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Schizotypal personality disorder and suicide: problems and perspectives

Published online by Cambridge University Press:  08 July 2021

Leo Sher Open the ORCID record for Leo Sher [Opens in a new window]
Leo Sher*
Affiliation:
James J. Peters VA Medical Center, Bronx, NY, USA Icahn School of Medicine at Mount Sinai, New York, NY, USA
*
Author for correspondence: Leo Sher, Email: [email protected]
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Abstract

Schizotypal personality disorder (SPD) is classified in DSM-V as a cluster A personality disorder. Cluster A personality disorders are described as odd or eccentric conditions. SPD is associated with significant disability and many psychiatric comorbidities. Several studies have shown that SPD and schizotypal traits are associated with suicidal ideation and behaviour. Suicide prevention interventions in individuals with SPD are impeded because (1) SPD is frequently not diagnosed; (2) SPD is difficult to treat; and (3) there are no guidelines for suicide screening or suicide prevention interventions in individuals with SPD. Suicide prevention in persons with SPD consists of (1) diagnosing SPD; (2) providing appropriate treatment for SPD; and (3) providing suicide screening and suicide prevention. Interventions aiming at reduction of depressive symptoms, improvement of self-esteem, and interpersonal skills may be effective at reducing suicide risk amongst individuals with SPD. Studies of suicidality in persons with SPD are needed and may be an important area of suicide research. It is to be hoped that future studies of the pathophysiology of suicidality in individuals with SPD will help to develop strategies for suicide screening and suicide prevention interventions in persons with SPD and improve suicide prevention in this challenging patient population.

Keywords

schizotypal personality disorderschizotypal traitssuicidedepression
Type
Perspective
Information
Acta Neuropsychiatrica , Volume 33 , Issue 5 , October 2021 , pp. 280 - 282
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Copyright
© The Author(s), 2021. Published by Cambridge University Press on behalf of Scandinavian College of Neuropsychopharmacology

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References

American Psychiatric Association (2013) Diagnostic and Statistical Manual of Mental Disorders, 5th Edn. doi: 10.1176/appi.books.9780890425596 Google Scholar
Berenbaum, H, Valera, EM and Kerns, JG (2003) Psychological trauma and schizotypal symptoms. Schizophrenia Bulletin 29(1), 143–152. doi: 10.1093/oxfordjournals.schbul.a006985 CrossRefGoogle ScholarPubMed
Braquehais, MD, Oquendo, MA, Baca-García, E and Sher, L (2010) Is impulsivity a link between childhood abuse and suicide? Comprehensive Psychiatry 51(2), 121–129. doi: 10.1016/j.comppsych.2009.05.003 CrossRefGoogle ScholarPubMed
Caqueo-Urízar, A, Rus-Calafell, M, Craig, TK, Irarrazaval, M, Urzúa, A, Boyer, L and Williams, DR (2017) Schizophrenia: impact on family dynamics. Current Psychiatry Reports 19(1), 2. doi: 10.1007/s11920-017-0756-z CrossRefGoogle ScholarPubMed
Fung, AL and Raine, A (2012) Peer victimization as a risk factor for schizotypal personality in childhood and adolescence. Journal of Personality Disorders 26, 428–434.CrossRefGoogle ScholarPubMed
Gong, J, He, Y, Wang, S and Liu, J (2020) Emotion regulation and depressive symptoms mediate the association between schizotypal personality traits and suicidality in Chinese college students. Archives of Suicide Research 1–12. doi: 10.1080/13811118.2020.1818655 CrossRefGoogle ScholarPubMed
Jahn, DR, DeVylder, JE and Hilimire, MR (2016) Explanatory risk factors in the relations between schizotypy and indicators of suicide risk. Psychiatry Research 238, 68–73. doi: 10.1016/j.psychres.2016.02.021.CrossRefGoogle ScholarPubMed
Joiner, TE, Gencoz, F, Gencoz, T, Metalsky, GI and Rudd, MD (2001) The relation of self-hatred and suicidality in people with schizophrenia-spectrum symptoms. Journal of Psychopathology and Behavioral Assessment 23,107–115.CrossRefGoogle Scholar
Kirchner, SK, Roeh, A, Nolden, J and Hasan, A (2018) Diagnosis and treatment of schizotypal personality disorder: evidence from a systematic review. NPJ Schizophrenia 4(1), 20. doi: 10.1038/s41537-018-0062-8 CrossRefGoogle ScholarPubMed
Koenigsberg, HW, Reynolds, D, Goodman, M, New, AS, Mitropoulou, V, Trestman, RL, Silverman, J and Siever, LJ (2003) Risperidone in the treatment of schizotypal personality disorder. Journal of Clinical Psychiatry 64(6), 628–634. doi: 10.4088/jcp.v64n0602.CrossRefGoogle ScholarPubMed
Layman, DM, Kammer, J, Leckman-Westin, E, Hogan, M, Goldstein Grumet, J, Labouliere, CD, Stanley, B, Carruthers, J and Finnerty, M (2021) The relationship between suicidal behaviors and zero suicide organizational best practices in outpatient mental health clinics. Psychiatric Services appips202000525. doi: 10.1176/appi.ps.202000525. Epub ahead of print.Google ScholarPubMed
Lentz, V, Robinson, J and Bolton, JM (2010) Childhood adversity, mental disorder comorbidity, and suicidal behavior in schizotypal personality disorder. Journal of Nervous and Mental Disease 198(11), 795–801. doi: 10.1097/NMD.0b013e3181f9804c.CrossRefGoogle ScholarPubMed
Millon, T, Millon, CM, Meagher, SE, Grossman, SD and Ramnath, R (2004) Personality Disorders in Modern Life, 2nd Edn. Wiley, Hoboken, NJ, 624 p.Google Scholar
Nazario, B (2020) Schizotypal personality disorder. Available at https://www.webmd.com/mental-health/schizotypal-personality-disorder (accessed 15 April 2021).Google Scholar
O’Hare, KJM, Poulton, R and Linscott, RJ (2021) Psychotic experiences and schizotypy in early adolescence predict subsequent suicidal ideation trajectories and suicide attempt outcomes from age 18 to 38 Years. Schizophrenia Bulletin 47(2), 456–464. doi: 10.1093/schbul/sbaa151.CrossRefGoogle Scholar
Pulay, AJ, Stinson, FS, Dawson, DA, Goldstein, RB, Chou, SP, Huang, B, Saha, TD, Smith, SM, Pickering, RP, Ruan, WJ, Hasin, DS and Grant, BF (2009) Prevalence, correlates, disability, and comorbidity of DSM-IV schizotypal personality disorder: results from the wave 2 national epidemiologic survey on alcohol and related conditions. Primary Care Companion to the Journal of Clinical Psychiatry 11(2), 53–67. doi: 10.4088/pcc.08m00679.CrossRefGoogle ScholarPubMed
Rosell, DR, Futterman, SE, McMaster, A, Siever, LJ (2014) Schizotypalpersonality disorder: A current review. Current Psychiatry Reports 16(7), 452. doi: 10.1007/s11920-014-0452-1.CrossRefGoogle ScholarPubMed
Serafini, G, Canepa, G, Adavastro, G, Nebbia, J, Belvederi Murri, M, Erbuto, D, Pocai, B, Fiorillo, A, Pompili, M, Flouri, E and Amore, M (2017) The relationship between childhood maltreatment and non-suicidal self-injury: A systematic review. Frontiers in Psychiatry 8, 149.CrossRefGoogle ScholarPubMed
Sher, L and Kahn, RS (2019) Family interventions and prevention of suicide in first-episode schizophrenia. Acta Psychiatrica Scandinavica 139(5), 484. doi: 10.1111/acps.13018.CrossRefGoogle ScholarPubMed
Stone, M (1985) Schizotypal personality: psychotherapeutic aspects. Schizophrenia Bulletin 11, 576–589.CrossRefGoogle ScholarPubMed
Teraishi, T, Hori, H, Sasayama, D, Matsuo, J, Ogawa, S, Ishida, I, Nagashima, A, Kinoshita, Y, Ota, M, Hattori, K and Kunugi, H (2014) Relationship between lifetime suicide attempts and schizotypal traits in patients with schizophrenia. PLoS One 9(9), e107739. doi: 10.1371/journal.pone.0107739.CrossRefGoogle ScholarPubMed
Torgersen, S, Kringlen, E and Cramer, V (2001) The prevalence of personality disorders in a community sample. Archives of General Psychiatry 58(6), 590–596. doi: 10.1001/archpsyc.58.6.590.CrossRefGoogle Scholar
Widiger, TA, Frances, A and Trull, TJ (1987) A psychometric analysis of the social-interpersonal and cognitive-perceptual items for the schizotypal personality disorder. Archives of General Psychiatry 44(8), 741–745. doi: 10.1001/archpsyc.1987.01800200069010.CrossRefGoogle ScholarPubMed