532 CHAPTER 12
part of a psychotic disorder. The person who had the
disorder at the outset is referred to as the primary
person and is usually diagnosed with schizophrenia
or delusional disorder. The individual diagnosed
with shared psychotic disorder comes to adopt the
delusions of his or her close friend or family mem-
ber. The delusions of the primary person may be
shared by more than one other person, as can oc-
cur in families when the primary person is a parent.
When the primary person’s delusions subside, the
other person’s shared delusions may or may not sub-
side as well.
For example, in one case of shared psychotic dis-
order, the primary person was a young woman with
hallucinations and delusions; she was later diagnosed
with schizophrenia. She believed that God was send-
ing messages to her. She lived with her two older sisters and convinced them that
God was talking to her and that they should join her in taking over a nearby house
because God wished it. Her sisters came to share the delusions; they attempted to
burglarize the house but were arrested. When the older sisters were separated from
their ill sister, their delusions abated (Joshi, Frierson, & Gunter, 2006).Schizotypal Personality Disorder
Eccentric behaviors and diffi culty with relationships are the hallmarks of schizotypal
personality disorder, to be discussed in more detail with the other personality dis-
orders in Chapter 13. Although schizotypal personality disorder is not technically a
psychotic disorder, we mention it here because some research suggests that it may in
fact be a milder form of schizophrenia (Dickey, McCarley, & Shenton, 2002). With
this personality disorder, problems in relationships may become evident in early
adulthood, marked by discomfort when relating to others as well as by being stiff
or inappropriate in relationships. However, before you start to become concerned
for yourself or someone you know, keep in mind that relationship diffi culties are
not enough for a diagnosis of schizotypal personality disorder; eccentric behavior,
such as having unusual mannerisms or diffi culty following social conventions, must
also be present. For example, people with schizotypal personality disorder may not
make eye contact and may look to one side of a person’s face when they speak to
him or her (and, to complicate things a bit, to be considered a symptom of schizo-
typal personality disorder, such behavior should not be due to social anxiety disor-
der). A person with schizotypal personality disorder may have very few if any close
friends, may feel that he or she doesn’t fi t in, and may experience social anxiety.
Schizotypal personality disorder, unlike schizophrenia, does not involve psychotic
symptoms. Table 12.3 summarizes the features of the psychotic disorders.
Figure 12.2 shows a decision tree for diagnosing psychotic disorders.Schizophrenia Facts in Detail
In this section we will discuss additional facts about schizophrenia—how common
it is, the disorders that are most frequently comorbid with it, gender and cultural
factors related to the disorder, and the prognosis for patients with the disorder.Prevalence
The world over—from China or Finland to the United States or New Guinea—
approximately 1% of the population will develop schizophrenia at some point in
their lives (Gottesman, 1991; Perälä et al., 2007).
Schizophrenia is one of the top fi ve causes of disability among adults in devel-
oped nations, ranking with heart disease, arthritis, drug use, and HIV (Murray &
Lopez, 1996). In the United States, about 5% of people with schizophrenia (aboutSalt Lake County Sheriff ’s Department/Getty Images Salt Lake County Sheriff ’s Department/Getty ImagesWanda Barzee and her husband, Brian David
Mitchell, kidnapped 14-year-old Elizabeth Smart
in 2002. Mitchell believed he was God, and Barzee
apparently came to share his belief. Although
diagnosing Barzee was diffi cult, some doctors
who examined her believed that she had shared
psychotic disorder.