TY - CHAP

T1 - Clinical Staging of Schizotypal Disorder

T2 - Preliminary Considerations and Treatment Implications

AU - Gundersen, Kristina Ballestad

AU - Polari, Andrea

AU - Glenthøj, Louise Birkedal

AU - Albert, Nikolai

AU - McGorry, Patrick D

AU - Rasmussen, Andreas Rosén

AU - Nelson, Barnaby

PY - 2023

Y1 - 2023

N2 - Schizotypy has been approached in various ways – as a dimension of personality, a personality disorder, and as a disorder within the schizophrenia spectrum. Many conditions, both in general medicine and in psychiatry, are now defined according to clinical stages. However, the clinical staging approach has not yet been applied to schizotypy. In this chapter, we consider schizotypy from a clinical staging perspective and the implications of this perspective for treatment. In order to guide this discussion, we provide a systematic overview of the literature on treatments of schizotypal disorder. There is some evidence that metacognitive therapy may reduce the global severity of symptoms and improve metacognition, cognitive behavioral therapy may improve interpersonal skills, obsessive-compulsive and social anxiety symptoms, and integration treatment may reduce the risk of progression to frank psychosis. Antipsychotic medication has some effect on improving clinical symptoms and functioning. Other pharmacotherapies may have benefits for neurocognitive functioning. There is an indication, however, that there may be significant side effects associated with antipsychotics. There is a paucity of research that informs a clinical staging perspective on schizotypy. The increased focus in recent decades on reducing the transition to frank psychosis in the clinical high risk for psychosis population may have inadvertently diverted attention from the identification of schizotypy and mapping its clinical trajectories, and may have reduced interest in evaluating specific therapies for this population. Further long-term longitudinal studies, ideally from childhood and adolescence, are required to map possible stages of schizotypal disorder and to test treatments according to stage of disorder evolution.

AB - Schizotypy has been approached in various ways – as a dimension of personality, a personality disorder, and as a disorder within the schizophrenia spectrum. Many conditions, both in general medicine and in psychiatry, are now defined according to clinical stages. However, the clinical staging approach has not yet been applied to schizotypy. In this chapter, we consider schizotypy from a clinical staging perspective and the implications of this perspective for treatment. In order to guide this discussion, we provide a systematic overview of the literature on treatments of schizotypal disorder. There is some evidence that metacognitive therapy may reduce the global severity of symptoms and improve metacognition, cognitive behavioral therapy may improve interpersonal skills, obsessive-compulsive and social anxiety symptoms, and integration treatment may reduce the risk of progression to frank psychosis. Antipsychotic medication has some effect on improving clinical symptoms and functioning. Other pharmacotherapies may have benefits for neurocognitive functioning. There is an indication, however, that there may be significant side effects associated with antipsychotics. There is a paucity of research that informs a clinical staging perspective on schizotypy. The increased focus in recent decades on reducing the transition to frank psychosis in the clinical high risk for psychosis population may have inadvertently diverted attention from the identification of schizotypy and mapping its clinical trajectories, and may have reduced interest in evaluating specific therapies for this population. Further long-term longitudinal studies, ideally from childhood and adolescence, are required to map possible stages of schizotypal disorder and to test treatments according to stage of disorder evolution.

U2 - 10.1007/978-3-031-41788-7_20

DO - 10.1007/978-3-031-41788-7_20

M3 - Book chapter

SN - 978-3-031-41787-0

SN - 978-3-031-41790-0

SP - 315

EP - 330

BT - A Dimensional Approach to Schizotypy

PB - Springer

ER -