According to ICD-11, which feature most clearly distinguishes 'schizotypal disorder' (ICD-11 6A22) from schizophrenia and from personality disorder?

• A Presence of prominent auditory hallucinations and thought broadcasting
• B Persistent negative symptoms in the absence of any positive symptoms
• C Eccentric behaviour, odd speech, magical thinking without meeting full schizophrenia criteria, classified as a psychotic spectrum disorder ✓
• D Brief psychotic episodes lasting less than 1 month triggered by stress

Explanation

ICD-11 places schizotypal disorder (6A22) within the schizophrenia spectrum and other primary psychotic disorders, unlike DSM-5 which lists schizotypal personality disorder under personality disorders. It is characterised by odd behaviour, eccentric speech, magical thinking, unusual perceptual experiences, and social anxiety, but without sustained psychotic symptoms meeting schizophrenia criteria. This categorical placement has implications for treatment (antipsychotics may be considered) and conceptualisation of the schizophrenia spectrum.

Reference: Kaplan & Sadock's Synopsis of Psychiatry, 11th ed.

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