Psychotherapy for patients with schizotypal personality disorder: A scoping review

Abstract

BackgroundTreatment of schizotypal personality disorder is complex. Currently, there are no clear evidence‐based recommendations for use of psychotherapy for individuals suffering from this mental illness, and studies are sparse. Our aim in this review is to map and describe the existing research and to answer the research question: What do we know about the use of psychotherapy for people with schizotypal personality disorder?MethodsWe conducted a scoping review using systematic searches in the Embase, MEDLINE and PsycINFO databases. Two reviewers screened possible studies and extracted data on subject samples, type of psychotherapy, outcomes and suggested mechanisms of change. The review is based on the PRISMA checklist for scoping reviews.ResultsTwenty‐three papers were included, and we found a wide variety of study types, psychotherapeutic orientations and outcomes. Few studies emerged that focused solely on schizotypal personality disorder.ConclusionPsychotherapy as a treatment for schizotypal personality disorder is understudied compared with diagnoses such as schizophrenia and borderline personality disorder. Our results included two randomized controlled studies, as well as mainly smaller studies with different approaches to diagnostic criteria, psychotherapeutic orientation and outcome measures. The findings are too sparse and too diverse to make any evidence‐based recommendations. We found some indications that psychotherapy may support and assist individuals with schizotypal personality disorder.

Time to put aside the false dichotomy between personality disorders and psychotic symptoms

“…The Orygen Institute's program in Australia, which is dedicated to teenagers and young adults with first-episode psychosis with cooccurring disorders, would be a good example of such integrated initiatives. The evidence base pertaining to Cluster A PDs and treatment is extremely limited (for both pharmacology and psychotherapy), preventing any definitive recommendations (Kirchner et al, 2018;Nielsen et al, 2023); nonetheless, more research would help identifying if treatment might reduce the conversion rate to schizophrenia (Hjorthøj et al, 2018;Nielsen et al, 2023). More precise recommendations for handling schizotypal PD in practice might be available following the publication of an upcoming systematic review (Gundersen et al, 2023).…”

Recent advances in research on personality disorders

“…The following articles in this Special Issue are focused on evidence‐based psychotherapy on patients with personality disorders. In the first study (Nielsen et al, 2023), a scoping review was conducted to identify relevant existing psychotherapy research with patients with schizotypal personality disorder. Unfortunately, very few relevant studies have been conducted with this group of patients and results are inconclusive.…”