Abstract
This paper supports the argument that schizophrenia is an extreme form of schizotypy. This argument bases its structures on research studies, which demonstrate the genetic link between both disorders and the medical evidence showing schizophrenia as an extreme form of schizotypy. The use of Meehl’s model to expose extreme forms of schizotypy as a manifestation of schizophrenia also informs the findings of this paper. This evidence (coupled with the fact that schizotypy is a continuum of mental disorders) demonstrate that schizophrenia is an extreme form of schizotypy. Comprehensively, the redefinition of schizophrenia as an extreme form of schizotypy signifies a strong impact on the classification of mental disorders.
Introduction
Clinically, it is often difficult to distinguish schizophrenia from schizotypy. However, Hoermann (2009) explains that both concepts are unrelated because schizophrenic patients exhibit severe symptoms of mental disorder while patients suffering from schizotypy experience mild forms of mental disorder. Schizophrenia is a mental disorder, which is often characterised by a strange perception of reality. Perhaps the most feared outcome for patients who have this disease is their high probability of committing suicide.
Recent estimates show that about a third of patients suffering from schizophrenia are suicidal (Hoermann, 2009). These statistics also show that most of these patients commit suicide within the first 20 years of diagnosis (Hoermann, 2009). The ambiguity in distinguishing schizophrenia from schizotypy partly contributes to this high suicide rate because some schizophrenic patients get the wrong diagnosis (a wrong diagnosis contributes to worsened mental states, which later contribute to high suicide rates).
It is, therefore, crucial to distinguish schizophrenia from schizotypy because they share similar symptoms. For example, if a patient suffers from schizotypy and gets the correct treatment plan, they may reduce the probability of developing schizophrenia. This way, the relationship between schizophrenia and schizotypy is established and severe outcomes of mental disorder (such as suicide) reduce. However, understanding the relationship between schizophrenia and schizotypy depends on understanding both mental disorders.
Schizotypy refers to a continuum of psychological states, which range from mild forms of normal dissociative behaviours to extreme forms of imagination and illusion (Mental Health Centre, 2012, p. 1). Patients who suffer from schizotypy show odd and peculiar behaviours, which characterise their personality throughout their illness. They are also more socially isolated than ordinary people are. The Mental Health Centre (2012) adds that it is also unsurprising to see patients who suffer from schizotypy harbouring odd beliefs and superstitions.
From the above definitions (of schizophrenia and schizotypy), many debates that have questioned the relationship between the two terms have arisen. Broadly, both disorders pose similar symptoms but this paper suggests that schizophrenia is simply an extreme form of schizotypy. This classification has a significant influence on the general classification of mental disorders.
Similarities between Schizophrenia and Schizotypy
The similarities between schizophrenia and schizotypy show that the two personality disorders share many characteristics. In fact, Stirling and McCoy (2012) mention that schizotypy is similar to schizophrenia because patients who suffer from both disorders perceive reality in a way that is extremely difficult for other people to understand. For example, the emotionless nature and social isolation of schizophrenic patients occur among schizophrenic and schizotypy patients (Birchwood, 2001). Nonetheless, the similarities between schizophrenia and schizotypy do not show (exclusively) that one disorder is an extreme form of the other. However, since patients with schizophrenia exhibit severe symptoms of schizotypy, this paper reinforces the fact that schizophrenia is an extreme form of schizotypy.
Genetic Relations
Emil Cocarro and Larry Siever have done several family-centred studies to investigate the relationship between schizophrenia and schizotypy. They discovered that patients suffering from schizotypy have a high likelihood of suffering from schizophrenia (or a family member suffering the same disorder) (Woods, 2011).
From this observation, there has been a clear genetic relationship between the two disorders. Albeit both disorders are genetically similar, their closeness does not provide enough evidence to show that schizophrenia is an extreme form of schizotypy; however, because mental disorders are often hereditary (and manifest in different degrees), it is correct to say that schizophrenia is commonly witnessed among patients with schizotypy (because schizophrenia falls under the continuum of schizotypy disorders). Woods (2011) explains that
“There is some indication that there is a strong genetic relationship between the two disorders since some of the symptoms and abnormal patterns in brain chemistry, brain structure, and brain functioning found in people with schizophrenia can also be found in people with Schizotypal Personality Disorder” (p. 3).
Albeit this paper demonstrates the genetic relation between schizophrenia and schizotypy as a manifestation that schizophrenia is an extreme form of schizotypy, Woods (2011) explains that this definition is reversible. In other words, Woods (2011) explains that schizotypy can be a mild form of schizophrenia. Referring to this observation, Woods (2011) explains that
“Some experts argue that schizotypal personality disorder might be a mild form of schizophrenia, whereas other researchers suggest that there is evidence that schizotypal personality disorder shares some characteristics with schizophrenia and that there are similar deficits in certain areas” (p. 5).
From the reliance on scientific evidence (showing that schizotypy is a mild form of schizophrenia), correctly, the opposite is also true because schizophrenia is an extreme form of schizotypy (Lauriello and Pallanti, 2012).
Nature of Schizotypy
The nature of schizotypy demonstrates that the illness is a continuum of personality disorders, which represent varying degrees of mental conditions. This characteristic shows that varying degrees of mental disorders fit the scope of schizotypy. Indeed, this paper has already shown that schizotypy refers to a continuum of personality characteristics, which range from “normal dissociative, imaginative states to more extreme states related to psychosis and in particular, schizophrenia” (Lauriello and Pallanti, 2012, p. 5).
These varying characteristics of mental disorders show that schizophrenia fits in an extreme category of schizotypy (because if schizotypy were not a continuum of personality disorders, it would be difficult to categorise schizophrenia as part of schizotypy). The nature of schizotypy as a dynamic mental disorder, therefore, promotes the view that schizophrenia is an antecedent of schizotypy (Kuo-Ming, 2009).
Meehl’s Model
Meehl’s model demonstrates that schizophrenia is an extreme form of schizotypy. Meehl’s model traces its roots to the early sixties when there was an ongoing inquest into the genetics of schizophrenia (Lenzenweger, 2006). Meeh’ls model traces its name from a well-known psychologist – Meehl. To “emphasise a genetically influenced aberration in the neural transmission that could lead to clinical schizophrenia, nonpsychotic schizotypic states, or apparent normalcy depending on the coexistence of other factors” (Lenzenweger, 2010, p. 163), Meehl’s model was revised. Within Meehls’ model, schizophrenia explains a blown-up version of schizotypy. This assertion reinforces the fact that schizophrenia is an extreme form of schizotypy.
However, according to Meehl’s model, not all forms of Schizotypy develop into schizophrenia (Lenzenweger, 2006). The model also warns that not all forms of schizophrenia are diluted versions of schizophrenia. Nonetheless, the specific types of schizotypy, which develop into schizophrenia, remain unclear because there is insufficient empirical evidence to predict this outcome. So far, there is enough evidence to show that schizotypy can develop into schizophrenia but the factors leading to this outcome are open for debate.
For example, some researchers advance the view that schizophrenia is different from schizotypy. These researchers base their evidence from the presence of psychotic behaviour among schizophrenic patients and not patients suffering from schizotypy. For example, Woods (2011) explains that patients suffering from schizophrenia have frequent and intense psychotic behaviours, which make them lose touch with reality. Woods (2011) further demonstrates the absence of psychotic signs among patients suffering from schizotypy as a difference between schizophrenia and schizotypy mental disorders. Instead, schizotypal patients are in touch with reality and can comprehend what goes on around them.
In fact, patients suffering from schizotypy understand the difference between reality and imaginary thoughts. From the above observations, some researchers believe that schizophrenia and schizotypy are different. The evidence used to prove the differences between the two conditions are reliable because valid medical research informs these findings. However, researchers who do not perceive schizophrenia and schizotypy to be different fail to conceptualise the bigger picture informing the definition of the two mental disorders. They fail to present schizotypy as a continuum of symptoms, which manifest different stages of mental disorders. From this understanding, their presentation of schizophrenia and schizotypy is shallow. To this extent, there is a reinforced view that schizophrenia is an extreme form of schizotypy.
Implications for the Classification of Mental Disorders
Scholars accredit Kraepelin (a well-known psychologist) to the process of classifying mental disorders. Kraepelin claimed that mental disorders shared different groups because they bore unique characteristics that were only exclusive to their group (Guha, 2005). This form of classification is unique for many other types of clinical classifications.
To classify mental disorders, Kraepelin based his analysis on the symptoms, course, and outcomes of mental illnesses. Kraepelin’s classification of mental illnesses fell into two groups: dementia praecox (schizophrenia) and manic-depressive psychosis (Guha, 2005). This classification was widely used to develop the now famously known Diagnostic statistical manual of mental disorders (DSM) (Guha, 2005).
This paper shows that schizophrenia (a major classification of Kraepelin’s mental disorders) manifests as an extreme form of schizotypy because schizophrenia is an extreme form of schizotypy. This analysis has a significant implication on the perception of schizophrenia as a wider classification of mental disorders because schizotypy now emerges as an umbrella continuum of mental disorders (that defines even severe mental disorders such as schizophrenia) (Hillman, 1998).
This redefinition of mental orders has a subsequent impact on the development of the DSM classification. Apart from the reclassification of DSM technique, the International Classification of Diseases (ICD) similarly reclassifies because (under the F2) classification; schizophrenia, delusional disorders and schizotypy are categorised under one group (Hillman, 1998). Since this paper proposes that schizophrenia is an extreme form of schizotypy, it will be untenable to present schizophrenia and schizotypy as equals under the same (F2) classification. Comprehensively, after considering the findings of this paper, a reclassification of schizophrenia and schizotypy is unavoidable. The reclassification would imply that schizophrenia is reclassified under a subgroup of schizotypal disorders (under the F2 classification of ICD). This reclassification would also imply that chapter five of the ICD, which relates to mental disorders, is revised again (Hillman, 1998).
Conclusion
Schizophrenia and Schizotypy share many similarities in their diagnosis. The difficulties in distinguishing the two disorders highlight the similarities (in the definition) that the two concepts share as well. This paper demonstrates that schizophrenia is an extreme form of schizotypy because the latter disorder is a continuum of mental disorders. Schizophrenia, therefore, represents an extreme form of schizotypy. Indeed, previous medical researches show that extreme forms of schizotypy manifest in schizophrenia. Furthermore, Meehl’s model shows that schizotypy can easily develop into schizophrenia. However, the same model shows that schizophrenia does not necessarily amount to schizotypy. Therefore, there should be a careful understanding that both disorders are not synonymous to one another.
Recent research is done on patients who have schizotypy and schizophrenia demonstrated that the two disorders commonly occur in patients who share similar genes. In other words, patients who have schizotypy suffer a high risk of developing schizophrenia. The genetic links between patients who share the two disorders, therefore, show that both disorders have a close relation in occurrence.
This outcome reinforces the fact that schizophrenia is an extreme manifestation of schizotypy. From this understanding, this paper shows that the redefinition of schizophrenia as an extreme form of schizotypy has a significant implication on the classification of mental disorders. Here, the implication of schizophrenia as an extreme form of schizotypy shows that schizotypy occurs as a broader classification of mental disorders. Schizophrenia, therefore, falls under it. Comprehensively, after weighing the findings of this paper, correctly, schizophrenia is simply an extreme form of schizotypy.
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