used. The dates on the work being cited are some of the most up-to-date that I can find. STPD is difficult to find current, relevant, peer reviewed, secondary sources on.
- Snqadri pointed out issues with my first citation. Fixes were made to the date on it.
- Several comments by Sfatima 12 and Snqadri were made about the addition of the History subheading. Many of them are related to finding more information to fill it out. Though the suggestions made are very helpful, trying to find information that also meets Wikipedia's requirements has proven to be difficult. If I fail to find anymore, I think that scrapping the History subheading would be in my best interest, as it would not offer much to improve the article.
- I think that the suggestion by Sfatima 12 of adding a subheading under Diagnosis that would be clarify some of the overlapping symptoms of STPD with schizophrenia or other personality disorders is interesting. However, I do think that many of these overlaps of addressed in the Comorbidity section or throughout the Diagnosis subheading. I think that much of the information that would be included in a subheading of this nature would become repetitive.
- Mention was made by Emiell490 of searching for more outdated content. I am searching for and updating it as I find it.
- Changes suggested by Emiell490 in language were made to clarify the information about olanzapine in the Medication subheading. I initially described it as an "antipsychotic". I think that this got confusing as antipsychotics are described as neuroleptics in the rest of the section. They seem to be the same thing, so I just changed the wording rather than moved the statement, as I felt that it best belonged there.
- Suggestions from Emiell490 were made to add more information about the use of stimulants for STPD. I haven't found a lot of other information about that, though I will continue to search for this as I find more relevant information for my article.
References
- ^ a b c d e f g h Rosell, Daniel R.; Futterman, Shira E.; McMaster, Antonia; Siever, Larry J. (2014). "Schizotypal Personality Disorder: A Current Review". Current psychiatry reports. 16 (7): 452. doi:10.1007/s11920-014-0452-1. ISSN 1523-3812. PMC 4182925. PMID 24828284.
- ^ a b Koch, Jessa; Modesitt, Taylor; Palmer, Melissa; Ward, Sarah; Martin, Bobbie; Wyatt, Robby; Thomas, Christopher (2016-03-08). "Review of pharmacologic treatment in cluster A personality disorders". The Mental Health Clinician. 6 (2): 75–81. doi:10.9740/mhc.2016.03.75. ISSN 2168-9709. PMC 6007578. PMID 29955451.
- ^ Kirchner, Sophie K.; Roeh, Astrid; Nolden, Jana; Hasan, Alkomiet (2018-10-03). "Diagnosis and treatment of schizotypal personality disorder: evidence from a systematic review". npj Schizophrenia. 4 (1): 1–18. doi:10.1038/s41537-018-0062-8. ISSN 2334-265X.
- ^ Anglin, Deidre M.; Corcoran, Cheryl M.; Brown, Alan S.; Chen, Henian; Lighty, Quenesha; Brook, Judith S.; Cohen, Patricia R. (2012-05-01). "Early cannabis use and Schizotypal Personality Disorder Symptoms from adolescence to middle adulthood". Schizophrenia Research. 137 (1): 45–49. doi:10.1016/j.schres.2012.01.019. ISSN 0920-9964. PMC 3591468. PMID 22325079.
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