Schizotypal Disorder in Children-A Neglected Diagnosis

Disabling psychotic-like perceptions, thoughts, and behavior have long been recognized in children. These symptoms have an adverse impact on child and family and are a developmental predictor of Schizophrenia Spectrum Disorders (SSD). Attempts to classify this phenomenon separately and within the Diagnostic and Statistical Manual of Mental Disorders (DSM) and International Classification of Diseases (ICD) systems have been unsuccessful until the DSM-5 and ICD-11. The categorization of Schizotypal Disorder within the SSDs in DSM-5 and ICD-11, and recognition that it is manifest in childhood, has established Schizotypal Disorder in Childhood (SDC) as a focus for clinical attention and research. This article aims to increase the awareness of this debilitating disorder by describing 3 case studies (ages 6, 8, and 9), which illustrate and refine the clinical presentation and cognitive profile of SDC. Biopsychosocial risk factors, comorbid disorders, and features that differentiate it from Autism Spectrum Disorder (ASD) are discussed. A comprehensive understanding of SDC will improve the accuracy and validity of the diagnostic process and pave the way for further research into its etiology, developmental pathway, and treatment.