MHM – Schizoid and Schizotypal. What’s the difference?

Schizoid and schizotypal personality disorders are in fact completely unrelated. They are both ‘eccentric’ personality disorders, but their characteristics, their outcomes and their relation to schizophrenia are both entirely unalike, though some characteristics may cause similar outcomes.

The first and most notable distinction is that schizoid is NOT related to schizophrenia and includes no danger of developing it, though it is understood that having schizophrenia in the family can mean you are more likely to develop schizoid personality disorder. On the other hand, schizotypal personality disorder bears a significant resemblence to schizophrenia and does include a danger of developing into full blown schizophrenia. That in itself shows how different the two disorders are.

Looking at separate symtoms required to diagnose each disorder, the distinction becomes even more apparent.

To be diagnosed Schizoid you must have a good portion of the following traits:

• no desire or enjoyment of close relationships, even with family members.
• a preference for solitary jobs and activities.
• pleasure in few activities, including sex.
• no close friends, except first-degree relatives.
• difficulty relating to others.
• indifference to praise or criticism.
• a tendency toward being aloof and showing little emotion.
• a propensity for daydreaming and/or creating vivid fantasies of complex inner lives

Those of us with schizoid find the creation of reciprocal relationships claustrophobic and unnerving. We actively avoid trying to form them, even though we might harbour a desire for more friends etc. The fantasy worlds we form are usually and escape mechanism from reality, a safe place to go to when things are too much to cope with, but we know they are not real. We know we have constructed them.

To be diagnosed schizotypal, you must possess a number of these traits:

• dressing, speaking, or acting in an odd or peculiar way
• a tendency to be suspicious and paranoid
• feeling uncomfortable or anxious in social situations due to their distrust of others
• making few friends and being extremely uncomfortable with intimacy
• a habit of misinterpreting reality/having distorted perceptions (for example, mistaking noises for voices)
• odd beliefs or magical thinking (for example, being overly superstitious or thinking of themselves as psychic)
• a preoccupation with fantasy and daydreaming
• being stiff and awkward when relating to others
• coming across as emotionally distant, aloof, or cold

The detachment here will likely directly relate to magical thinking/paranoia/inability to distinguish between reality and fantasy, and the fantasy worlds created may well feel more real than the real world and be mistaken for it. Or rather the real world will be viewed as suspicious or uncertain. This is of course far closer to the nature of schizophrenia, which is why a sufferer of schizotypal personality disorder is in danger of developing schizophrenia.

I hope that provides a solid means to tell the difference between the two disorders. Personally I feel that schizoid should be renamed to better reflect its lack of connection and its actual presentation in a sufferer. At present I feel those of us with schizoid can be mistaken for being far less connected to reality and aware of behaviour than we are. We choose to disconnect from people, we choose to avoid reality, we are not under any delusions and have no paranoia about reality or people. Our decisions are based on an unease and discomfort with the world as it is and people as they are.