Skip to main content
Log in

New perspectives on schizotypal personality disorder

  • Published:
Current Psychiatry Reports Aims and scope Submit manuscript

Abstract

Schizotypal personality disorder is the prototype of the schizophrenia-related personality disorders and has been demonstrated to have phenomenologic, biologic, treatment, and outcome characteristics similar to those of schizophrenic patients. These studies suggest that patients with schizotypal personality disorder, like schizophrenic patients, show cognitive impairment, but the impairment is more focal and involves primarily working memory, verbal learning, and sustained attention rather than generalized intellectual deficits. Schizotypal patients, like schizophrenic patients show reductions in temporal lobe volume, but seem to be spared the frontal volume reductions found in some studies of schizophrenic patients and in our laboratory. Better frontal “buffering” may prevent the more severe cognitive and social deterioration associated with schizophrenia. Furthermore, schizotypal patients appear to show less susceptibility to psychotic symptoms, in part perhaps because of better buffered subcortical dopaminergic activity as suggested by recent data from a SPECT/amphetamine paradigm, glucose metabolic study, and structural studies of basal ganglia. These findings are discussed in terms of a model of schizotypal personality disorder where schizotypal patients have better capacity for compensatory buffering in lateral and subcortical brain regions, protecting them from the more severe symptoms of chronic schizophrenia.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References and Recommended Reading

  1. Raine A, Reynolds C, Lencz T, et al.: Cognitive-perceptual, interpersonal, and disorganised features of schizotypal personality. Schizophrenia Bulletin National Institute of Mental Health 1994, 20:191–202.

    CAS  Google Scholar 

  2. Bergman AJ, Harvey PD, Mitropoulou V, et al.: The factor structure of schizotypal symptoms in a clinical population. Schizophr Bull 1996, 22:501–509.

    PubMed  CAS  Google Scholar 

  3. Kendler KS, Ochs AL, Gorman AM, et al.: The structure of schizotypy: a pilot multitrait twin study. Psychiatry Res 1991, 36:19–36.

    Article  PubMed  CAS  Google Scholar 

  4. Siever LJ, Friedman L, Moskowitz J, et al.: Eye movement impairment and schizotypal pathology. Am J Psychiatry 1994, 151:1209–1215.

    PubMed  CAS  Google Scholar 

  5. Friedman L, Jesberger JA, Siever LJ, et al.: Smooth pursuit performance in patients with affective disorders or schizophrenia and normal controls: analysis with specific oculomotor measures, RMS error and qualitative ratings. Psychol Med 1995, 25:387–403.

    Article  PubMed  CAS  Google Scholar 

  6. Harvey PD, Keefe RS, Mitroupoulou V, et al.: Informationprocessing markers of vulnerability to schizophrenia: performance of patients with schizotypal and nonschizotypal personality disorders. Psychiatry Res 1996, 60:49–56.

    Article  Google Scholar 

  7. Lees Roitman SE, Cornblatt BA, Bergman A, et al.: Attentional functioning in schizotypal personality disorder. Am J Psychiatry 1997, 154:655–660.

    Google Scholar 

  8. Braff DL: Impaired speed of information processing in nonmedicated schizotypal patients. Schiz Bull 1986, 7:499–508.

    Google Scholar 

  9. Sacuzzo DP, Schubert DL: Backward masking as a measure of slow processing in schizophrenia spectrum disorders. J Abmorm Psychol 1981, 86:261–266.

    Article  Google Scholar 

  10. Lenzenweger M, Korfine L: Perceptual aberrations, schizotypy, and the Wisconsin Card sort Sorting test. Schizophr Bull 1994, 20:345–357.

    PubMed  CAS  Google Scholar 

  11. Trestman RL, Keefe RS, Mitropoulou V, et al.: Cognitive function and biological correlates of cognitive performance in schizotypal personality disorder. Psychiatry Res 1995, 59:127–136.

    Article  PubMed  CAS  Google Scholar 

  12. Lees-Roitman SE, Keefe RSE, Dupre RL, et al.: Visuospatial working memory in schizotypal personality disorder. Schizophr Res. 2000, in press.

  13. Voglmaier MM, Seidman LJ, Salisbury D, et al.: Neuropsychological dysfunction in schizotypal personality disorder: A profile analysis. Biol Psych 1997, 41:530–540.

    Article  CAS  Google Scholar 

  14. Bergman A, Harvey P, Lees Roitman S, et al.: Verbal learning and memory in schizotypal personality disorder. Schizophr Bull 1998, 24:635–641.

    PubMed  CAS  Google Scholar 

  15. Niznikiewicz M, Voglmaier M, Shenton M, et al.: Electrophysiological correlates of language processing in schizotypal personality disorder. Am J Psychiatry 1999, 156:1052–1058.

    PubMed  CAS  Google Scholar 

  16. Siever LJ, Rotter M, Losonczy M, et al.: Lateral ventricular enlargement in schizotypal personality disorder. Psychiatry Res 1995, 57:109–118.

    Article  PubMed  CAS  Google Scholar 

  17. Silverman JM, Smith CJ, Song LG, et al.: Lateral ventricular enlargement in schizophrenic probands and their siblings with schizophrenia-related disorders. Biol Psych 1998, 43:97–106.

    Article  CAS  Google Scholar 

  18. Buchsbaum MS, Yang S, Hazlett E, et al.: Ventricular volume and asymmetry in schizotypal personality disorder and schizophrenia assessed with magnetic resonance imaging. Schizophr Res 1997, 27:45–53.

    Article  PubMed  CAS  Google Scholar 

  19. McCarley RW, Salisbury D, Voglmaier MM, et al.: Temporal lobe dysfunction and schizotypal personality disorder. American Psychiatric Association Annual Meeting, Miami, FL. Abstract 34D., May 18–20, 1995.

  20. Downhill JE, Buchsbaum MS, Hazlett EA, et al.: Temporal lobe volume in schizotypal personality disorder and schizophrenia. American Psychiatric Association Annual Meeting, San Diego, CA. Abstract NR 172., May 17–22, 1997.

  21. Kwon J, Shenton M, Hirayasu S, et al.: MRI study of cavum septi pellucidi in schizophrenia, affective disorder, and schizotypal disorder. Am J Psychiatry 1998, 155:509–515.

    PubMed  CAS  Google Scholar 

  22. Raine A, Sheard C, Reynolds GP, et al.: Pre-frontal structural and functional deficits associated with individual differences in schizotypal personality. Schizophr Res 1992, 7:237–247.

    Article  PubMed  CAS  Google Scholar 

  23. Siever LJ, Kalus OF, Keefe RS: The boundaries of schizophrenia. Psychiatry Clin North Am 1993, 16:217–244.

    CAS  Google Scholar 

  24. Shihabuddin LS, Buchsbaum MS, Siever LJ, et al.: Striatal F-Deoxyglucose-PET and MRI in schizotypal disorder. Annual Meeting of the American Psychiatric Association. Abstract NR718., May 15–20, 1999.

  25. Buchsbaum MS, Trestman RL, Hazlett E, et al.: Regional cerebral blood flow during the Wisconsin Card Sort Test in schizotypal personality disorder. Schizophr Res 1997, 27:21–28.

    Article  PubMed  CAS  Google Scholar 

  26. Davidson M, Davis KL: A comparison of plasma homovanillic acid concentrations in schizophrenics and normal controls. Arch Gen Psychiatry 1988, 45:561–563.

    PubMed  CAS  Google Scholar 

  27. Amin F, Siever LJ, Silverman JM, et al.: Plasma HVA in schizotypal personality disorder. In Plasma Homovanillic Acid Studies in Schizophrenia, Implications for Presynaptic Dopamine Dysfunction. Edited by Friedhoff AJ, Amin F. Washington DC: American Psychiatric Press Progress in Psychiatry Series; 1997:133–149.

  28. Goldberg SC, Schulz SC, Schulz PM, et al.: Borderline and schizotypal personality disorders treated with low-dose thiothixene versus placebo. Arch Gen Psychiatry 1986, 43:680–686.

    PubMed  CAS  Google Scholar 

  29. Hymowitz P, Frances A, Jacobsberg LB, et al.: Neuroleptic treatment of schizotypal personality disorder. Compr Psychiatry 1986, 27:267–271.

    Article  PubMed  CAS  Google Scholar 

  30. Szigethy EM, Schulz SC: Risperidone in comorbid borderline personality disorder and dysthymia. J Clin Psychopharmacol 1997, 17:326–327.

    Article  PubMed  CAS  Google Scholar 

  31. Siegel BV, Trestman RL, O’Flaithbheartaigh S, et al.: D-amphetamine challenge effects on Wisconsin card sort test. Performance in schizotypal personality disorder. Schizophr Res 1996, 20:29–32.

    Article  PubMed  Google Scholar 

  32. Kirrane RM, Mitropoulou V, Nunn M, et al.: Effects of amphetamine on visuospatial working memory in schizophrenia spectrum personality disorder. Neuropsychopharmacology. 2000, in press.

  33. Williams GV, Goldman-Rakic PS: Modulation of memory fields by dopamine D1 receptors in prefrontal cortex. Nature 1995, 376:572–575.

    Article  PubMed  CAS  Google Scholar 

  34. Lipska BK, Jaskiw GE, Weinberger DR: Postpubertal emergence of hyperresponsiveness to stress and to amphetamine after neonatal excitotoxic hippocampal damage: a potential animal model of schizophrenia. Neuropsychopharmacology 1993, 9:67–75.

    PubMed  CAS  Google Scholar 

  35. Suddath RL, Christison GW, Torrey FE, et al.: Anatomical abnormalities in the brains of monozygotic twins discordant for schizophrenia. New Engl J Med 1990, 322:789–794.

    Article  PubMed  CAS  Google Scholar 

  36. Pycock CJ, Kerwin RW, Carter CJ: Effect of lesion of cortical dopamine terminals on subcortical dopamine in rats. Nature 1980, 286:74–77.

    Article  PubMed  CAS  Google Scholar 

  37. Weinberger DR: Implications of normal brain development for the pathogenesis of schizophrenia. Arch Gen Psych 1987, 44:660–669.

    CAS  Google Scholar 

  38. Davis KL, Kahn RS, Ko G, Davidson M: Dopamine and schizophrenia: a reconceptualization. Am J Psychiatry 1991, 148:1474–1486.

    PubMed  CAS  Google Scholar 

  39. Abi-Dargham A, Gil R, Krystal J, et al.: Increased striatal dopamine transmission in schizophrenia; confirmation in a second cohort. Am J Psychiatry 1998, 155:761–767. This paper reports that patients with schiophrenia demonstrate increased dopamine release in the striatum compared with normal controls.

    PubMed  CAS  Google Scholar 

  40. Breier A, Su TP, Saunders R, et al.: Schizophrenia is associated with elevated amphetamine-induced synaptic dopamine concentrations: evidence from a novel positron emission tomography method. Proc Natl Acad Sci U S A 1997, 94:2569–2574.

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Rights and permissions

Reprints and permissions

About this article

Cite this article

Kirrane, R.M., Siever, L.J. New perspectives on schizotypal personality disorder. Curr Psychiatry Rep 2, 62–66 (2000). https://doi.org/10.1007/s11920-000-0044-0

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11920-000-0044-0

Keywords

Navigation