Differentiating Behavioral Disorders

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Differentiating Behavioral Disorders

By CareerSmart Learning Contributor, September 25, 2016, as published by Healthcare Hot Spot

Schizophrenia is a mental disorder that is characterized by a disconnection from reality, typically resulting in a combination of delusions, hallucinations, disorganized thought processes, and bizarre or eccentric behaviors. It can manifest in different ways for different people, such as schizophrenia with or without paranoia, but the consistent trait of schizophrenia is difficulty differentiating between “what is real and not real” (MedlinePlus, 2016). Symptoms of schizophrenia typically include an inability to think clearly, behave normally in social circumstances, and have normal emotional reactions (MedlinePlus, 2016). 

There are, however, several other mental health disorders that present similar to schizophrenia but are very different from one another. Three of these include a) schizoaffective disorder, b) schizotypal personality disorder, and c) schizoid personality disorder. Although these three disorders share a common prefix, they are more different than they sound. 

Schizoaffective disorder is characterized by two different conditions: symptoms of schizophrenia, like hallucinations or paranoia, with the addition of a mood disorder, like depression (depressive schizoaffective disorder) or bipolar disorder (bipolar schizoaffective disorder). A person with schizoaffective disorder may also present with feelings of worthlessness, thoughts of suicide, loss of appetite, and weight loss. Since schizoaffective disorder presents as a combination of two mental health disorders, it is very challenging to diagnose and therefore not clearly defined or understood. Treatment can vary greatly depending on each person’s schizophrenia symptoms and the severity and type of mood disorder (Mayo Clinic Staff, 2014).

Personality disorders (PD) are categorized into three groups called “clusters.”  Cluster A represents personality disorders that exhibit “odd or eccentric behaviors” (Esterberg, Goulding, & Walker, 2010). Schizotypal PD and schizoid PD are both categorized under cluster A. In addition to exhibiting odd or eccentric behavior, people with both schizotypal PD and schizoid PD find it difficult to socially connect with people and lack emotional expression. Unlike schizophrenia, people with schizotypal PD and schizoid PD are connected to reality (MedlinePlus, 2014).

Approximately 3-4% of the general population has schizotypal PD. They will typically exhibit strongly held, odd beliefs (such as the belief of aliens) or fears (such as being monitored by the government) that make it difficult to form lasting relationships with people. In addition to having odd beliefs, those with schizotypal PD will present with paranoia and “odd thinking and speech,” this includes being vague or tangential (Esterberg et al., 2010). Schizotypal PD in adolescents is also considered a risk factor for developing schizophrenia later in adulthood. Nearly 30% of adolescents with schizotypal PD are later diagnosed with a psychosis, including schizophrenia. It is unclear whether schizotypal PD develops into schizophrenia or if the early symptoms of schizophrenia are being misdiagnosed as schizotypal PD (Esterberg et al., 2010). 

Schizoid PD affects approximately 1% of the population and presents very differently from schizotypal PD. While people with schizotypal PD find it difficult to form relationships out of paranoid fears, people with schizoid PD simply do not want or enjoy close relationships. Although it can be difficult to follow the odd thoughts and speech of someone with schizotypal PD, a person with schizoid PD can communicate in a more comprehensible manner, but their intonation and gestures are generally abnormal (Mayo Clinic Staff, 2016).

While schizotypal PD and schizoid PD are very different, both personality disorders share many characteristics with the autistic-spectrum disorders and, in particular, Asperger’s disorder. These similarities can be seen in eccentric behaviors, social difficulties, and lack of emotional functioning (Esterberg et al., 2010). However, Asperger’s disorder does not present with disordered thought processes, paranoia, and odd beliefs like schizotypal PD. 

Learning more about mental health disorders can help destigmatize these issues. Mental health issues do not simply affect a small group of the people – they affect everyone in different ways at different times. For some people, it’s a situational crisis, like severe anxiety due to a stressful month at work and home. Other people may experience chronic depression. Approximately 5.5% of the population have schizophrenia, schizoaffective disorder, schizotypal PD, or schizoid PD. Understanding schizophrenia and the differences between schizoaffective disorder, schizotypal PD, and schizoid PD can increase the likelihood that someone with one of these disorders is getting the appropriate help they need.

Esterberg, M.L., Goulding, S.M., & Walker, E.F. (2010).  A Personality Disorders: Schizotypal, Schizoid and Paranoid Personality Disorders in Childhood and Adolescence.  Journal of Psychopathological and Behavioral Assessment, 32 (4), 515-528.

Mayo Clinic Staff (2016).  Schizoid personality disorder.  Mayo Clinic.  Retrieved from http://www.mayoclinic.org/diseases-conditions/schizoid-personality-disorder/home/ovc-20214901

MedlinePlus (2016).  Schizophrenia.  Retrieved from https://medlineplus.gov/ency/article/000928.htm

MedlinePlus (2014).  Schizotypal personality disorder.  Retrieved from https://medlineplus.gov/ency/article/001525.htm